OPEN LETTER TO THE SECRETARY TO THE GOVERNMENT OF THE FEDERATION
Senator Anyim Pius Anyim
Secretary to the Government of the Federation
Shehu Shagari Complex
Three Arms Zone
FACING THE CHALLENGES IN THE HEALTH SECTOR.
RESOLUTIONS OF THE NIGERIAN MEDICAL ASSOCIATION (NMA) NATIONAL OFFICERSâ€™ COMMITTEE (NOC) MEETING HELD ON THE 10TH OF JUNE, 2014 AT THE NATIONAL SECRETARIAT AND SUBMITTED TO THE OFFICE OF THE SECRETARY OF THE GOVERNMENT OF THE FEDERATION WEDNESDAY 11TH JUNE 2014.
1. The post of Deputy Chairman Medical Advisory Committee (DCMAC) has been circularized and operational. Rather than abolish it, the NMA hereby demands that four (4) DCMACs for teaching hospitals and three (3) for the Federal Medical Centres be appointed forthwith to assist the CMACs whose statutory responsibilities are too heavy for any single individual to handle. Directors in other government agencies are supported by several Deputy Directors, why not the CMAC who is also a Director? Such a DCMAC must have same qualifications as the CMAC.
2. The NMA is opposed to the appointment of Directors in the Hospitals. This Position distorts the chain of command in the hospital, induces anarchy and exposes the patient to conflicting treatment and management directives with attendant negative consequences.
3. The NMA demands that grade level 12 (CONMESS 2) in the health sector MUST be SKIPPED for medical doctors. Consequently no medical/dental practitioners should be on that grade level anymore.
4. The title â€œCONSULTANTâ€ in a hospital setting describes the relationship between the Specialist Medical Doctor and his patient. It will be a source of confusion if the title is applied to any other health worker who statutorily does not own patient. NMA therefore declares with unmitigated emphasis that if â€œnon-doctor consultantsâ€ are appointed, it will lead to chaos and anarchy in the health sector. This should not happen.
5. Relativity in health sector is sacrosanct. The NMA hereby demands for immediate implementation of the January 3rd, 2014 circular. The NMA also demands the immediate payment of the arrears of the corrected relativity for 22 years during which her members were short changed.
Much as we are not against salary increase for any category of workers, either in health or elsewhere, the NMA demands for immediate adjustment of the doctorsâ€™ salary to maintain the relativity as agreed and documented once CONHESS is adjusted.
6. That Government should expedite the passage of the National Health Bill (NHB), and extend Universal Health Coverage to cover 100% of Nigerians and not 30% as currently prescribed by National Health Insurance Scheme (NHIS).
7. Surgeon General of the Federation MUST be appointed with immediate effect.
8. The entry point of the House Officer should be corrected to CONMESS 1 step 4 as originally contained in MSS/MSSS while the Registrar/Medical Officer is moved to CONMESS 3 step 3.
9. Clinical duty allowance for Honorary Consultants should be increased by 90% of CONMESS
10. Adjust the specialist allowance as contained in the 2009 collective bargaining agreement. Additionally, ALL doctors on CONMESS 3 and above MUST be paid specialist allowance or its equivalent that is not less than 50% higher than what is paid to other health workers.
11. Hazard allowance MUST be at least N100, 000 per month for Medical Doctors.
12. Immediate release of the circular on rural posting, teaching and other allowances which MUST include house officers.
13. Immediate withdrawal of the CBN circular authorizing the Medical Laboratory Science Council of Nigeria (MLSCN) to approve licenses for the importation of In-Vitro Diagnostics (IVDs).
14. Immediate Release of Circular on retirement age for Medical Doctors as agreed with the Federal Government (FG)
15. The Federal Government through the Federal Ministry of Health should formalise and implement the report of the interagency committee on residency training as well as release the uniform template on appointment of Resident Doctors in line with earlier agreements. Moreover, a concrete Funding framework for residency training must be established. The Overseas clinical attachment must be fully restored and properly funded in the interest of the nation.
16. That in the interest of harmony in Federal Medical Centre, Owerri the government should pay the salaries of our members in the centre as agreed on 21st October, 2013.
17. Immediate concrete steps must be put in place for the reintegration of our members back into the IPPIS platform.
18. All attempts to coerce house officers not to join NARD must stop.
19. The orchestrated intimidation, harassment and physical assault of our members in departments of Pathology (Laboratory Medicine) by Laboratory Scientists which is being tolerated by the Federal Ministry of Health (FMOH) must stop.
20. The Endless circle of incomplete salary payment to our members in many hospitals in the name of shortfalls in personnel cost must stop.
21. Universal applicability of all establishment circulars on the remuneration and conditions of service for doctors at all levels of Government must be guaranteed.
22. Government should as a matter of urgency set up a health trust fund that will enhance the upgrading of all hospitals in Nigeria.
23. The position of Chief Medical Director/Medical Director must continue to be occupied by a Medical Doctor as contained in the Act establishing the tertiary Hospitals. This position remains sacrosanct and untouchable.
WHY DID THEY NOT ASK THAT THE POST OF VICE CHANCELLOR BE OPEN TO EVERYONE IN THE UNIVERSITY SINCE ASUU AND SANU ARE MADE UP OF GRADUATES
CAN YOU BE A JUDGE OF THE HIGH COURT OR COURT OF APPEAL IF YOU ARE NOT A LAWYER?
WHY DO THEY THINK THE HOSPITALS WHERE LIVES ARE SAVED EVERYDAY SHOULD SACRIFICE THE ESTABLISHED LEADERSHIP I.E. CHIEF MEDICAL DIRECTOR?
24. The NMA henceforth shall not accept the continued violation of any of the terms of the 2009 Collective Bargaining Agreement. This is exemplified by the payment of Medical Physicists and Optometrists with OD (who are on CONHESS) call duty allowance using the CONMESS Circular. Similarly, the phrase â€œMinistries, Departments and Agenciesâ€ (MDA) in the said agreement should replace â€œFederal Ministry of Health and other Federal Health Institutionsâ€ as contained in the 2009 CONMESS Circular.
In the light of the fore-going therefore, the NMA hereby gives government 14 days to meet all her demands as stated above or have her members called out for a resumption of the TOTAL and INDEFINITE withdrawal of service suspended on 5th January 2014.
The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted.
We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent.
We hereby appeal to all Nigerians for their understanding and to press on Government to meet with our demands to avoid the STRIKE which is scheduled to start on the 1st of July 2014 from 00.10 hours GMT.
DR. Kayode OBEMBE DR. Adewunmi ALAYAKI
President Secretary General
President of the Senate, FRN
Speaker, House of Representatives, FRN
Hon. Minister of Health
Hon. Minister of State for Health
Hon. Minister of Labour and Productivity
Hon. Minister of Finance
The Head of Service of the Federation
Chairman, Senate Committee on Health
Chairman, House Committee on Health
Chairman National Salaries, Wages and Income Commission
Inspector General of Police
Director of State Security Service
Chairman, Committee of CMDs
All Heads of NMA Affiliate bodies