For more than two months, health workers under the Joint Health Sector Unions (JOHESU) in Lagos State have been on strike, disrupting services across public hospitals and health facilities in the state. The industrial action stems from unresolved issues bordering on salary structures, professional recognition and welfare concerns.
In this interview with PREMIUM TIMES, the Secretary of the Lagos State Council of JOHESU, Adegboyega Kabiawu, speaks on the origins of the strike, the union’s demands at both the national and state levels, efforts at dialogue with the Lagos State Government, and the conditions under which the union would suspend the action.
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PT: Can you walk us through what has happened between JOHESU and the Lagos State Government since the strike began?
Mr Kabiawu: Before the strike commenced, the Lagos state government engaged us and appealed to us not to embark on the strike. However, we made it clear, we would only be willing to suspend the strike if there was tangible evidence that our local demands were being implemented. Unfortunately, that did not happen.
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After the strike officially began on 3 December, there was another meeting about a week later. That meeting raised hopes that dialogue would continue, but since then, there has been no further engagement. What we have experienced instead is silence from the government, despite several correspondence from our side.
It is important to stress that JOHESU does not embark on a strike lightly. We repeatedly reached out, writing letters and using every available channel to draw the government’s attention to the need for reconciliation. However, there has been no sustained response. That is why we insist that what is needed at this stage is not public statements but genuine engagement and concrete steps towards resolving the issues.
PT: What exactly triggered the Lagos strike, and how does it connect with the national JOHESU action?
Mr Kabiawu: When JOHESU declares a national strike, it typically affects federal health institutions first. At the state level, there is a laid-down procedure which we always follow. We issue a mandatory 15-day notice to the government, outlining our grievances and giving room for engagement. That was exactly what we did in Lagos State.
After the 15-day notice elapsed without a meaningful resolution, we proceeded on strike on 3 December. While the national strike provided a broader context, the Lagos strike was also driven by long-standing local issues that have remained unresolved for years.
Historically, whenever there is a national action, state chapters also take the opportunity to push for their local demands. This is because many of these issues have been discussed repeatedly with state governments, often with promises made but never fulfilled. Lagos is not an exception in this regard.
PT: At the national level, what is JOHESU demanding from the Federal Government?
Mr Kabiawu: At the national level, our demand is very straightforward. Unlike previous strikes where multiple issues were raised, this time JOHESU is demanding only one thing: the adjustment of the Consolidated Health Salary Structure, popularly known as CONHESS.
CONHESS was introduced in 2009 alongside other salary structures such as the Consolidated Medical Salary Structure (CONMESS). While CONMESS has been adjusted on three different occasions since its introduction, CONHESS has not been adjusted even once.
For years, successive governments made promises that this anomaly would be addressed. Committees were set up, reports were written, and assurances were given. However, nothing concrete was done. Eventually, the national body felt that the only way to compel the government to act was to embark on a strike.
This demand is about fairness and equity within the health sector. You cannot continue to adjust one salary structure while leaving another stagnant for over a decade and still expect industrial harmony.
PT: Beyond the national issue, what are the specific local demands of JOHESU in Lagos State?
Mr Kabiawu: Our local demands in Lagos State are five in number, and none of them is new. The most prominent among them is the domestication of the consultancy pharmacist cadre. A federal circular issued in 2020 directed states to domesticate this cadre. Lagos had actually done so earlier, around 2018, but the policy was later suspended following opposition from medical practitioners.
Since then, we have continued to engage the government on the need to re-domesticate the consultancy pharmacist cadre. It is important to note that this cadre is already operational in federal health institutions within Lagos State, including the Federal Medical Centre, Ebute Meta; the Neuropsychiatric Hospital, Yaba; and the National Orthopaedic Hospital, Igbobi. Several other states across the federation have also domesticated it without any crisis.
Another key demand is the creation of a Directorate of Medical Laboratory Services. This issue went through extensive stakeholder engagement, and at some point, the government agreed in principle. However, the process was stalled following opposition based on the argument that pathology already exists. Our position is that medical laboratory services deserve proper administrative recognition, just like other specialised services within the health sector.
We are also demanding equity in the payment of retention allowances. The idea behind retention allowance is to retain health workers across board, yet in Lagos, only some categories benefited while others were excluded. This selective implementation defeats the purpose of the allowance and fuels dissatisfaction among workers.
In addition, we have raised concerns about errors in the calculation of call-duty and shift-duty allowances. We did not just make allegations; we provided documentary evidence, including a federal circular that reviewed these allowances. Despite this, Lagos State has not implemented the reviewed rates.
Finally, there is the issue of staff transportation. Previously, the health sector had about ten staff buses across the three tiers of healthcare in Lagos State. Today, only one bus is functional. This affects punctuality and productivity, especially given the peculiar working hours of health workers, many of whom resume very early or close very late.
PT: How extensive is JOHESU’s membership, and who exactly is affected by the strike?
Mr Kabiawu: JOHESU members make up about 85 per cent of the health workforce, while doctors and nurses account for the remaining 15 per cent. This means that the strike affects the bulk of personnel that keep hospitals and health facilities running on a daily basis.
Our membership includes a wide range of professionals and support staff. These include pharmacists, medical laboratory scientists, physiotherapists, radiographers, dietitians, health information managers, engineers, administrative staff, cleaners, cooks, porters and many others.
Because of this diversity, the impact of the strike is felt across virtually all departments in public hospitals. It is not targeted at patients, but unfortunately, when such a large segment of the workforce is neglected for so long, industrial action becomes inevitable.
PT: There have been discussions around a possible ‘no work, no pay’ policy. What is JOHESU Lagos’ response to this?
Mr Kabiawu: As of now, we have not received any official pronouncement from the Lagos State Government regarding a ‘no work, no pay’ policy. What we are advocating is reconciliation, not threats.
At the federal level, the minister has adopted a hard-line approach, ruling out reconciliation and resorting to threats. Federal workers have responded by remaining resolute and continuing with the strike. Our hope is that Lagos State will choose a different path.
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We believe that dialogue and reconciliation are more effective tools for resolving industrial disputes, especially in a sensitive sector like healthcare. Threats only harden positions and make resolution more difficult.
PT: What would it take for JOHESU Lagos to suspend the strike?
Mr Kabiawu: All our demands are well known to the government. In fact, some of them had agreements that were supposed to be implemented before the government reneged. If Lagos State presents us with a clear and concrete memorandum of understanding that outlines how the five local demands will be implemented, we are willing to suspend the strike.
Once that happens, we will seek approval from the national body, which we have successfully done in the past. Even if the national strike continues, Lagos can resume work once our local issues are addressed.
We have also carried organised labour along. The Nigeria Labour Congress, the Trade Union Congress and the Joint Negotiation Council are all aware of the situation and have written to the government on our behalf. If the government continues to ignore us, organised labour has indicated readiness to solidarise with JOHESU.
Strike action is always a last resort for us, particularly because of the essential nature of our work. What we are demanding is fairness, equity and respect for agreements already reached. We remain open to reconciliation.
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