For now we have a health team wherein everyone wants to do everything
that is a Doctor's job even when they can barely master theirs, where
everyone wants to take everything that is a Doctor's pay even when
theirs is relatively more, where everyone wants to be the Doctor's
public foe yet private friend so that they may keep those free,
secret, consultations aboard. Now they want to be Doctors (and
Consultants), do not want to go through Medical School to be such, and
definitely do not want to endure the rigours of residency.
And what is worse? Rather unlike when they threatened strike actions,
cut ICU power supply, and locked everything up, even bedpans, whenever
they go on their political strikes; now they form a coalition against
the disciples of Hippocrates so that they can challenge our rights to
freedom of association and of decision, malign us, and sue us to
court– and actually do.
So that now government hospitals are paralysed, people are dying, and
privatization is looming. And all these because of insincerity, for
JOHESU want to have their cake and eat it, yet he who comes to Equity
must come with clean hands... They feed the common man with lies to
turn him against his Doctor, Boko-Haram style, and hope, foolishly
enough, that their propaganda will survive. Of course they won't;
falsehood may endure for a night but truth comes in the morning...:
The peak of their careers: Consultancy.
JOHESU are quick to point out the particular dictionary meaning of a
consultant being a specialist in his chosen field. Yet, as there is
hardly a word worthy of placement in the dictionary and yet having a
singular meaning, JOHESU are mischievously silent on such definitions
(for example, as in Oxford Concise Medical Dictionary, Sixth Edition,
page 155), that "A Consultant is a fully trained specialist in a
branch of medicine who accepts total responsibility for patient care."
Alas, each field of human endeavour has its rules and regulations, and
consultants– those that, as JOHESU conveniently put it, have reached
"the peak of their careers". Yet, there are requirements for reaching
this peak, and there are jurisdictions. For example, however
brilliant, versed, confident a paralegal is, he will not represent the
client in court, not as a lawyer; he will never be a Judge without
first going to Law School and being a lawyer; he will never be the
Chief Justice or the Attorney-General, arguably the peak of his
Coming back to Medicine… In the other climes that JOHESU readily cite,
non-Doctor consultants are fellows of postgraduate colleges such that
there are minimum requirements and qualifications, and so that the
competence of each consultant can be vouched for having been assessed.
The question therefore that the NMA asks is, Are JOHESU
consultants-to-be going to be enrolled in residency programmes? Are
they going to be Fellows of (inter-)national medical colleges? Or are
they just going to be sharing consultancy titles among themselves?
Sounds fair, doesn't it? But the best answer JOHESU can proffer is
that Doctors must not dictate the goings-on in other professions. Fair
enough! In the spirit of the International Best Practices that JOHESU
are purportedly agitating for, standards must be set, especially since
human lives are irreplaceable; and to set standards, each discipline
must know its duties and boundaries so it may (itself) be disciplined
and be disciplined (of others). Yet JOHESU have refused to state what
shall be the boundaries of their own consultants, one thing very much
worth clamouring for since every arrangement must have a control.
And what is worse? Since our government is only amenable to violence
and strike actions, the latter a rather frequent tool of JOHESU in
recent times and one they are now begging the courts to approve their
copyright patent to, and to grant them a monopoly of; the government
went ahead anyway and appointed non-Doctor consultants despite NMA
insistence that the appointees only be those, if any, who have
successfully passed through residency training and/or are fellows of
reputable postgraduate colleges.
At the Nnamdi Azikwe University Teaching Hospital, a “Consultant
Pharmacist” invaded the wards with his team, cancelling patients’
prescriptions and also demanded that a Consultant Cardiologist remove
a key drug in an inpatient prescription, on grounds that the drug has
some known adverse effects.
In the Abuja University Teaching Hospital, the Antenatal Clinic was
invaded by Nurses who decided to consult patients and make
prescriptions; the Doctors left the clinic and the patients were
confused. Patients who sought to see their Doctors were told that
there was a “Consultant Nurse” who does whatever a Consultant does.
In the University College Hospital, Ibadan, a Consultant Plastic
Surgeon was barred from reviewing the surgical wound he created
post-operatively because a “Consultant Nurse” had reviewed the wound
earlier and was satisfied with her findings.
Suffice it to say that these are unbelievably new results as they are
scenarios that were not created anywhere else in the world and could
only have occurred in Nigeria being uniquely Nigerian; read: JOHESU.
Now the questions the NMA asks are, If a pilot study showed chaos,
would you, sane as you are, go ahead and implement the full-scale
design? If some insane elements insisted that a chaotic model be
implemented nonetheless, wouldn't you oppose such brainless act to the
extent of your strength and resilience, especially if you took an oath
to only act in the best interests of your patients?
And the best JOHESU can see fit to do, rather than apologise for the
apologetic actions of its members, is sue the NMA to court since "only
trade unions can go on strike." Ignoring the sensibility, or
otherwise, of the suit, one still finds himself proceeding to wonder
if Nigerians were a trade union when we protested the non-installation
of GEJ as President following the obscure demise of Yar'Adua, if we
are a trade union in protesting the abduction of our girls, if we need
to be a trade union to stand for commonsense, which regrettably, but
not unexpectedly, is not so common– and, particularly so, in some
The peak of their careers: Directorship.
Another lie JOHESU have peddled is that only Doctors hold important
positions in the Ministries of Health! Yes, such positions as
Directors; Chief Medical Directors (CMDs); Chairmen, Medical Advisory
Committee (CMACs); Ministers of Health; positions they have eyes on;
but not Permanent Secretaries, a position they very much have noses
upon. And the real Oliver Twist that they are, they forever want more.
To set the records straight, the Federal Ministry of Health (FMOH) of
Nigeria has eight directorates, and they are not all headed by
Doctors. Going by the Presidential Committee on a Harmonious Work
Relationship amongst Health Workers and amongst Professional Groups in
the Health Sector, chaired by Hon. Justice Bello A. Gusau,
"By its approved structure, the Federal Ministry of Health has eight
Department of Human Resources;
Department of Finance & Accounts;
Department of Planning, Research & Statistics;
Department of Procurement;
Department of Hospital Services;
Department of Public Health;
Department of Family Health; and the
Department of Food & Drugs Services.
Of the four Professional Departments, three are headed by medical
practitioners while one is headed by a health professional who is not
a medical practitioner."
Do you propose JOHESU to head Hospital Services, Public Health or Family Health?
Yes, the CMD and the CMAC are doctors, but the latter is a director of
clinical services representing all the clinical departments with a
single vote just like the director of administration, the director of
nursing services, and the director of pharmaceutical services, all of
whom are JOHESU members.
And as the CMD is a Doctor because the law said so, JOHESU can always
go to court if JOHESU are not happy about that; after all, they very
well know the way to Equity and have mastered the art of presenting
gloved hands, they very well have people in the House of
Representatives that they have fed their Doctors-only-examine hogwash,
they very well know how to get the government to sign silly deals and
ruin the status quo...
The peak of their careers: Remuneration.
JOHESU have, like the thieving child spanked by his no-nonsense
father, come out to say the Doctors' pay is unfairly higher than
theirs. Yet, this is not considering that Doctors spend far longer in
school and to acquire specialist skills, that Doctors do not run
shifts and get night-offs, that Doctors do call duties but do not get
call-duty offs, and that Doctors should therefore be paid more.
That said, it is quite interesting how that among the healthcare
workers in other climes, particularly the United States, the United
Kingdom, Canada, India, Australia, and South Africa, nurses, on the
average, seem to earn the least even though the difference in salary
is not particularly marked in comparison with the laboratory
scientists, and physiotherapists; while the highest earning
professionals in the health sector are Clinical Pharmacists and
The highest average salary for Nurses, Pharmacists and Doctors is
distributed in a ratio of 1:1.4:3.1 in the US, 1:2.6:3.0 in the UK,
1:1.9:2.8 in Canada, 1:1.1:2.3 in Australia and 1:-:2.5 in South
Africa. In Nigeria, within the health care system alone are two salary
CONHESS (Consolidated Health Salary Structure, for Pharmacists,
medical laboratory scientists, nurses and other health workers in the
health sector of the Federal Public Service), and
CONMESS (Consolidated Medical Salary Structure, for Medical and Dental
officers in the Federal Public Service).
It will appear that while NMA is asking for relativity ranging from
1:1.1 (at CONMESS 3) to 1:1.5 (at CONMESS 7), JOHESU are at variance
with this proposition. But judging by the relativity highlighted above
as per the other countries, can the demand by the NMA be considered
unreasonable? And for all the International Best Practices and
how-it-is-done-in-other-climes claims that JOHESU conveniently pop out
of their tall, pointed, hats, shouldn't they rather agitate that
Doctors be paid more? But no, we Doctors are charitable slaves
deserving no much money; no, not while we even like money too much!
Apart from alleging that Consultants only work once a week, JOHESU
proclaim that they get paid twice for the same job, or no job at all.
One expects that even a junior staff knows that everyone's salary is
divided into basic salary and allowances. As consultants are lecturers
in the universities as well as specialist Doctors in the hospitals,
the Ministries of Education pay them basic salary as lecturers, while
the Ministries of Health pay them call and specialist allowances. Does
that constitute double salary?
You see, JOHESU should never dabble into something they have no
knowledge of. If they don't understand something, it is better asked
than assumed. Ojú ŕfọ́-ěfọ́tán, Ějŕ níí dááálẹ; the partially blinded
eye causes disagreements...
Ayokunle Ayk Fowosire.
Whatsapp ONLY: +2348068619636
And contrary to JOHESU-made popular opinion, Doctors do not lord over
paramedics, Doctors do not fight to be put in charge, Doctors do not
agitate to be noticed or respected. One wishes one could say the same
for our waka-comes. Uneasy lies the head that bears the crown. Being a
Doctor, being the captain, being the boss, are not a pastime, they are
a responsibility; for with great power comes great responsibility.
And the Doctor's leadership role is not without limits.
The Doctor will not head a Maternity Centre; being neither a midwife
nor -husband. Yet, they must refer complications to him, and he must
head the Labour Room, the Department of Obstetrics, the Hospital.
The Doctor will not head a Pharmacy Department or a patent medicine
shop that is not his. But he may choose what drug, what brand, and
(therefore) what shop. Besides, why, in their sales adverts, do
pharmaceutical companies ask patients to consult their Doctors after
certain periods, commonly three days, of insignificant improvement in
condition? after their drugs must have (apparently) failed?
The Doctor must not head the medical lab scientist; but a Doctor must
head the clinical laboratory. If you decide to open your private lab,
no Doctor will lord over you, but then he may not accept or make use
of your results.
In light of these, one can only hope that this composition is reason
enough to set the Eyes of Medusa upon the hydra-headed monster that
JOHESU has (inadvertently, eventually) become; that the legendary Eyes
of Medusa, the hydra-haired mortal Gorgon, yet turn into stone; that
the Eyes of Medusa stop JOHESU dead in their hydra-footed tracks
towards plunging the Nigerian Health Sector into abysmal chaos, one
from which it may never recover.
That everyone now sees that as the peak of the paralegal's career is
not the peak of the lawyer's career, the peak of the paramedic's
career is not the peak of the Doctor's career: the peak of JOHESU's
career is invariably not invariably the peak of JOHESU's career.