NMA, JOHESU, PSN bicker over Yayale Ahmed-led panel report on inter-professional harmony

THE latest effort by the Federal Government to harmonise doctors and other professionals in the health sector may be heading for the rocks yet again.

  Reason: the concerned parties appears not ready to sheath their sword and work together in the interest of their patients. This is evident in their fresh disagreement and bickering over provisions in a White Paper, even before it is made public.

  It would be recalled that Federal Government had inaugurated the Yayale Ahmed-led Presidential Committee of Experts on Professional Relationships in the Public Health Sector (YAPCEPRPH) to address all grey areas and come fought with recommendations. 

  The committee had barely submitted the White Paper to the Ministry of Health when the Joint Health Sector Union (JOHESU) and other allied health workers began allegations that the panel was bias and all recommendations were tailored to favour doctors. In fact, a petition was written to President Goodluck Jonathan on why the Yayale-Ahmed panel report should not be implemented.

  Apparently in condemnation of the JOHESU’s allegation, the Nigerian Medical Association (NMA), an umbrella body for the doctors, recently issued a public notice, expressing confidence and respect for the committee and their recommendations

  Chairman, Publications and Publicity Secretary of the NMA, Dr. Obitade Obimakinde admitted that the perennial rancour among the health practitioners (though blamed on the allied health workers) is an ill wind that blows nobody good. 

  According to him, “Our health care system by persons entrusted with the responsibility of discharging the duty of care, due to inordinate ambitions, agitations and self-serving mentality of what the health care system should be as against international best practices.”

  Obimakinde said NMA would reserve it comments on the provisions of the White Paper because they were yet to see it, though took a swipe at JOHESU and the likes for hasty criticisms. 

  “Going by our understanding of the character of the agitating organisations and the principal actors, we would not be surprised to learn that they would have misrepresented or outrightly falsified the alleged contents of the report in an effort to curry underserved and unnecessary sympathy of members of the public as well as influence the White Paper,” he said.

  Reacting to the public notice by the NMA, the Young Pharmacists Group (YPG) said the Nigerian people should not be carried away by the “mischief of the NMA”. 

  The group said “grapevine sources” indicate the coordinating apparatus of the Federal Government with regards to the Yayale Ahmed Committee Report was handed over to some consultants who had a doctor in their midst. 

  “Naturally, this doctor hoodwinked others to institutionalise and rationalise legendary illogicalities including putting laboratory scientists under pathologists, optometrists under ophthalmologists and radiographers under radiologists permanently in Nigeria. Pathologists, Ophthalmologists and Radiologists are all specialist doctors for sake of emphasis,” Coordinator of the group, Martins Eze said.

  Eze alleged that the cardinal goal of the NMA had always been to dominate and subdue all other health professionals in Nigeria. 

  “The shortest cut to achieving this remains hijacking the regulatory functions of these groups. In the reality that the National Health Act has jeopardised this ancient desire, the godfathers of NMA naturally continued plotting to achieve a single template to regulate 15 professional groups and 55 Federal Health Institutions, a proposal which is both ridiculous and stupid calling a spade a spade in terms of the logistics of execution and any chance of a productive output for such envisaged commission. Consumers of health should therefore understand the enthusiasm of the NMA, which applauded the dead on arrival report of the Yayale Ahmed Committee,” he said.

  Continuing, Eze said it was indeed “shameful” that the NMA continues to mouth global best practices but has never walked the talk. 

  “Nigerian doctors who celebrate their ignorance by declaring ‘approval of consultancy status for health professionals other than doctors will cause confusion in hospitals’ without elaborating on why such confusion is non-existent in other climes or who oppose Pharm D or O.D which is the norm in the global arena for Pharmacists and Optometrists simply because they have one of their own at the helm in National Universities Commission (NUC) remain at best smart users of fallacies to maintain a lamentable status quo. A lot of Nigerian doctors need to grab the World Medical Association Ethics Manuals to appreciate new thinking with regards to relationships with other health workers.”

  The young pharmacists also took a swipe at the NMA, on the call on government to introduce Public Private Partnership (PPP) in pharmaceutical sections of hospitals. The NMA said such measure was necessary for improved productivity and proper utilisation of government resources.

 Absolving hospital pharmacists of any blame, Young Pharmacists Group observed that over 88 per cent of health budgets are dedicated to only recurrent expenditure. Out of this huge cost, 82.5 per cent is dedicated to only personnel expenditure. 

   Of the total cost reserved for healthcare, staff emoluments gulps 61% is through salaries of sometime an over bloated clinical staff in Federal Health Institutions. In apocalyptic terms, what has played out in recent years is that over 50 per cent of total health budget is dedicated to paying only one cadre of personnel in healthcare.

  “The unfortunate scenario depicted above is one of the reasons why healthcare infrastructure remains in a limbo and endeavours which facilitate Research and Development are completely comatose in an ever dynamic health sector in the global arena.

  Eze said if there is a profession that constitutes avoidable drain on the treasury of Nigeria, “it is the medical profession through its flurry of largely unproductive honorary consultants which is estimated at over 16,500 in the 55 Federal Health Institutions by the research and data unit of the PSN.”

  “While it is true that we need consultants in public health facilities, it is a waste to have between 300 at the minimum to as much 500 of these personnel in some Federal Health Institutions. Government must tinker with this exaggerated demand for this cadre of personnel who drain the national purse with little productivity as honorary consultants who earn millions of naira visit the public facilities on an average of twice a week. They also work for less than four hours a day if they show up at all. This is why you have consultants who have conducted five surgical operations in a three-year period in our facilities and yet they still earn millions.

  “The Young Pharmacists Group is compelled to call on the Federal Government and indeed government at all levels to see an urgent need to drastically reduce the unproductive recurrent expenditure invested in personnel emolument of some clinical staff which can be diverted to fruitful capital projects as well as Research and Development initiatives,” he said.

  The group calls for a privatisation of some level of clinical services especially at Outpatient Department levels at all levels of care (primary, secondary and tertiary) in Nigeria. 

  This approach, according to them, will inculcate bringing in tested private sector players (private hospitals) to take over the running of some services in public sector hospitals in Nigeria. In some areas where service might be in higher demand clinical service providers might be hired on locum basis as we have seen been successfully implemented by some state Governments in Nigeria.

  “The advantages inherent in this model are numerous as it checkmates the obvious propensity to embark on strikes perennially by those who should provide services but do otherwise. The age-long strength of the private sector in the area of service delivery will be felt maximally in the health sector, which continues to misfire at the detriment of the consuming public.

  “It is a matter of common sense that in the absence of an active public clinical service provider at some of the delivery points in the hospitals, Government can dedicate more funds to revamp infrastructure and equipment of secondary and tertiary levels in particular.

  “The Nigeria institute of Pharmaceutical Research and Development as well as Nigeria Institute of Medical Research will also be beneficiaries of this process as substantial votes to these institutions will ultimately re-position healthcare in Nigeria,” Eze said.