JOHESU, healthcare professionals write Jonathan, reject surgeon-general position

THE last is yet to be held concerning the planned creation of the position of surgeon-general as the health workers under the aegis of the Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professionals have written to President Goodluck Jonathan to register their displeasure with the planned creation of the office.
  The letter was jointly signed by President, Pharmaceutical Society of Nigeria (PSN), Olumide Akintayo, JOHESU Chairman, Wabba Ayuba, President, National Association of Nigerian Nurses and Midwives (NANNM), Mr. Abdulrafiu Adeniji, Chairman, Assembly of Healthcare Professional Associations (AHPA), Dr. Godswill Okara, President, Nigeria Society of Physiotherapy (NSP), Mr. Taiwo Oyewumi, President, Association of Radiographers of Nigeria (ARN) Dr. Mark Okeji and President, Health Information Managers Association of Nigeria (HIMAN), Mr. Wole Ajayi.
  Meanwhile health professionals under the aegis of the Nigerian Union Of Allied Health Professionals (NUAHP) have declared that the position of surgeon-general would worsen the nation’s already porous healthcare system.

  In a statement made available to The Guardian in Lagos and signed by NUAHP National President, Felix Olukayode-Faniran and National General Secretary, O.C Ogbonna, the body said with the planned creation, “our union cannot (no longer) guarantee any further industrial peace in the health sector.”
  The union, therefore, advised the presidency against the creation of the office, even as it noted: “The president should create various posts of physiotherapist-general, pharmacist-general, Medical Laboratory Scientist” to assuage the feelings of other healthcare professionals if it must go ahead with the contentious position.
  JOHESU contended, “office of the surgeon-general in whatever nomenclature will mean an unnecessary duplication of offices and functions which are presently being articulated and undertaken by the office of the minister of health and the minister of state for health with an array of directors, deputy directors and assistant directors.”
  The health professionals wondered, “What is the enabling law to justify the appointment of a surgeon-general in Nigeria?” Nothing “an act to establish the office of a surgeon-general was sponsored in the 6th National Assembly and was rejected and thrown out because it was found out that it would exacerbate the acrimonious and chaotic situation in the health sector.”
  The letter reads: “The attention of the Assembly of Healthcare professionals and Joint Health Sector Unions (JOHESU) has been drawn to the purported approval of the post of a Surgeon-General for the Federation by Your Excellency.
  “The justification for the position of a Surgeon-General in contemporary publications and reflections is hinged on the need for such a public officer to be saddled with the responsibility of coordinating public health. This assertion on face value is ridiculous and certainly most unconvincing because the basic tenets of medical training positions any registered medical practitioner to undertake the responsibility of driving processes that border on public health.
 “The information provided on the need for the post of the Surgeon-General cannot be a compelling factor to waste scarce public funds for an ego trip. The precedence of a Surgeon-General draws its parallel from only the U.S.A. It is not the norm in any other part of the world. The best in terms of ranking ever achieved by a Surgeon-General was as an Assistant Secretary of Health. Today the incumbent Surgeon-General reports to an Assistant Secretary of Health in the United States, which promotes the concept. The Surgeon-General’s office in the U.S.A. works with commissioned corps officers, which include more than 6700 uniformed health officers from different professions who serve in locations around the world.
  “It is instructive to note that the office of the Assistant Secretary of Health to which the Surgeon-General reports in the U.S.A. is junior to the Minister of State for Health in Nigeria.
  “On July 19, 2013, Pharmacist and Rear Admiral Scott Giberson was named Deputy Surgeon-General. In addition Rear Admiral Bovis D. Lushimak MD MPH was named acting U.S. Surgeon General to succeed Regina Benjamin who stepped down on July 16, 2013.  This information puts paid to the mischief of clever users of untruth who give the impression that the office of Surgeon-General is a professional cadre for doctors in the U.S.A. It is actually a post assumed by a care-provider who has military background on special assignments often times akin to Peace Corps.
  “The Office of the Surgeon-General in whatever nomenclature will mean an unnecessary duplication of offices and functions which are presently being articulated and undertaken by the Office of the Minister of Health and the Minister of State for Health with an array of Directors, Deputy Directors and Assistant Directors. The set-up at the Federal Ministry of Health and State Ministries of Health has created the Offices of the Director of Hospital Services, Director of Public Health which are today the exclusive preserve of doctors who also dominate the Top Management Committee (TMC) of the Federal Ministry of Health/State Ministries of Health with over 80 per cent of the directors who are doctors. Some stakeholders in health probably see Nigeria as a Health outpost that deserves a Chief Medical Officer. The fact is that Healthcare is increasingly a team concept and multidisciplinary where each stakeholder contributes to a pooled effort to achieve desired outcomes.
  “The health sector has suffered from avoidable entropy because of ill-conceived policies and statutes over time. We as genuine stakeholders who represent over 95 per cent of the health workforce in Nigeria are worried that another strange and unlawful concept is about to be imposed on our sector. Fundamentally we ask, what is the enabling law to justify the appointment of a Surgeon-General in Nigeria?
  “For the records a bill for an act to establish the Office of a Surgeon-General was sponsored in the 6th National Assembly and was rejected and thrown out because it was found out that it would exacerbate the acrimonious and chaotic situation in the health sector. An attempt to formalize it by Justice Abdullahi Gusau Committee on Harmony in the Health Sector also failed and was rejected. We wonder how then it can come through a Presidential fiat in a democratic dispensation. We believe strongly that this development amounts to a joke, which must not degenerate to a fraud of the century in Nigeria.
  “Our nation needs appointments that can truly impact by ameliorating the burdens of our depressed citizenry and not those that intensify conflict potentials in a perennially tension-soaked sector at the detriment of overwhelming public interest.”
  The letter is a follow up of the earlier media briefing on Monday in Lagos where the healthcare professionals protested against the planned creation of the position of Surgeon -General and complained against several injustices being done against healthcare workers.
  The Akintayo, who spoke on behalf of the healthcare professionals in the media briefing, noted that the “insistence that other health worker must not be allowed to skip CONHESS  (consolidated health salary structure) 10 which is now a major demand in the quest to placate doctors not to go on strike is a national embarrassment and fraud”, adding, “ today there is a substantive order of the National Industrial Court of Nigeria (NICN) that some cadres of health workers be legitimately allowed to skip CONHESS 10.”
  The healthcare professionals said, “unscrupulous Medical Salary Scale (MSS) initiated by (late Prof.) Olikoye Kuti in the 90s” laid “ the foundation of industrial disharmony in Nigeria today.”
 Akintayo said, “we note with serious concern that court judgments in the Health Sector are now treated with levity by the Federal Ministry of Health under the watch of the Minister of Health who has reduced that honourable office to that of the official spokesperson of the Nigeria Medical Association (NMA),” adding, “it has become imperative to stress the agenda of delay tactics associated with implementing agreements with the health sector profession and unions since 2009.”
  The medical professionals called for immediate circularization of the approval of consultancy status for some cadres of health workers and payment of the arrears of all honorary consultants appointed by the boards of management of hospitals which were arbitrarily stopped on the directive of the health minister, the release of official circulars to enforce the decision of National Industrial Court that some cadres of the health workforce be legitimately allowed to skip CONHESS 10, a presidential directive compelling the National Salaries, Incomes and Wages Commission to negotiate and approve reasonable and respectable allowances as well as emoluments for health workers in Nigeria as indicated in collectively signed agreement with Government since December, 2009.
  Other demands of the healthcare professionals include an unconditional halt to the appointment of a Surgeon-General for the Federation, even as they asked government to remember the consequences of the unlawful Medical Salary Scale (MSS) of the 90s; amendment of the extremely obnoxious Act 10 of 1985 which laid the foundation for oppression in the health sector through appointments unduly skewed in favour of Nigerian doctors contrary to international best practices; an immediate evaluation of the draft National Health Bill through an outright deletion of the potentially dangerous section 1 (1) which provides that “a National Health system will regulate and control all the health professions and services” and rejuvenation of a well funded and properly positioned Presidential Committee of Experts on harmony in the health sector for a permanent and equitable structure in the privileges of all healthcare-providers in Nigeria.
  In conclusion, they wrote: “It has become imperative to declare on this unique occasion that healthcare-providers in Nigeria will not surrender their inalienable right to liberty, fairness, equity and justice under whatever circumstance. No one will be allowed to ride on us roughshod in the health sector, be they elected or appointed representatives of Nigerians or any component of the health sector which we subscribe to will be allowed the luxury of misadventure to perpetuate tyranny and unwholesome dominion in our sector anymore.
  “Consequent upon this and the expiration of the 15-day ultimatum earlier given, the Joint Health Sector Unions and the Assembly of Healthcare Professionals of Nigeria in league after appraising all its options painfully direct all its members to proceed on a 5-day warning strike from Wednesday, January 15, to Tuesday, January 21, 2014, to enable government led personally by Your Excellency redress through constructive dialogue its prayer/grievances as reflected in this position paper which has been made available to government. The condition precedent to dialogue with Your Excellency is a minimum conditionality which is also non-negotiable as the President who is the father of the nation must be willing to give all his children a listening ear in a conflict that continues to fester as a rotten and infected wound because the future of healthcare-providers in Nigeria can no longer be left with Presidential aides who find it difficult to disguise their affection for the interest of only one profession in a multi-disciplinary sector.
  “In the event that government does not enter into meaningful dialogue within two weeks of this notice, we shall be left with no option than to commence a more excruciating and total nationwide strike to enforce our liberties.”
   NUAHP, which comprised physiotherapists, pharmacists, radiographers, medical laboratory scientists, dietitians, occupational therapists among others in teaching hospitals across the federation said: “The attention of the National Secretariat of our union has been drawn to various newspaper publications of January 3, that  (President) Jonathan has agreed to meet Nigerian Medical Association’s (NMA) demands. It was reported that the President has agreed to appoint a surgeon-general of the federation who will be a medical practitioner. Our union strongly rejects this appointment because it is capable of worsening the existing crisis in the health sector.
  “It is sad to note that the president could take such an important and serious decision without a proper stakeholders’ conference. The NMA constitutes just 10 per cent of the workforce in the health sector while the remaining 90 per cent of physiotherapists, pharmacists, radiographers, medical laboratory scientists, dietitians, occupational therapists, dental therapists, dental technologists, health information officers, medical social workers, nurses, optometrists among others were left out at the so called ‘stakeholders meeting’, which was attended by medical practitioners where the agreement was reached.
  “The union advises Mr. President to adopt the habit of promoting team spirit in resolving issues in the health sector as it is done in
civilised nations.
  “Furthermore, Mr. President should be cautious with the agreement he reached with the NMA without other health professional associations and other health personnel representatives. It would be recalled that in year 2007, then President Olusegun Obasanjo was confronted with the same demand by NMA where he called a meeting involving all the stakeholders in the health sector. The issue of surgeon-general was discussed and it was rejected then.
  “Earlier on, a medical practitioner and senator of the National
Assembly had proposed the introduction of surgeon-general for the nation’s health sector but it was well debated and reasonably rejected. Also, the 2011 Presidential Committee on Harmonious Work.
  Relationship in the health sector headed by Justice Abdullahi Bello (rtd.) discussed the same issue as proposed by NMA. The matter received very active attention by the 38 member Committee but was also thrown out because it was capable of causing serious disharmony and further crisis in the health sector.”
  The statement continued: “ Therefore, now that Mr. President has granted approval to this controversial demand made by NMA, the nation should be ready to face a very serious industrial unrest from the other healthcare professionals and workers in the health sector who constitute more than 90 per cent of the workforce in the health industry. The President is advised to toe the line of peace and leave the issue of surgeon -general out because creating such post would lead to agitations by all other health care professionals who would also demand for the creation of similar posts for each of the other health professional groups.
  “Any attempt to make a medical practitioner to be a perpetual ‘head’ of the managerial or administrative outfit of the health sector as the present surgeon-general appointment connotes would meet with stiff opposition, as it is already rearing its head over the appointment of chief executive officers (CEO) of teaching and other hospitals in the country.
  “More so, such appointment amounts to wasting of resources and unnecessary duplication. Unless Mr. President suspends and withdraws his support for the creation of surgeon-general for the nation, our union cannot guarantee any further industrial peace in the health sector. Otherwise Mr. President should create various posts of physiotherapist-general, pharmacist-general, medical laboratory scientist”.