Healthcare delivery is manpower intensive, and it is physician-driven. Therefore, the health workforce needs to be taken care of, to enable it to rededicate itself to delivering quality healthcare to Nigerians. In the last year, we’ve had reasons to carry our various advocacies at the federal, state, and even at the local government levels.

Our advocacy is to push for the retention of our health workforce to deliver quality and best care practices for Nigerians. Amongst the challenges we had been advocating is the arrears on the increase in the consolidated medical salary structure, which has been approved by Mr. President, and the implementation started in January 2024. For the last 18 months, we have been very patient across the medical profession, across all healthcare providers, and have been patient to ensure that the government delivers on its promises.

While this was going on, the consequential adjustment on salaries came, including the consequential adjustment on the consolidated medical salary structure.

When the National Wages, Incomes and Salaries Commission brought out its circular indicating the consequential adjustment on the consolidated medical salary structure, the Nigerian Medical Association noticed that the commission did not apply certain Collective Bargaining Agreements of 2001, 2009 and 2014 on the allowances because these allowances are a product of a percentage of the basic salary. However, this was not applied.

In line with our principles of advocacy, we wrote to the commission through the Ministry of Health calling their attention to make this correction. We kept playing advocacy, going from pillar to post to ensure that these issues are addressed. However, by the first of this month, a circular was issued by the National Salaries, Incomes and Wages Commission.

This circular was issued unilaterally, and it completely ignored the observations that were raised. It even refused to involve the Federal Ministry of Health in developing this circular. There were no inputs or dialogues with us who presented the complaints to them, so that if there were any issues to negotiate, we could have mutually negotiated them. But beyond tax, the circular did two very critical, unacceptable things.

It did not stop there; the circular went ahead to reduce some of the allowances of senior consultants who are already leaving this country. We have great challenges with the health workforce.

Has there been any engagement from the Ministry of Health with the NMA or relevant health unions to resolve these issues?

Yes, we have had relevant engagements. We have not had one yet from the Federal Ministry of Health, at least not at their direct invitation, even though we have had a direct engagement with the Minister of State for Health. The engagement was mutually respectful, beneficial, and it points to a direction that we are likely to have solutions before the end of the ultimatum.

What can be done to ensure that essential workers like yours and your colleagues don’t down tools?

Our demands are very simple; they are very straightforward. We don’t have a single demand that is new. All our demands have already been approved. The only demand that is unilateral is the product of the circular by the National Salaries, Wages and Incomes Commission.

Our simple demand is that the circular from the National Salaries, Incomes and Wages Commission should be withdrawn so that all stakeholders can come to the negotiating table and discuss.

Our second demand is to ensure all the arrears that have accrued over the last 18 months are also settled immediately. That is also not far-fetched because President Bola Tinubu has approved the payment of those allowances. We wonder who along the line is refusing to implement. Part of the demand is to set up a collective bargaining agreement process, which has been due for review for over the last 10 years. All these are processes that are very easy to comply with.

While we are talking about retaining the health workforce, doubling the carrying capacity for our health institutions to produce more healthcare professionals, particularly doctors, dentists, nurses, to replace the dwindling population of healthcare workers as a result of the japa syndrome, the demand on the healthcare workforce is to such an extent that every day we have burnouts, which makes delivery of healthcare very difficult. All we are asking for is a collective bargaining agreement that will address some of these critical issues, and we don’t think what we are asking for is too much.

While that is going on, good measures were taken by the Federal Government, but we await implementation, and this includes increasing the retirement age for critical healthcare workers who are involved in direct care of patients to 70 years of age.

What’s at stake here?

We risk the whole healthcare system of this country being shut down, which the Nigerian Medical Association does not in any way want to see happen. That won’t happen as long as the government is responsive.

What are the Ministry of Health and the Ministry of Finance saying about the implementation of these issues?

With the japa syndrome, we’re losing a very critical health workforce. In addition, we are doubling the capacity of our tertiary institutions to train more healthcare providers. All this has put a great strain on those of us who have been patriotic to remain home to have these problems and challenges addressed. Now, the policies are in place. The president has given a waiver to the health sector to recruit the critical clinical workforce that will ensure that the best quality healthcare that is patient-centred and respectful is provided to all Nigerians.

However, that policy has not been fully implemented because the health institutions that should do the recruitment have not received these waivers, from which they have been exempted. So, this is a responsibility between the Federal Ministry of Health and the tertiary health institutions. If the boards of the tertiary health institutions were in place, all these problems would have been significantly solved.

We have to ensure that more young doctors go into the residency training programme so that, down the line, we are not hit by a worse situation, because what we have at the moment is a situation where a smaller number of medical graduates go for postgraduate medical training to become specialists. Most of them opt to go to other parts of the world to receive training.

The government is in a position to solve these challenges. It is just a matter of commitment. Nigerian doctors have been committed, continue to be recommitted and dedicated, providing quality healthcare for all Nigerians. (Channels TV)