The Nigerian government has instructed all major federal tertiary health institutions where members of the National Association of Resident Doctors (NARD) are currently on strike to implement the “no work, no pay rule,” beginning from August 2, when the nationwide industrial action commenced.
But the striking doctors have stuck to their guns, saying the government’s hard stance would not force them to suspend its almost one-month-old strike.
While the government conveyed its directive through a circular issued to the concerned hospitals on Thursday, the doctors made its position known in a communiqué issued at the end of a virtual extraordinary meeting of its National Executive Council (NEC), which held on Wednesday.
The federal ministry of health, in a circular dated August 26, 2021, directed all Chief Medical Directors (CMDs), Medical Directors (MD) and registrars at all federal health institutions to implement the “no work no pay rule” starting from August 2 when the National Association of Resident Doctors (NARD) downed their tools.
The circular reads in part; “The ministry is in receipt of a letter from the honorable minister, the federal minister of labour and employment, informing the ministry of the laws governing the ongoing strike by the Nigerian Association of Resident Doctors (NARD) and the need to apply the provisions of the section 43(I)(a) of the trade dispute act on special provision with respect to payment of wages during strikes and lockouts known in labor practice as ‘no work no pay’ rule with effect from Monday 2nd of August when the strike was commenced by NARD members.”
The circular was signed on behalf of the health minister, Osagie Ehanire, by the director of hospital services, Adebimpe Adeniyi.
“You are to compute the financial implication of the ‘no work no pay’ from the salaries of the resident doctors and any other health worker that participated in the strike using the attached template and forward same to the IPPIS office through the FMOH for the implementation with immediate effect from August 2nd, 2021.
“This directive is in line with the provisions of the section 43(I)(a) of the trade dispute act which inter alia states… “where any worker takes part in a strike, he shall not be entitled to any wages or remuneration for the period of the strike and any such period shall not account for the purpose of reckoning the period of continuous employment and all right dependent on continuity of employment shall be prejudicially affected accordingly…” the circular added.
In a communique jointly signed by the union’s president, Uyilawa Okhuaihesuyi; the Secretary General, Jerry Isogun, and the publicity secretary, Dotun Oshikoya, the publicity secretary, the association said its NEC unanimously voted that the ongoing strike should continue.
The communique said the NEC took the decision after observing with dismay that despite the express instructions given by President Muhammadu Buhari to the ministry of health to “side step all technicalities in resolving the issues of dispute between us and the government, not one item in the table has been resolved.”
The NEC said it was also embarrassed by the misinterpretation of the court ruling by the federal ministry of labour, “thereby misinforming the public that the National Industrial Court had ordered that the strike should be suspended.”
According to the communique, made available to PREMIUM TIMES on Thursday night, the NEC said it was disappointed but not surprised at the Governor of Abia State for failing to offset the 19 months salary arrears being owed “our members in his state, which he promised to pay over 23 days ago..
The communique added that; “We also frown at the actions of the governors of Imo, Ekiti and Ondo states who are still owing our members 10 months, 6 months and 4 months salaries respectively.
“After critical appraisal of the actions of both federal and state governments on all the issues affecting the welfare of our members as observed above and the perpetual insincerity from governments as evidenced by the reckless interpretation of the ruling of the National industrial court of Nigeria, NICN, the NEC unanimously agreed via vote to sustain the ongoing industrial action until all demands are met as contained in the MOA signed more than 140 days ago and the recent MOU signed between the government and the NMA.
“The NEC reiterated her position that the circular from the head of service removing house officers from the scheme of service be withdrawn.
“The NEC demanded that an emergency meeting of National Health Council on health be convoked to discuss these emergencies and to fashion out ways to universally resolve the state health institutions in the country.”
Doctors set to flee
Meanwhile, hundreds of medical doctors across the country during the week besieged Sheraton hotel in the federal capital territory, to be part of a process to relocate to the kingdom of Saudi Arabia, where they said the working conditions would be better than what they currently experience in Nigeria.
The recruitment exercise was organised by Meeds Consultants, a consultancy firm for doctors willing to work abroad.
The Abuja-based firm organised the interview on behalf of the Saudi Arabia Ministry of Health, a development that angered many Nigerians, leading to accusations of irresponsibility levelled against the government.
Some of the applicants, who spoke to journalists, described their decision as the last resort, adding that the poor welfare conditions of Nigeria’s health workers forced them to change their loyalty to a nation they so much love.
Migration not new – Labour Ministry
But the Nigerian labour ministry said it is unmoved by the exodus of Nigerian healthcare workers abroad, even when the ministry denied it was officially aware of the recruitment exercise by the Saudi authorities.
Reacting, the spokesperson of the labour ministry, Charles Akpan, said the recruitment of Nigerian professionals by foreign countries is a normal phenomenon and that the government has no power to to stop it.
“We cannot ask anybody not to seek opportunities outside the country. It is their right and there is nothing wrong with that,” he told PREMIUM TIMES’ reporter on the phone.
“It’s not just in the medical profession. In the petroleum sector and others, foreign companies recruit professionals from Nigeria. So it’s a normal thing.”
On whether the situation would further cause more damage to the health sector that is already in a crisis, the official said he could not comment on that as the development is yet to be made official.
Calls and texts to Segun Adetola, the spokesperson of the health ministry for response over the development were neither returned nor responded to.
Meanwhile, Mr Okhuaihesuyi expressed displeasure in what he described as the government’s inactions by allowing medical professionals snatched away from Nigeria to other climes.
He said; “I will not discourage any of my members attempting to write the exam because the government, through the federal ministry of health, is not serious about keeping out doctors in Nigeria. Nevertheless, I am not happy as a Nigerian because of the effect of this in future.
“The interview was planned even before we embarked on strike. The government’s reaction to the strike only increased the number of applicants present for the interview.
“NARD, under my leadership, has worked hard to discourage brain drain… We have also provided alternative sources of income through our tele-health programme and alleviate members’ suffering by pushing for abolishment of bench fee but the government and minister of health have rubbished all our hard work with their insensitivity to my members welfare.”
On his part, the president of the Nigeria Medical Association (NMA), Innocent Ujah, in a statement, said it is difficult to say the exact number of doctors currently practising in the country as they continue to leave in droves daily.
The NMA spokesperson, Emeka Akpa, told our reporter that the organisation is aware of the recent recruitment exercise but is yet to officially take a position.
Prior to the recruitment exercise the consulting firm had circulated a flier online about the recruitment details, schedule and processes.
According to the invitation, the specialties that will be interviewed for employment include anesthesia, ICU, paediatrics surgeon, family medicine (consultants only), obstetrics and genecology, ENT, Emergency medicine, all subspecialties (surgery), all subspecialties (internal medicine), orthopedic surgery, Ophthalmology, Radiology as well as Haematology and Histopathology.
The invitation also listed requirements such as originals and photocopies of all credentials; updated CV with chronologically detailed summary of experience, two passport-sized photographs and a valid form of identification.
Efforts made by our reporter to reach the firm on the telephone line on its website did not yield results as the line did not connect.
An enquiry posted on the website has also not been replied to.
Meanwhile, another recruitment of flyer for medical registrars willing to relocate to Saudi Arabia is also circulating online.
Medical registrars are senior doctors above house officers but below consultants.
Doctors vs government
In the first week of the strike, the labour minister, Chris Ngige, on August 6th while appearing on a Channels Television’s programme – Politics Today – said he had invoked the ‘no work, no pay rule,’ against the striking doctors, saying “they were taking the country for a ride.”
The health minister, Osagie Ehanire, would later back the application of the rule, noting that the ‘No Work, No Pay’ rule isn’t a punitive measure against the striking doctors but an implementation of the provisions of law.
He said embarking on an industrial action in the middle of an outbreak is “unconscionable.”
But the leadership of the striking NARD rebuffed the threats, insisting on continuing the strike until the 12 demands they made are fully met.
A marathon meeting held last weekend between the NARD leadership, the NMA and the federal government among other concerned parties did not reach a conclusive end to the crisis just like previous negotiation attempts.
While the NMA signed a memorandum of understanding (MoU) with the government aimed at meeting the demands of the junior doctors, the NARD backed out of the agreement.
Attempts to compel the doctors to return to their duty posts through the National Industrial Court (NIC) sitting in Abuja also failed as the presiding judge, John Targema, for the second time on Monday, refused to grant the government’s application on the grounds that he could not issue such a restraining order against the resident doctors in their absence.
Patients suffer consequences
While the federal government and the striking doctors continue to bicker, patients who throng public health facilities get little or no care.
Medical residents, doctors practising to become specialists, make up the larger number of the medical workforce across federal and state health facilities.
Therefore, their recent strike, the fourth and the longest since the COVID-19 pandemic began, has relatively paralysed the health system, with the patients bearing the brunt.
Most hospitals have long stopped admitting new patients while those on admission are sent home or directed to private health facilities.
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