I have been a victim of an industrial action by medical doctors. And, I guess, unless you are a direct victim of their action, you may not think through their action deeply. For me, each time doctors go on strike, I always felt that they were acting in the best interest of the country and the medical profession. I always blamed government for not doing the needful in addressing what I thought were part of the issues in the strike. For those like me who see doctors’ strike from the outside, the issue has always that of fixing the hospitals and providing doctors the necessary and essential tools to work with. You go to the numerous general hospitals across the country and you pray never to fall sick. No one remembers health centres that once dotted the Nigerian landscape. I grew up knowing of dispensaries manned by trained healthcare workers in rural communities. They are no more. Sometimes, you feel that our hospitals are euthanasia centres.
I had in the past written about the state of healthcare in Nigeria. A Health Minister, Prof. Isaac Adewole, had at one time urged medical doctors to also learn a second trade, maybe, tailoring, if they felt their profession no longer paid. I had thought he was too crass. Incumbent Labour Minister, Dr. Chris Ngige, had also come under serious excoriation by Nigerians for his position against striking medical doctors. Many believed he was insensitive to their plight. I thought so too. But after reading a note sent to me by a retired permanent secretary at the Ministry of Health, I started doubting my previous positions on strike by medical doctors. I doubt because doubt bring out the best logic in man. Remember, cogito ergo sum.
I have secured the permission of the retired permanent secretary, who at a time acted as Health Minister also, to publish his position in this column. His name is Mr. Linus Awute, a member of the National Institute. He titled it: “I stand by Dr. Chris Ngige.”
Read on…
“I stand strongly by Dr. Chris Ngige, the Honourable Minister, although he may not have presented his point for political correctness, but his sincerity, truth and straightforwardness of his response to the issues of brain drain are clear and should not be wished away. Strictly speaking, the noise about brain drain is a narrative pushed by the doctors themselves and echoed by those who have been indoctrinated by the repetitiveness of the slogan or narrative all the time.
“Dr. Ngige knows what he is talking about. First of all, he is a medical doctor. He had worked in the Federal Ministry of Health. He was once a ranking member in the Senate of the Federal Republic of Nigeria and he was also a ranking member of the Senate Committee on Health. I believe he made a very valid point because the facts stand out as facts.
“I was in the health sector for two times as permanent secretary. I also doubled as acting minister of health in a very significant part of 2015. I know that there are some historical facts that have, unfortunately, projected Nigerian doctors, under the employment of the Federal Government, as very unpatriotic and sometimes unreliable and insincere in their relationship with their employer, the government. Evidence also exists where they have exceptionally lived up to expectations at their individual level. But what can be more unpatriotic when in 2014 the Nigerian medical doctors went on strike in the face of the outbreak of a pandemic, the Ebola virus disease. These are the people the nation could only rely upon under the circumstance but rather than waking up to take leadership in the sector, they went on AWOL (Absent Without Leave). Some of their demands then were so ridiculous, unexpected and unappealing to common sense. One of such demands was that the nomenclature “Honourable Minister of Health” should be changed to “Surgeon General of Nigeria.” Another demand was that since other health workers have skipped a particular grade level in their promotional ladder, they, the medical doctors, must be allowed to skip one level too. These and many more were their demands and the very reason why all the tertiary hospitals were shut down at a period in 2010 and in 2014. Now they are at it again.
“Lagos University Teaching Hospital (LUTH), in 2014, as mentioned above, between June and July only, lost more than N260 million in revenue. Meanwhile the salaries of medical doctors in the same LUTH was N312 million, per month. It might surprise anyone to hear that for many months that the strike lasted, these striking doctors were also paid their full salaries. Then, management of the Federal Ministry of Health invoked the principle of ‘No Work, No Pay’ and thereafter sacked the resident doctors, but in the generous spirit of the government of the day, the same government intervened and the resident doctors were recalled and forgiven.
“Indeed, these doctors know what they are doing each time they talk about brain drain. They use the slogan of ‘brain drain’ to blackmail government when in actual sense of it they all believe in working for themselves in their own private clinics or outside the country. This is a well-researched fact that many people know about. Things that they shout and yell the loudest are the things that they least believe in. It is a well noted fact that the behaviour of these doctors is part of the very reason why the public have become too disillusioned with government hospitals. Most of them have violated every code of polite conduct in their relationship with their employer, with their profession and with their job environment.
“Due to the incessant strikes, between 2014 and 2015, we lost, from the records of 56 federal tertiary hospitals across Nigeria, about 438 patients, as a result of denial of service and outright abandonment of patients by doctors. Many have called this a criminal act, as it also violated their own very Hippocratic Oath. The Hippocratic Oath is an oath of ethics, which is historically taken by physicians upon qualifying to practice medicine. The law in this requires a qualified medical doctor to swear and to uphold certain ethical standards. The core value of that oath is that it forbids a medical doctor to abandon admitted patient(s). It also forbids a medical doctor from being the cause of the death of his patient whether by abandonment, negligence, mistake or deliberate denial of services that are due for the patient.
“During the first briefing of the incoming administration of President Muhammadu Buhari, in my capacity as the permanent secretary/acting minister, I recommended that ‘the President should proscribe, or, suspend all trade unions and associations under the health sector in order not to compromise the health security of our nation’. My argument was hinged on the fact that the President, under the law, has the power to declare a state of emergency in the health sector, in line with Trade Disputes and Essential Services Act of 1975 No. 23: ‘the President can proscribe any trade union or association whose members are employed in any essential service by government.’ Health care is essential service, it is also about the security of the nation, compromising and or controverting this fact can be deemed unpatriotic.”
Now, are the medical doctors really patriotic or is government the cause?