A Dying Health Sector...

Medic-ALL (14:08:2014)

"Work Hard and Get Out" !!! Said in the meanest and most scary tone I have heard in a surgery lecture room. Those were the words of one of the foremost Plastic surgeons in West Africa to my graduating class after a tutorial class on the eve of our final medical school exams. As puzzling as those words may seem, I was perfectly in tune with the heartfelt and sincere burden on the mind of this very senior colleague that would have prompted him to render such counsel to a focused group of medical students on their way into the real world of medicine in a country like ours.

This was a class that had to spend an extra 6 months in school, because of a strike action by resident doctors in the state to challenge the decision of the State Government to pay less than the stipulated CONMES(Consolidated Medical Salary Scale) approved by the Federal Government to it's doctors, in spite of the obvious fact that these doctors are overworked as compared to their Federal counterparts due to a perennial under-staffing. At the time the State Government eventually went ahead to issue sack letters to the doctors (including residents and Consultant specialists) in the state and employed contract medical-officers in their place. The sack-scare paid off and the strike was subsequently called off ,but the state doctors never got a decision in their favor.

Fast-Forward to 2014 , and its a nationwide strike by the Nigerian Medical Association to challenge certain Federal Government health sector policies which the body believes does not augur well for the future of the sector in the country as well as to see the implementation of other demands summed up in the union 23-point demand sent to the Federal Government a few weeks before embarking on a withdrawal of service.

The strike has lingered on for weeks , despite the outbreak of the deadly Ebola virus in the country and  several meetings have being held among the various stakeholders to ensure a resolution of the issues surrounding the 45-day old strike, no positive conclusions are yet to be reached. There have being rumours regarding how the Federal Government will choose to tackle the problems in the barely thriving health sector, including reports indicating that the Government was planning to privatise the Public Hospitals (including Teaching Hospitals!). This of course raised several questions and sparked debates particularly as it relates to the Act that created Teaching Hospitals for the primary purposes of training and research as opposed to Private Hospitals which are more or less profit-making establishments.

An authoritative answer to these questions was received earlier today in the form of a Federal Government directive suspending residency training (training of doctors into specialists) in the country indefinitely and the immediate sack of the doctors presently in residency training. While the directive was said to be for the purpose of appraising the problems in the health sector, many are wondering if this drastic step would not leave the health sector in shambles!...and hoping that this is not the "Beginning of the End" of Nigeria's already "Frail" health sector as we know it.

Genuine Questions Arising?

Did the Federal Government take this decision in order to force the hand of the striking doctors to come to a compromise?

Was the decision taken to weaken the resolve of the NMA (Nigerian Medical Association) , keeping in mind that it is believed that the NARD (National Association of Resident Doctors) serves as the mitochondria of the sister body?

Is this a way of pitching the doctors against each other (as was the case between the Lagos State resident Doctors and the locum doctors employed on contract during the CONMESS struggle)? Moreso as the Presidency has ordered immediate employment of locum doctors on a contract basis.

Is there still anything to fight for as far as the Nigerian Medical Association (NMA) are concerned?

In a country where the health sector already suffers a huge shortage of personell, particularly doctors ,thanks to the daily mass exodus of Nigerian doctors to countries were they are perhaps more appreciated(40,000 on the United States halth care system). Will such a decision force many more out of a system that seems to be in need of help as it is?

How well can the health sector thrive without specialist training?

What is the future of medicine and healthcare in this country?

Where do we go from here?....

Medic-ALL.Inc 2014

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