NMA and Her Egocentric
Demands: The Height of Gross
Lawlessness, Impunity and Blackmail
In an open letter written to the secretary to the
Federal Government of Nigeria, Senator Anyim Pius
Anyim, on the 10th of June and sent to him on the
11th of June 2014, the Nigerian Medical
Association (NMA) under the leadership of Dr.
Kayode Obembe as President and Dr. Adewumi
Alayaki as secretary had written 24 demands that
must be urgently met. They have given the
Government a 14-day ultimatum, failure of which
NMA would call her members out on an indefinite
strike nationwide. NMA is made up of ASSOPON-
Association of Pathologist of Nigeria, MDCAN -
Medical and Dental Consultants of Nigeria, ARD-
Association of Resident Doctors and smaller sister
Associations, who are doctors in public and private
practice.
For many years, Allopathic Medical Doctors in
Nigeria have always hoodwinked the Government
and the general public, through falsehood and
blackmail. They have coerced the Government to
take unfavorable decisions which have always been
detrimental to the health sector and the Nigerian
populace. They have continually done this as a
result of the structural injustice that has been
perpetuated by many members of NMA in high
places in Government. They undermine the laws
setting up the hospital system, the Public Service
Rules and above all the constitution of the Federal
Republic of Nigeria.
At this juncture let us have a critical look at those
demands.
(1) APPOINTMENT OF THE POST OF THE DEPUTY
CMAC IN HOSPITALS. In line with the University
Hospitals (reconstruction of boards) cap U15, LFN
2004 commonly called decree 10 of 1985 which
governs Hospital practice in Nigerian, there is the
office of the CMAC but it never provided for the
office of the DCMAC. In section 4, it provides thus;
“there shall be for each Hospital, a Chairman of the
Medical Advisory Committee who shall be
appointed by the Board and responsible to the
Chief Medical Director for all the Clinical and
Training activities of the Hospital”. Section 2i
provides that; the CMAC is a member of the board.
There is no place in the organic law setting up the
hospital that created the office of the DCMAC and
there is no place it says that only Allopathic
Medical Doctors should be appointed as such. Yet
NMA is insisting that the Government must appoint
four DCMAC in every Teaching Hospital and three
in every Federal Medical Centre. All along, Boards
of Hospitals as a result of threats from NMA have
been allowing this illegal office to be used to
undermine statutory approved Scheme of Service
of other professional groups. The Public Service
Rule in section 1-general in 160101 provides; ‘A
Parastatal is a government-owned organization,
established by statutes to render specified service
(s) to the public. It is structured and operates
according to the instrument establishing it and also
comes under the policy directives of government.
In line with 160201 (a) statutory boards/council
shall set operational and administrative policies in
accordance with government policy directives and
supervise the implementation of such policies. A
situation where Allopathic Medical Doctors in
Nigeria wants the Government to continue to
create post and responsibilities not backed by
statutes undermines the principles of good
governance. It is gross violation of the law setting
the Government owned institution. Moreover, it is
trite law that you cannot add to a statute. That will
be ultra verse.
(2) NMA IS OPPOSED TO THE APPOINTMENT OF
DIRECTORS IN HOSPITALS. It should be noted that
this statement is laden with deceit as postulated
by NMA, that having Directors in hospitals will
affect patient care negatively. This is fallacy of the
highest order. The truth of the matter is, NMA does
not want professional departments as directorates
in the various Scheme of Service, rendering
professional duties like the department of
Pharmaceutical Services headed by the Director of
Pharmaceutical Services who is a Pharmacist.
Department of Nursing Services under the Director
Nursing Services, who is a Nurse. The Department
of Medical Laboratory Services under the Director
of Medical Laboratory Services, who is Medical
Laboratory Scientist etc.And all are answerable to
the Chief Medical Director. It should be noted that,
NMA and her members were the ones who
negotiated their present Scheme of Service that all
their members can rise to level 17 without being
called Directors. Other Healthcare Personnel have
continued to follow their own Scheme of Service
where only one person gets to level 17 and is
designated the Director, which is the most popular
path in the Public Service. Again in the criteria for
employment as stated in the Public Service rule in
020205,-“to be eligible for appointment into the
federal Public Service, every applicant must
020205(e) possess requisite qualification as
provide in the Scheme of Service.” The Scheme of
Service of all other Healthcare Personnel in the
hospital provides for a Directorate system. Now
NMA and her members want to go on strike for
Government to jettison the Public Service Rule
which is a Government Policy Document. The
Scheme of Service for Allopathic Medical doctors
provides for a non Directorate system. AND NO
PROFESSIONAL GROUP IMPOSES HER OWN
SCHEME OF SERVICE ON THE OTHER. SECONDLY
NO EMPLOYEE DETERMINES THE CONDITION OF
SERVICE OF ANOTHER EMPLOYEE. They are
agitating for this in order to entrench professional
imperialism, so that all other healthcare staff will
not reach the zenith of their career. That is the
singular reason, a doctor on level 15 is called a
Head of Department heading someone already on
level 17 and is designated a Director .This is gross
absurdity against the Public Service Rule. There is
no Government Institution in Nigerian where such
is seen, only in our Hospitals. And that is what
NMA wants to perpetuate. Rule 160103 of the
Nigerian Public Service Rule provides –“Parastatals
are to retain and improve existing rules,
procedures and practices in their establishments
and ensure that there are no deviations from the
general principles contained in the Public Service
Rules………………………………however in the absence of
internal rules and regulations on any matter, the
relevant provisions of the Public Services Rule
shall apply”. This can also be seen in section 5(5)
and 17 of the act governing hospital practice in
Nigeria. NMA’s demands are anti- Public Service
Rule.
(3) NMA DEMANDS THAT GRADE LEVEL 12
SHOULD BE SKIPPED BY DOCTORS.
This demand is not in line with Government
approved Scheme of Service for Doctors.NMA in
her usual falsehood has always accused JOHESU
members of skipping when in actual sense there is
nothing like that. The term is a misnomer this is
because skipping is when a Civil Servant moves
from a grade level to a higher grade level that is
not provided for in the Scheme of Service e.g.
when a worker moves from 8-10 and there is no
approval for such a special promotion ,this is
skipping. But when you move from 10- 12 this is
not skipping because this is provided in the
Scheme of Service and there is no level 11 in the
Scheme of Service. A baby physician enters the
Service on level 12, which is a principal grade.
Now NMA is insisting that they must be appointed
on level 13, which is an Assistant Chief Cadre.
Haba! How can a beginner enter the Civil Service
on an Assistant Chief Cadre? There is no Nigerian
worker that enters the Service on such grade.
There is no Nigerian Civil Servants that skips. This
is not provided in any known Nigerian scheme of
Service.
(4 ) APPOINTMENT OF OTHER MEDICAL
PERSONNEL AS CONSULTANTS.
NMA is threatening to go on strike because the
Government has chosen to obey Court judgment in
favour of other Health Personnel that they can also
be appointed as consultants in their chosen field.
In a false sense of well being, NMA insists that
they own the patients and as such only the
medical doctor can be called a Consultant. Nobody
owns the patient; rather the patient is the epi-
centre of Healthcare Service. Medical doctors are
just one of the professional skilled healthcare
attendants in a hospital, attending to the healthcare
needs of the patient. Each medical personnel are
given a license to practice their chosen field. The
various scheme of Service for Pharmacists,
Physiotherapist, Nurses, Medical Laboratory
Scientists etc provides that they can be appointed
as consultants. All over the world, it is not only
Allopathic Medical Doctors that are appointed as
consultants. A simple google search will show that
there are different consultants in the Health Field.
The word consultant is not an exclusive term to
designate Allopathic Medical Doctors who are
specialists. William A .Cohen, PhD, in his
bestselling book “How to Make It Big as a
Consultant” has this to say on pages 2 and 3.
“Consultants operate in many different fields.
Import-export, management, human resources,
engineering, and marketing are some of the more
common ones. There are consultants in
archeology and consultants in clothes selection.
There are even consultants to help authors
overcome writer’s block.” On page 3 he has this to
say. “A consultant is simply anyone who gives
advice or performs other services of a professional
or a semiprofessional nature in return for
compensation”. NMA wants to stop working
because other Healthcare Personnel are appointed
as consultants. Is NMA saying that they are the
only Professionals in the Health Field?
(5) RELATIVITY IN HEALTH SECTOR
On what basis is NMA still agitating for relativity
when at the point of entry this has been taken care
of and resolved based on the number of years one
spends in school. Those who spend four years
have their entry point as level 8,those that spend
five years on level 9 ,those that spend five years
with one year of internship on level 10,while those
that spend six years with one year internship on
level twelve. The agitation for the so called
relativity is discriminatory and violates the Nigerian
Constitution as stipulated in section 34-(1). NMA
insisting that this must be sacrosanct in the Health
Sector is on what basis? It should be noted that
members of NMA are just employees of the
Government, just like every other Civil Servant, and
as such no employee determines what another
employee is to be paid. It is never done anywhere
in the world. This is a sense of megalomania, and
so this jack of all trade mentality must stop.
(6) NATIONAL HEALTH BILL.
NMA is calling for the implementation of the
National Health Bill which has been shown to
contain a lot of clauses that are anti-people. Many
professional Associations, Civil Societies and well
meaning Nigerians have called for the removal of
these obnoxious sections of the Bill. But NMA in
the bid to actualize her set selfish agenda has
refused to give good reason a chance. Again some
part of the Bill undermines the Nigerian
Constitution in use in a Federal System of
Government. No Nigerian Health Worker is against
having a Health Bill but all we are saying is that in
order to meet Government set objectives to
enhance the total wellbeing of the citizenry the
obnoxious sections has to be expunged.
(7) THE APPOINTMENT OF SURGEON GENERAL.
This office is not created by law. There is no
Nigerian statute that says that we must have the
office of the Surgeon General. Creation of this office
will lead to more agitation and anarchy in the
Health Sector which is already polarized. Every
professional group will be agitating for the creation
of X-general, e.g. Pharmacist general, Nurse
general, Optometrist general, Radiographer general,
Physiotherapy general, Dietician general; Medical
laboratory scientist general etc. The creation of this
post will lead to more problems in the health
sector. Secondly of what role and benefit is the
office of the Surgeon general when we already have
two Ministers of Health and there are many
Directors also having such functions?
( THE ENTRY POINT OF HOUSE OFFICER TO BE
ON COMMESS 1 STEP 4
This level is equivalent to grade level 10 steps 4.
On what is this agitation predicated on, when such
entry point is not supported by any Scheme of
Service, used as one of the criteria for appointment
into the Public Service of the federation? It should
be noted that house officers are intern or Pupil
Medical Doctors. There is no intern in Nigerian that
enters the service on step four. Moreover, steps
are indicators of the level of experience or years
the person /officer have spent on that grade level.
On what criteria is a neophyte/green horn in his
profession placed on step four? What you have is
either step one or step two. Government should
not accede to this demand that undermines ethical
procedural practice in the Public Service.
(9) CLINICAL ALLOWANCES FOR HONORARY
CONSULTANTS TO BE INCREASED BY 90% OF
CONMESS.
Early this year, under the immediate past President
of NMA, Dr Enabulele, NMA had had an upward
salary increase for their members. Not up to 5
months, NMA is now calling for another bloated
allowance. Note that consultants are meant to
render quality service as Attending Physicians, but
what do we see daily in our hospitals? Most of the
times, the “consultants/honorary consultants” are
never around. Yet they want to be paid such a
jumbo allowance. Those that are around, work four
times in a month, having one clinic day in a week.
(10) NMA, with the huge sum they are paid, still
wants adjustment in their specialist allowance to
be paid to all doctors on CONMESS 3 and above,
and must be paid its equivalent that is not less
than 50% higher than what is paid to other Health
Workers. How can NMA be the one to decide what
other Health Workers get? NMA should go and read
the Parable of one Talent Payment.
(11) NMA is calling for Government to pay her
members 100,000 naira every month as just
hazard allowance. How can NMA be demanding for
such, despite all she is already receiving? She is
being too selfish/greedy in her demands. Even
other workers with worse occupational hazards are
not receiving such.

Double post.

(12) NMA insists on immediate
release of circulars on rural
posting, teaching and other
allowance which must include House Officers.
Since 2009 NMA and her members have been
collecting teaching allowance even though that
teaching allowances as approved by the
Government was for very Senior Medical Doctors
(Consultants and very Senior Registrars)that are
involved in teaching of doctors in training,
especially the junior and senior interns. House
officers are the junior interns while Resident
doctors are senior interns doing a student
fellowship to become a specialist .Now NMA is
agitating that the interns who are still doctors in
training should be paid teaching allowance. House
officers and resident doctors by government
circulars are not entitled to this payment; it is
because of them that Government is paying the
teaching allowance. How can the doctor in training
be asking for teaching allowance when he is a
trainee, and who is he teaching? Since the
approval in 2009 and full implementation in 2010,
House Officers and Resident Doctors who are NMA
members, have been fraudulently collecting huge
monthly teaching allowances which they are not
entitled. There is no government circular or
template that approved such payment. It was in
this year 2014, that the Government through the
Call Budget Circular from the Ministry of Finance
opposed and stopped the payment of teaching
allowance to interns. For five years members of
NMA who were not entitled to teaching allowance
have been defrauding the Government. He who
comes to equity must come with clean hands.
(13) NMA calls for immediate withdrawal of CBN
circular authorizing the Medical Laboratory Science
Council of Nigerian (MLSCN) to approve licenses
for the importation of in vitro diagnostics (IVDS). It
is so petty that NMA is going on strike because the
Federal Government (which means well for
Nigerians), has taken the bull by the horn to
making sure that fake/ substandard diagnostic
consumables are removed from the system, by
effectively empowering MLSCN-the Agency who
has the statutory function to do this job. Sections
4b, and 4e of MLSCN act 11 2003 provides- the
function of the board are
(B) Regulate the Practice of Medical Laboratory
Science in Nigerian.
(c) Regulate the production, importation, sales, and
stocking of diagnostic reagents and chemicals.
Section 19 of the MLSCN act mandates MLSCN
Board to also make rules. Section 19(d) goes
thus-the board may make rules for the
maintenance of good standard of Medical
Laboratory practice and services with respect to
the regulation and control of private practice
including statutory inspection, approval, and
monitoring of all Medical Laboratories including
those adjoined to Clinics, Private and Public Health
Institutions. Instead of NMA to partner with MLSCN
to kick fake diagnostics out of Nigeria, she is out
there encouraging quackery and fighting a lost
battle by being anti-Establishment.
(14) NMA wants immediate release of circular on
retirement age. Dear Nigerians by increasing
retirement age from 60 to more years how will it
bring better productivity in the health sector? When
within the next ten years of a doctor starting
work ,he can get to the zenith of his career which
work will he be doing? And when most of our
consultants are part time doctors because they
work and have Clinics days only once a week.
(15) NMA , Residency and Oversee Training.NMA
should look inwards and stop hiding under
residency and oversee training to encourage
medical tourism and waste of tax payers money.
For self reliance and self determination the Alma
Ata declaration has a lot to help a young economy
like Nigeria. Health has a lot to do with socio-
economic indices. Diseases in the tropics are not
the same as in the temperate region. Alma Ata
declaration of 1978, encourages young economies
to look inwards locally in providing healthcare at
low and affordable manner. All over the world it is
not only one group in the health field that does
residency. Veterinarians, Podiatrist, Medical
Physicist, Optometrist, Pharmacist, Physical
Therapist, Doctors of Ethnomedicine, Doctors of
Holistic Medicine, Doctors of Natural Medicine etc
all have residency program. Yet none of these
group in Nigeria have gone on strike because of no
oversee residency program. A privilege is not a
right. There is no government law that says that
Allopathic Doctors can only become good doctors
only when they go oversee.NMA should stop
encouraging this mentality that anything African is
inferior.NMA should know that what they are
asking is not part of the rules of engagement. This
is the time for more humane and humble request.
Indian doctors are becoming one of the best
doctors in the world not because they are looking
overseas but because they are looking inwards.
(16) NMA insist on payment of salaries of her
member in Owerri. Her members should also meet
part of their own responsibilities and agreement as
workers. NMA must learn to obey constituent
authority, and must make her members to be
amenable to discipline.
(17) NMA members and IPPIS platform. NMA has
always shown double standard on this issue.
Before now, members of NMA went on strike
because of the Government policy that all worker
must be on IPPIS platform. How come it is now
that NMA is just waking up from sleep, to say that
if her members are not on IPPIS she will call her
members for indefinite strike? The Government
policy is that if you are not on a pensionable
appointment you cannot be on IPPIS. So how can
house officers and residents be on IPPIS when
their appointment is not permanent? Moreover the
2014 Call Budget Circular from the Ministry of
Finance provides that you cannot hold more than
one appointment and be placed in two places
under IPPIS platform. When IPPIS came many
members of NMA opposed it because it did not
allow them to be on Government pay role in two
places.
(18) NMA wants to go on strike because House
Officers are said not to be part of NARD-National
Association of Resident Doctors. The big question
here is, are house officers also paid the same as
their senior residents? In as much that the House
Officer is a junior resident while the doctor in
training to become a specialist is a senior resident
the duo cannot be part of any strike action even
with their consultants, because they belong to an
Association and not a trade Union.NMA is only
calling for House Officers to be part of NARD for
them to be part of their numerous illegal strike
action.
(19) NMA accuses Medical Laboratory Scientists of
harasment.NMA has shown herself that she is a
Joker. The world knows that it is the other way
round. That it is members of NMA that are
harassing Medical Laboratory Scientists in
Nigerian. The number of Medical laboratory
Scientist that NMA members have instigated their
sack/termination of appointment/suspension is
worrisome. But thanks are to the Most High for the
Judiciary who brings hope for the common man,
by setting aside most of the sack/termination/
suspension. Medical laboratory Scientists are
people who do not act on impulse, or with
impunity. Why is NMA resorting to self help when
issues she has with members of Association of
Medical Laboratory Scientists of Nigerian are in
court? Why is she the judge in her own case? The
spirit of Medical Laboratory Scientists can never be
broken. We shall always move with great
crescendo to protect patients’ interest and the
public at large, despite the provocation and
lawlessness that is being perpetuated by members
of NMA in the Health Sector. The laws of the land
shall be our strength, for he who holds the mace
of truth and justice can never falter. We cannot be
intimidated by her Goliath posturing.
(20) NMA says-‘the endless circles of incomplete
salary payment to our members in many hospital
in the name of short falls in personal cost must
stop’. This is the only legitimate demand out of
the 24 demands by NMA because the labourer is
worthy of his wages. But NMA cannot call her
members out for strike based on this, because she
is not a registered Trade Union but a charity. This
problem is not peculiar to only Allopathic Medical
Doctors but to all personnel working in the Health
Sector.
(21) NMA in her number 21 demand states
‘universal application of all establishment circulars
on remuneration and condition of service for
doctors at all levels of Government must be
guaranteed’. NMA is not justified here, because
this borders on Constitutional Matter. And the
Central Government has some limits to want they
can impose on the State, bearing in mind that we
are practicing a Federal System of Government,
where power is shared among the three tiers of
Government, the Federal, State and the Local
Government. NMA members should come to terms
that they are the employee and not the employer. It
is very interesting to note, that NMA who
champions the lost battle, insists that the approved
Scheme of Service/circulars of other healthcare
workers will never be implemented is the one now
agitating that even things not given by any
Scheme Service/circular must be implemented.
(22) NMA demands that Government must urgently
set up a health trust fund that will enhance the
upgrading of hospitals.NMA is being sentimental
here, the problems of our hospital is not funding
but mismanagement and accountability. Even if the
Government sets 100 trust funds with billions of
naira much will not come out of it, because the
hospitals are managed contrary to Government
laws and principles. Hospital/health administrators
should be the ones to head and manage the
hospitals. Our hospitals have been poorly
managed under the leadership of Allopathic
Physicians. When there is good management and
accountability Government set goals/objectives
can be actualized.
(23) APPOINTMENT INTO THE OFFICE OF THE CMD/
MD.
NMA is always doctoring and adding to organic
laws. In her 23rd demand, NMA stated “the
position of the 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.” I can beat my chest
and say that the leadership of NMA have never
seen nor read the content of University Teaching
Hospitals (reconstruction of boards) cap U15, LFN
2004 commonly called decree 10 of 1985.There is
no where it stated what NMA quoted above. In fact
the term medical doctor was never used in that
document or Act. Section 5 of the act provides;
(1) There shall be for each hospital a Chief Medical
Director who shall be appointed by the president
on such terms and conditions as may be specified
in his letter of appointment or as may be
determined from time to time by the Federal
Government.
(2)The Chief Medical Director shall
(a)Be a person who is medically qualified and
registered as such for a period of not less than 12
years, and has had considerable administrative
experience in matters of health and holds a post
graduate medical qualification obtained not less
than 5 years prior to the appointment as chief
medical director and
(b)Be charged with the responsibility for the
execution of the polices and matters affecting the
day to day management of the affairs of the
hospital.
In the afore-mentioned Act, there is no place it
said that the person must be a Medical Doctor.
The International best practice is that, it is not only
Medical Doctors that head Hospitals rather, in most
places; it is a qualified hospital/health
administrator that manages the Hospital. If you do
a search on the internet on the criteria to become
a truck driver in USA, note that you will see that it
says that the person must be medically qualified.
So does being medically qualified here mean that
one must be a medical doctor to be a truck driver?
The capital answer is “no”. It means being
medically fit. The term medically qualified as used
in the act has been misinterpreted to mean a
holder of a certificate registrable by MEDICAL AND
DENTAL COUNCIL OF NIGERIA.(MDCN). Currently
there is a case instituted in the Federal High Court
Awka by Comr. A. A Obi a distinguished Medical
Laboratory Scientist and the suit number is FHC/
AWK/CS/38/2013.The suit is to interpret the
meaning of who is medically qualified as used in
section 5 of the act. So why is NMA and her
members jumping the gun to go on strike on an
issue before the Court is that not subjudice? All
along NMA has used acts of impunity to
undermine the rule of law. The organic law did not
say the person will be a Medical Doctor or be
registrable with MDCN even though all adverts for
the posts of CMD/MD have come to illegally say
so.
It is lucid that from the foregoing, certain questions
arise. Can NMA as an Association declare and call
for strike, when it is not a Trade Union? Is NMA
above the law, that it can undermine the provisions
of the Constitution of the Federal Republic of
Nigeria, by trampling on the code of conduct for
Public Officers as stated in the constitution?
Section 2 subsections 1,2 and 3 of the Trade Union
Act, states “A trade union shall not perform any
act in furtherance of the purpose for which it has
been formed unless it has been registered under
this act……………..”
section 2 subsection 2-where a trade union
registered under this act ceases to be registered, it
shall not there after perform any action in
furtherance of this purpose…………….
section 2 subsection 3-if any act which is
prohibited by section (1) or (2) of this section, is
performed by a trade union, then
(a)The Union and every official thereof; and
(b) Any member thereof who, not being an official
thereof, took any active part in the performance of
that act, shall be guilty of an offence against this
act.
NMA is not a registered Trade Union, so she
cannot be doing this, entrenching sabotage and
acts of impunity against the State. Above all,
endangering the lives of the citizens, she swore on
oath to protect. A situation where NMA is going on
strike as a result of these frivolous demands is
gross misconduct and acts of negligence. Section
3 of 030301( h) of the Public Service Rule terms
negligence as a misconduct.030402 (e) terms
absence from duty without leave as serious acts of
misconduct. Sabotage in 030402(t) is also stated
as serious misconduct. Section 33(1) of the
Nigerian Constitution 2011 as amended provides
every person has a right to life and no one shall be
deprived intentionally of his life………section 172 of
the same Constitution states “A person in the
Public Service of the Federation shall observe and
conform to the code of conduct of the Federation “.
The fifth schedule part 1 code of conduct for Public
Officers says:
(1) A public officer shall not put himself in a
position where his personal interest conflicts with
his duties and responsibilities.
(9) A public officer shall not do or direct to be
done, in abuse of his office, any contrary act
prejudicial to the rights of any other person or
contrary to.
It is so glaring that what NMA is asking is
prejudicial and tramples on the rights of Nigerian
Citizens.
(24) IN her 24 demand NMA forgot that she is an
employee of the Government and it is not for her
to dictate on how Optometrist or Medical Physicist
should be paid. Nigeria is not Govern by the
whims and caprices of NMA but by laws and
polices made by the Government.
CONCLUSION.
NMA and her members are not justified on going
on strike. The only reasonable demand is demand
number 20 haba! A student who scored one out of
twenty four is not doing well at all. NMA members
should know that as workers they have duty of
Fidelity, they as Civil Servants are bound to only
obey rightful orders from NMA. They also have
duty of care and skill to the patient. And above all
their loyalty/allegiance is to the Nigerian state. A
situation where NMA gives her members unlawful
orders undermines the rule of law and as such,
such orders cannot hold sway.
NMA has become a fifth columnists working
against the state. It is sad that NMA and her
members who have benefitted so much from the
state are now turning themselves against the
Nigerian state to become the killer of the Nigerian
People, instead of being the Physician who is to be
the healer of the patient and people. Nigerians
must rise and say no to this medical imperialism
by using the instrumentality of the law to stop
NMA from inflicting untold hardship on her
citizenry. The Federal Government through the
Ministry of Health under Prof Onyebuchi CHukwu
must act to maintain law and order, now that NMA
has told the world that it is because of some of the
things She granted to JOHESU on merit, is the
reason NMA is going on strike. She should seek an
injunction restraining NMA from going on strike
just as he did to JOHESU, pending the
determination of the motion on notice to know if
NMA has the locus standi to go on strike when she
is not a Trade Union. JOHESU should be firm to
seek a legal redress to restrain NMA in this acts of
lawlessness,if the Government does not act.There
must be a total restructuring of the Health Sector.
All Nigerians from all works of life must condemn
these acts of sabotage against the State by
doctors of Allopathic Medicine under the auspices
of NMA. The Nigerian Government as a matter of
urgency should support the Natural Medicine
Development Agency Kofo Abayomi Victoria Island,
to reposition our Traditional Medicine to be like
what is seen in China, USA, U.K, India, Korea etc.
And it should be integrated into the mainstream
Healthcare System in Nigeria.
Allopathic Monopolistic Medicine should give way
to Pluralistic Medicine. Government should create
an enabling environment for the practice of the
different Medical Systems like, Functional Medicine,
Holistic Medicine, Ethnomedicine, Ayurvedic
Medicine, Homeopathy, Osteopathy etc. All over
the world, no country is currently solely dependent
on one Medical System. Nigerians must say no to
NMA that has become anti people. The Nigerian
Government should not allow herself to be
blackmailed by NMA. She should first and foremost
challenge NMA for acts of impunity against the
state. The federal Government should take a leaf
from Governor Fashola of Lagos State, for enough
is enough. The Government should also take a
queue from the former governor of Anambra state,
Mr Peter Obi
BY BENJAMIN CHUKWUNONSO AJUFO


www.medicalworldnigeria.com/2014/06/nma-and-her-egocentric-demands-the-height-of-gross-lawlessness-impunity-blackmail-by-benjamin-chukwunonso-ajufo-part-2

Frontpage material. Let the whole world know that these doctors are selfish. The FG should not concede to their demands and the Minister of Health should be fired.

JOHESU make sure u people admit new patients, run the A/E, the specialized clinics, the operating theatre and least i forget, shame on you if you bring your family members to the private hospitals around town. Mumu ppl !

adeola_drg:


NMA and Her Egocentric
Demands: The Height of Gross
Lawlessness, Impunity and Blackmail
In an open letter written to the secretary to the
Federal Government of Nigeria, Senator Anyim Pius
Anyim, on the 10th of June and sent to him on the
11th of June 2014, the Nigerian Medical
Association (NMA) under the leadership of Dr.
Kayode Obembe as President and Dr. Adewumi
Alayaki as secretary had written 24 demands that
must be urgently met. They have given the
Government a 14-day ultimatum, failure of which
NMA would call her members out on an indefinite
strike nationwide. NMA is made up of ASSOPON-
Association of Pathologist of Nigeria, MDCAN -
Medical and Dental Consultants of Nigeria, ARD-
Association of Resident Doctors and smaller sister
Associations, who are doctors in public and private
practice.
For many years, Allopathic Medical Doctors in
Nigeria have always hoodwinked the Government
and the general public, through falsehood and
blackmail. They have coerced the Government to
take unfavorable decisions which have always been
detrimental to the health sector and the Nigerian
populace. They have continually done this as a
result of the structural injustice that has been
perpetuated by many members of NMA in high
places in Government. They undermine the laws
setting up the hospital system, the Public Service
Rules and above all the constitution of the Federal
Republic of Nigeria.
At this juncture let us have a critical look at those
demands.
(1) APPOINTMENT OF THE POST OF THE DEPUTY
CMAC IN HOSPITALS. In line with the University
Hospitals (reconstruction of boards) cap U15, LFN
2004 commonly called decree 10 of 1985 which
governs Hospital practice in Nigerian, there is the
office of the CMAC but it never provided for the
office of the DCMAC. In section 4, it provides thus;
“there shall be for each Hospital, a Chairman of the
Medical Advisory Committee who shall be
appointed by the Board and responsible to the
Chief Medical Director for all the Clinical and
Training activities of the Hospital”. Section 2i
provides that; the CMAC is a member of the board.
There is no place in the organic law setting up the
hospital that created the office of the DCMAC and
there is no place it says that only Allopathic
Medical Doctors should be appointed as such. Yet
NMA is insisting that the Government must appoint
four DCMAC in every Teaching Hospital and three
in every Federal Medical Centre. All along, Boards
of Hospitals as a result of threats from NMA have
been allowing this illegal office to be used to
undermine statutory approved Scheme of Service
of other professional groups. The Public Service
Rule in section 1-general in 160101 provides; ‘A
Parastatal is a government-owned organization,
established by statutes to render specified service
(s) to the public. It is structured and operates
according to the instrument establishing it and also
comes under the policy directives of government.
In line with 160201 (a) statutory boards/council
shall set operational and administrative policies in
accordance with government policy directives and
supervise the implementation of such policies. A
situation where Allopathic Medical Doctors in
Nigeria wants the Government to continue to
create post and responsibilities not backed by
statutes undermines the principles of good
governance. It is gross violation of the law setting
the Government owned institution. Moreover, it is
trite law that you cannot add to a statute. That will
be ultra verse.
(2) NMA IS OPPOSED TO THE APPOINTMENT OF
DIRECTORS IN HOSPITALS. It should be noted that
this statement is laden with deceit as postulated
by NMA, that having Directors in hospitals will
affect patient care negatively. This is fallacy of the
highest order. The truth of the matter is, NMA does
not want professional departments as directorates
in the various Scheme of Service, rendering
professional duties like the department of
Pharmaceutical Services headed by the Director of
Pharmaceutical Services who is a Pharmacist.
Department of Nursing Services under the Director
Nursing Services, who is a Nurse. The Department
of Medical Laboratory Services under the Director
of Medical Laboratory Services, who is Medical
Laboratory Scientist etc.And all are answerable to
the Chief Medical Director. It should be noted that,
NMA and her members were the ones who
negotiated their present Scheme of Service that all
their members can rise to level 17 without being
called Directors. Other Healthcare Personnel have
continued to follow their own Scheme of Service
where only one person gets to level 17 and is
designated the Director, which is the most popular
path in the Public Service. Again in the criteria for
employment as stated in the Public Service rule in
020205,-“to be eligible for appointment into the
federal Public Service, every applicant must
020205(e) possess requisite qualification as
provide in the Scheme of Service.” The Scheme of
Service of all other Healthcare Personnel in the
hospital provides for a Directorate system. Now
NMA and her members want to go on strike for
Government to jettison the Public Service Rule
which is a Government Policy Document. The
Scheme of Service for Allopathic Medical doctors
provides for a non Directorate system. AND NO
PROFESSIONAL GROUP IMPOSES HER OWN
SCHEME OF SERVICE ON THE OTHER. SECONDLY
NO EMPLOYEE DETERMINES THE CONDITION OF
SERVICE OF ANOTHER EMPLOYEE. They are
agitating for this in order to entrench professional
imperialism, so that all other healthcare staff will
not reach the zenith of their career. That is the
singular reason, a doctor on level 15 is called a
Head of Department heading someone already on
level 17 and is designated a Director .This is gross
absurdity against the Public Service Rule. There is
no Government Institution in Nigerian where such
is seen, only in our Hospitals. And that is what
NMA wants to perpetuate. Rule 160103 of the
Nigerian Public Service Rule provides –“Parastatals
are to retain and improve existing rules,
procedures and practices in their establishments
and ensure that there are no deviations from the
general principles contained in the Public Service
Rules………………………………however in the absence of
internal rules and regulations on any matter, the
relevant provisions of the Public Services Rule
shall apply”. This can also be seen in section 5(5)
and 17 of the act governing hospital practice in
Nigeria. NMA’s demands are anti- Public Service
Rule.
(3) NMA DEMANDS THAT GRADE LEVEL 12
SHOULD BE SKIPPED BY DOCTORS.
This demand is not in line with Government
approved Scheme of Service for Doctors.NMA in
her usual falsehood has always accused JOHESU
members of skipping when in actual sense there is
nothing like that. The term is a misnomer this is
because skipping is when a Civil Servant moves
from a grade level to a higher grade level that is
not provided for in the Scheme of Service e.g.
when a worker moves from 8-10 and there is no
approval for such a special promotion ,this is
skipping. But when you move from 10- 12 this is
not skipping because this is provided in the
Scheme of Service and there is no level 11 in the
Scheme of Service. A baby physician enters the
Service on level 12, which is a principal grade.
Now NMA is insisting that they must be appointed
on level 13, which is an Assistant Chief Cadre.
Haba! How can a beginner enter the Civil Service
on an Assistant Chief Cadre? There is no Nigerian
worker that enters the Service on such grade.
There is no Nigerian Civil Servants that skips. This
is not provided in any known Nigerian scheme of
Service.
(4 ) APPOINTMENT OF OTHER MEDICAL
PERSONNEL AS CONSULTANTS.
NMA is threatening to go on strike because the
Government has chosen to obey Court judgment in
favour of other Health Personnel that they can also
be appointed as consultants in their chosen field.
In a false sense of well being, NMA insists that
they own the patients and as such only the
medical doctor can be called a Consultant. Nobody
owns the patient; rather the patient is the epi-
centre of Healthcare Service. Medical doctors are
just one of the professional skilled healthcare
attendants in a hospital, attending to the healthcare
needs of the patient. Each medical personnel are
given a license to practice their chosen field. The
various scheme of Service for Pharmacists,
Physiotherapist, Nurses, Medical Laboratory
Scientists etc provides that they can be appointed
as consultants. All over the world, it is not only
Allopathic Medical Doctors that are appointed as
consultants. A simple google search will show that
there are different consultants in the Health Field.
The word consultant is not an exclusive term to
designate Allopathic Medical Doctors who are
specialists. William A .Cohen, PhD, in his
bestselling book “How to Make It Big as a
Consultant” has this to say on pages 2 and 3.
“Consultants operate in many different fields.
Import-export, management, human resources,
engineering, and marketing are some of the more
common ones. There are consultants in
archeology and consultants in clothes selection.
There are even consultants to help authors
overcome writer’s block.” On page 3 he has this to
say. “A consultant is simply anyone who gives
advice or performs other services of a professional
or a semiprofessional nature in return for
compensation”. NMA wants to stop working
because other Healthcare Personnel are appointed
as consultants. Is NMA saying that they are the
only Professionals in the Health Field?
(5) RELATIVITY IN HEALTH SECTOR
On what basis is NMA still agitating for relativity
when at the point of entry this has been taken care
of and resolved based on the number of years one
spends in school. Those who spend four years
have their entry point as level 8,those that spend
five years on level 9 ,those that spend five years
with one year of internship on level 10,while those
that spend six years with one year internship on
level twelve. The agitation for the so called
relativity is discriminatory and violates the Nigerian
Constitution as stipulated in section 34-(1). NMA
insisting that this must be sacrosanct in the Health
Sector is on what basis? It should be noted that
members of NMA are just employees of the
Government, just like every other Civil Servant, and
as such no employee determines what another
employee is to be paid. It is never done anywhere
in the world. This is a sense of megalomania, and
so this jack of all trade mentality must stop.
(6) NATIONAL HEALTH BILL.
NMA is calling for the implementation of the
National Health Bill which has been shown to
contain a lot of clauses that are anti-people. Many
professional Associations, Civil Societies and well
meaning Nigerians have called for the removal of
these obnoxious sections of the Bill. But NMA in
the bid to actualize her set selfish agenda has
refused to give good reason a chance. Again some
part of the Bill undermines the Nigerian
Constitution in use in a Federal System of
Government. No Nigerian Health Worker is against
having a Health Bill but all we are saying is that in
order to meet Government set objectives to
enhance the total wellbeing of the citizenry the
obnoxious sections has to be expunged.
(7) THE APPOINTMENT OF SURGEON GENERAL.
This office is not created by law. There is no
Nigerian statute that says that we must have the
office of the Surgeon General. Creation of this office
will lead to more agitation and anarchy in the
Health Sector which is already polarized. Every
professional group will be agitating for the creation
of X-general, e.g. Pharmacist general, Nurse
general, Optometrist general, Radiographer general,
Physiotherapy general, Dietician general; Medical
laboratory scientist general etc. The creation of this
post will lead to more problems in the health
sector. Secondly of what role and benefit is the
office of the Surgeon general when we already have
two Ministers of Health and there are many
Directors also having such functions?
( THE ENTRY POINT OF HOUSE OFFICER TO BE
ON COMMESS 1 STEP 4
This level is equivalent to grade level 10 steps 4.
On what is this agitation predicated on, when such
entry point is not supported by any Scheme of
Service, used as one of the criteria for appointment
into the Public Service of the federation? It should
be noted that house officers are intern or Pupil
Medical Doctors. There is no intern in Nigerian that
enters the service on step four. Moreover, steps
are indicators of the level of experience or years
the person /officer have spent on that grade level.
On what criteria is a neophyte/green horn in his
profession placed on step four? What you have is
either step one or step two. Government should
not accede to this demand that undermines ethical
procedural practice in the Public Service.
(9) CLINICAL ALLOWANCES FOR HONORARY
CONSULTANTS TO BE INCREASED BY 90% OF
CONMESS.
Early this year, under the immediate past President
of NMA, Dr Enabulele, NMA had had an upward
salary increase for their members. Not up to 5
months, NMA is now calling for another bloated
allowance. Note that consultants are meant to
render quality service as Attending Physicians, but
what do we see daily in our hospitals? Most of the
times, the “consultants/honorary consultants” are
never around. Yet they want to be paid such a
jumbo allowance. Those that are around, work four
times in a month, having one clinic day in a week.
(10) NMA, with the huge sum they are paid, still
wants adjustment in their specialist allowance to
be paid to all doctors on CONMESS 3 and above,
and must be paid its equivalent that is not less
than 50% higher than what is paid to other Health
Workers. How can NMA be the one to decide what
other Health Workers get? NMA should go and read
the Parable of one Talent Payment.
(11) NMA is calling for Government to pay her
members 100,000 naira every month as just
hazard allowance. How can NMA be demanding for
such, despite all she is already receiving? She is
being too selfish/greedy in her demands. Even
other workers with worse occupational hazards are
not receiving such.

ebiskem: JOHESU make sure u people admit new patients, run the A/E, the specialized clinics, the operating theatre and least i forget, shame on you if you bring your family members to the private hospitals around town. Mumu ppl !

Sorry, you are clearly missing the point, the issue is obviously not about relevance because even an infant should know that a hospital without doctors would be rendered useless and so also without members of JOHESU.

However, what is at stake is the validity of these 24 demands by doctors; which clearly embodies: arrogance, greed , selfishness and damn right recklessness.
NMA is making a big mistake by taking its case to court because it would appear that it is the one operating outside the law - with impunity; I therefore can't see them winning this case legitimately in court, without magu magu.