JOHESU, AHPA, others, fault Yayale Ahmed-led panel report on inter-professional cooperation

JOINT Health Sector Union (JOHESU) and Assembly of Healthcare Professional Association (AHPA) have described the Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH) report as “biased, one-sided and out of line.

They said the report is designed to institutionalise confusion and a recipe for more chaos, as they called on President Goodluck Jonathan to withdraw it in the interest of the public and the future of the health sector.

   In a letter to the President, also made available to The Guardian, they expressed their disapproval and non-acceptance of the report. T

   The group stated that the report led by Dr. Yayale Ahmed “only seeks to further marginalise our members and compromises the future of generations of our members who will be permanently made sub-servient to their contemporaries in medicine.”  

   According to them, “our findings confirm our fears that as usual, the secretariat of the Committee was infiltrated by the Nigerian Medical Association (NMA) through the instrument of its privileged members in high places in government. 

   “Nothing gives insight to this better than the phraseologies which perennially referred to doctors as ‘eaders of the health team’ while other health professionals were favoritely dubbed ‘allied health professionals’ remains an incontrovertible proof of this position.”

   The group listed out the areas in the report, which they expressed their resentment on the way the committee handled and gave out suggestions to the Federal government to effect. 

   The issues included: Establishment of the office of Chief Medical Adviser to the President; Creation of a National Healthcare Commission; Matters Arising from Teaching Hospital Act which are headship of Teaching Hospitals, appointment of CMAs, appointment of Deputy CMAs, Consultancy cadre for eligible health professionals and composition of Boards of Management for Federal Health Institutions; 

   Others are: opposition to appointment of other health professionals as directors in Federal Health Institutions; establishment of post-graduate colleges for ‘Allied Health Professionals’; obvious bias against health professionals other than doctors especially in the reflected areas- position of the panel on Pharm D and 0.D Programmes, withdrawal of Central Bank of Nigeria (CBN) circular authorizing MLSCN to approve licence for importation of In-vitro diagnostics (IVDs) and poor hazard, call-duty and related allowances to health professionals.  

   Explaining their stand in the letter for rejecting the report, the group said: “In one of the most nauseating recommendations of the Yayale Ahmed Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH), it recommended the establishment of an unnecessary office of Chief of Medical Adviser to Mr. President.

   “A perusal of the functions of this office including “exercising essential responsibilities for issuing reports on such issues as “smoking and health” as well as issuing warning to the public on health hazards, advising the President in coordinating National Health emergency preparedness and advising the President on emergent public health issues confirms that this recommendation is only a short-cut to bring back to life the concept of Surgeon-General as demanded by the Nigerian Medical Association (NMA). 

   “The Yayale Ahmed Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH) found it necessary to cite experiences in climes where doctors have monopoly of some public health initiatives. It conveniently and cleverly avoided the United States America experience of the Surgeon-General, which is open to all health professionals. 

   “Your Excellency, it is fundamental to draw you memory lane by positing that the Sixth National Assembly, the 2014 National Conference which are all legislative templates have all rejected the concept of Surgeon-General or any of its epitome. All the health professional associations apart from NMA and the trade unions in the health sector, which collectively make up 95 percent of the health workforce, have repeatedly rejected the need for a Surgeon-General in Nigeria. 

   “For the umpteenth time, we restate with necessary emphasis that for a country whose public sector wage profile has increased by a whopping 100 percent from N890 billion to N1.83 trillion in five years period should not be contemplating setting up fresh bureaucracies especially when it is unnecessary to satisfy ego trips. If the structure at the Federal Ministry of Health provides for two cabinet Ministers of Health, a Permanent Secretary, 10 Directors out of which one is in charge of public health and another hospital services, why on earth do we need another dramatis personae whose job is to advice the President on emergent Public Health issues or issue reports on ‘smoking and health’? 

   “Mr. President Sir, we respectfully submit again that the establishment of any new bureaucracy in health is amounts to an unnecessary duplication and waste of public funds, since it adds no value.   

   Furthermore, they said: “In discourses that evidently betrayed the mandate of the YAPCEPRPH to facilitate harmony in the health sector, the Presidential Committee proposed a template for the age-long desire of the Nigerian Medical Association (NMA) and its appendages to have a short-cut to regulate and control all the cadres of health professions in Nigeria. 

   “One of the major recurrent contentions in the National Health Bill which Your Excellency refused to sign into law when passed by the Seventh National Assembly was because a potentially explosive section One (1) created a caveat that a supposed National Health System would “regulate and control” all health services in Nigeria. 

   “Your Excellency, the recently approved National Health Act was acceptable to JOHESU and AHPA only when necessary safeguards to protect the autonomy of all health professions was inculcated into section One (1) of the National Health Bill. That safeguard is the clause that declares that regulation of health services in section One (1) of the new Health Act is without prejudice to existing health laws. 

   “Even when the Yayale Ahmed’s Presidential Committee was designed to create harmony, we find it expedient to lament very loudly that this particular recommendation is clearly out of line and a design to institutionalise confusion. In terms of logistics, how can one commission as proposed take over the functions of 15 different professional regulatory councils as well as regulate the activities of 55 Federal Health Institutions as presently constituted?      

   “It should be a matter of common-sense that this is a recipe for unprecedented entropy. For some of the old professional councils like Pharmacists Council of Nigeria (PCN) established through its precursor the Pharmacists Board of Nigeria (PBN) in 1958 the peculiarities of the output are diversified. It is not just registers the relevant professionals like other professional Councils, but registers pharmaceutical premises. Most other health facilities including private clinics are registered at state levels through agencies that now have established structures.

   “Why then create avoidable confusion, because people must be whipped into adopting defective policies at the whimsical and capricious propensities of Nigerian Medical Association (NMA)?

   “If there is a particular area the Yayale Ahmed Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH) went too far in the realm of irrational logic, then it appears it was this ill-conceived concept of a healthcare commission to replace 15 regulatory agencies which are products of valid Acts of parliament as section 315 of the constitution conveys validity on those laws that were creations of the military.”

   The group also pointed out the committee’s biasness towards other health professionals other than the doctors which they noted was reflected in their recommendations to the Federal Government not to recognize programmes of the health workers and also to maintain status quo in the huge gulf in their earnings.

   It reads: “We draw the attention of Government to the tragic position and recommendations of the YAPCEPRPH report in the following areas: Its declaration that Government at all levels should refuse to recognize the Pharm. D programme of Pharmacists and O.D Programme of Optometrists because the Nigeria University Commission (NUC) has not approved them. 

   “How does a supposed arbiter take a position to truncate the future developmental agenda of a stakeholder and yet expect to enjoy the confidence of such stakeholders? For the records the Pharmaceutical Society of Nigeria (PSN), Pharmacists Council of Nigeria (PCN) are still engaging the NUC to regularise grey areas identified as drawbacks in Pharm. D. and so nobody has a right to shut the door prematurely. This is same for stakeholders in optometry. 

   “The recommendation that the Central bank of Nigeria immediately withdraws its circular authorizing MLSCN to approve licences for the importation of In-vitro diagnostics (IVDs) in deference to NMA demands is lamentable. This matter will be subject to further interventions in the weeks ahead as the YAPCEPRPH report makes the situation more inflammable. 

   “The insistence that the status-quo of maintaining 100 percent differential in the call-duty, rural, hazard and other allowances between doctors and other health professionals until an acceptable job evaluation is the climax of the many absurdities of the YAPCEPRPH report. 

   “Doctors who already enjoy a much more superior entry point are structured to earn over 100% of basic salary across board in all allowances. What this transcends to is that the most junior doctor (house-officer) earns more in allowance than other health professionals at apogee level (Director/HOD). 

   “This is the unfortunate status-quo the Yayale Ahmed Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH) has recommended we maintain.” 

   They therefore, among other issues called on the Federal government to reject and discard the report stating: “we the under listed stakeholders in health find it necessary to inform the Federal Government that we outrightly reject the very biased and one-sided Yayale Ahmed Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH) in both public and professional interests.”