Despite public appeal, the Nigerian Medical Association (NMA) has embarked on an indefinite nationwide strike from today over some grievances against the Federal Government, thereby revisiting total withdrawal of services suspended on January 5, 2014.
Recall that two weeks ago, the NMA gave the Federal Government 14 days ultimatum to meet her demands through a letter dated June 11, 2014, addressed to the Secretary to the Government of the Federation .
In the letter, signed by NMA’s National President, Dr Kayode Obembe,  the association noted that the post of Deputy Chairman, Medical Advisory Committee (DCMAC) has been circularised and operational. “Rather than abolish it, the NMA hereby demands that four DCMACs for teaching hospitals and three for the Federal Medical Centres be appointed forthwith to assist the CMACs, whose statutory responsibilities are too heavy for any single individual to handle. Directors in other government agencies are supported by several deputy directors; why not the CMAC who is also a director? Such a DCMAC must have same qualifications as the CMAC,” the letter read in part.
Obembe said  the NMA was opposed to the appointment of directors in the hospitals. According to him, this distorts the chain of command in the hospital, induces anarchy and exposes the patient to conflicting treatment and management directives with attendant negative consequences.
“The NMA demands that Grade Level 12 (CONMESS 2) in the health sector must be skipped for medical doctors. Consequently, no medical/dental practitioner should be on that grade level anymore,” he said.
The NMA also argued that the title, “consultant,” in a hospital setting describes the relationship between the Specialist Medical Doctor and his patient. The association stated that it would be a source of confusion if the title was applied to any other health worker, who statutorily does not own a patient. “NMA therefore, declares with unmitigated emphasis that if ‘non-doctor consultants’ are appointed, it will lead to chaos and anarchy in the health sector. This should not happen.
“ Relativity in the health sector is sacrosanct. The NMA hereby demands for immediate implementation of the January 3, 2014 circular. The NMA also demands the immediate payment of the arrears of the corrected relativity for 22 years, during which her members were short changed.
“Much as we are not against salary increase for any category of workers, either in health or elsewhere, the NMA demands for immediate adjustment of the doctors’ salary to maintain the relativity as agreed and documented once CONHESS is adjusted,” it stated.
“ Also the NMA urged the government to expedite the passage of the National Health Bill (NHB) and extend Universal Health Coverage to cover 100 per cent of Nigerians and not 30 per cent as currently prescribed by National Health Insurance Scheme (NHIS).
Also, it demanded for immediate withdrawal of the CBN circular authorising the Medical Laboratory Science Council of Nigeria (MLSCN) to approve licenses for the importation of In-Vitro Diagnostics (IVDs).
“ Immediate release of circular on retirement age for Medical Doctors as agreed with the Federal Government (FG).”
Doctors said  the Federal Government through the Federal Ministry of Health should formalise and implement the report of the interagency committee on residency training as well as release the uniform template on appointment of Resident Doctors in line with earlier agreements. “Moreover, a concrete Funding framework for residency training must be established. The Overseas clinical attachment must be fully restored and properly funded  in the interest of the nation.”
They said that in the interest of harmony in Federal Medical Centre, Owerri, the government “should pay the salaries of our members in the centre as agreed on 21^st October, 2013.
“Immediate concrete steps must be put in place for the reintegration of our members back into the IPPIS platform.
“ All attempts to coerce house officers not to join NARD must stop.
“ The orchestrated intimidation, harassment and physical assault of our members in departments of Pathology (Laboratory Medicine) by Laboratory Scientists which is being tolerated by the Federal Ministry of Health (FMOH) must stop.
“The Endless circle of incomplete salary payment to our members in many hospitals in the name of shortfalls in personnel cost must stop.
“ Universal applicability of all establishment circulars on the remuneration and conditions of service for doctors at all levels of Government must be guaranteed.”
The NMA said government should as a matter of urgency set up a health trust fund that will enhance the upgrading of all hospitals in Nigeria.
They demanded that the position of Chief Medical Director/Medical Director must continue to be occupied by a Medical Doctor as contained in the Act establishing the tertiary Hospitals. “This position remains sacrosanct and untouchable.
“Why did they not ask that the post of vice chancellor be open to everyone in the university since ASUU and SANU are made up of graduates
“Can you be a judge of the High Court or Court of Appeal if you are not a lawyer?
“Why do they think the hospitals where lives are saved everyday should sacrifice the established leadership i.e. Chief Medical Director?,” Obembe queried.
“The NMA henceforth shall not accept the continued violation of any of the terms of the 2009 Collective Bargaining Agreement. This is exemplified by the payment of Medical Physicists and Optometrists with OD (who are on CONHESS) call duty allowance using the CONMESS Circular. Similarly, the phrase “Ministries, Departments and Agencies” (MDA) in the said agreement should replace “Federal Ministry of Health and other Federal Health Institutions” as contained in the 2009 CONMESS circular.
“In the light of the fore-going therefore, the NMA hereby asks government  to meet all her demands as stated above or have her members called out for a resumption of the total and indefinite withdrawal of service suspended on 5^th January 2014.
“The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted.
“We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent.
“We hereby appeal to all Nigerians for their understanding and to press on Government to meet with our demands to avoid the strike which is scheduled to start on the 1^st of July 2014 (today) from 00.10 hours GMT,” Obembe stated.

Doctors begin nationwide strike