The Nigerian Health Sector has been in the news for
some time now, as a result of the lingering crisis
that has bedeviled the Sector. The HEALTH sector is
expected to be a place of total wellbeing but why is
there so much hostility in the Sector which has
taken a hydra-headed form? Why is the Sector
matching towards Tophet; the Valley of Destructio
n?
There is so much misinformation, impunity,
violation of Established Rules and Codes of
Conduct. Why is the Place polarized with mistrust,
and disharmony? Why has the Government allowed
herself to become a pawn in the hands of Nigerian
Medical Association (NMA) and Medical and Dental
Consultants Association(MDCAN) which are not
legally recognized Trade Unions ? Why does the
Government allow double Standards within the same
Sector? The government that was able to restrain a
registered Trade Union from going on strike has not
stopped an unregistered body posturing as a Trade
Union. Why has the Government allowed the
Constitution of the Federal Republic, to be violated
by NMA who sees herself as the Imperial Majesty,
who must continue to subjugate other workers in
the Health Sector? Before we bring answers to
these numerous WHYS, let us x-ray the
pathogenesis of the crisis in the Health Sector.
SALARY STRUCTURES IN THE HEALTH SECTOR
Under the then President, His Excellency Alhaji
Umaru Musa Yar’Adua, the Nigerian Government in
2009 had approved two different Salary Structures
in the Health Sector. These two Salary Scales were
known as Consolidated Medical Salary Scale
(CONMESS) and Consolidated Health Salary Scale
(CONHESS).Medical Doctors in the Service of the
Nigerian Civil Service are on CONMESS, while every
other person working in the Health Sector was
placed under the CONHESS structure. Before the
emergence of the late President UMARU MUSA YAR’
ADUA, President Olusegun Obasanjo, had placed all
Nigerian Health Workers under a unified Salary
Scale.NMA had seriously kicked against this unified
Salary Scale. It was NMA that negotiated CONMESS
for her members while the Joint Health Sector
Union (JOHESU), a recognized Trade Union made up
of all Unions in the Health Sector outside Medical
Doctors, negotiated CONHESS for her members.
Below is the two Salary Scales.
CONMESS SALARY SCALE
CONMESS 01----- HOUSE OFFICER/YOUTH CORPS
DOCTOR – Grade Level 10
CONMESS 02----- Registrar/Medical Officer - Grade
Level 12
CONMESS 03----- Senior Registrar Grade 11/Senior
Medical Officer Grade 2 Grade Level 13
CONMESS 04---- - Senior Registrar Grade 1/Senior
Medical Officer Grade 1 Grade level 14
CONMESS 05------ Consultant/Principal Medical
officer Grade 2 Grade Level 15
CONMESS 06------ Consultant Special Grade 2/
Principal Medical Officer Grade 1 Grade Level 16
CONMESS 07-------Consultant Special Grade 1/Chief
Medical Officer Grade Level 17
CONHESS SALARY SCALE
CONHESS 7 INTERNS/NYSC ----------- Grade Level 8
CONHESS 8 X -Officer 1 ----------- Grade Level 9
CONHESS 9 Senior X-Officer ----------- Grade Level 10
CONHESS 11 Principal X- Officer ----------- Grade
Level 12
CONHESS 12 Assistant Chief X-Officer ------------
Grade Level 13
CONHESS 13 Chief X-Officer ------------- Grade Level
14
CONHESS 14 Assistant Director X-Officer ----------
Grade Level 15
CONHESS 15 Deputy Director X-Officer -------------
Grade Level 16
CONHESS 16 Director X-Officer ---------------------Grade
Level 17
THE FACE OF JANUS AND THE MATCH TOWARDS
TOPHET!
In the late 2009, NMA, started a campaign of
calumny, against members of JOHESU , that they
were Skipping, which she alleged as a violation of
Government policy. And they as Medical Doctors are
treated unjustly in the health sector .As shown
above, we have seen that NMA members were the
greatest beneficiary of the Government approved
Salary Scale, with higher entry point and jumbo
pay.NMA was of the opinion that any member of
JOHESU, who had moved from CONHESS 9 -to
CONHESS 11, should be brought down by one grade
level. JOHESU members were unjustly accused of
skipping and the polity was heated up. The Public
Service Rule provides in 020205 and 020205 (e)- To
be eligible for appointment into the Federal Public
Service (e) possess requisite qualifications as
provided for in the scheme of service. The
accusation was faulty because in the Scheme of
Service for JOHESU members, there was nothing
like Grade level 11.In fact it is a misnomer to term
the movement from Grade Level 10 to Grade Level
12 skipping. This is not skipping, because there is
no level 11 and what you have in the Scheme of
Service is movement from Grade level 10 to 12.The
Ministry of Health was seeing through the prism
and binoculars of NMA.

She supported the
recommendation subscribed by NMA that all
JOHESU members who have moved from Grade
Level 10 to Grade level 12 should be brought down
by one Grade level. In a circular dated 11th of
January 2010 , with reference number HCSF /EPO/
EIR/RR/B.63755/T1/77 ,the office of the Head of
Service of the Federation stopped the movement of
JOHESU members from Grade 10 to Grade level 12.
About a year later, the Head of Service in a similar
circular dated 10th of February, 2011 with reference
number HCSF/EPO/EIR/63755/T1/149 called the
movement of Workers from Grade 10 to Grade Level
12 an unauthorized Skipping. By June 2011, the
Health Sector was already heated up with drum
beats of war between the Workers under the aegis
of JOHESU and the Nigerian Government
represented by the Ministry of Health. It should be
recalled, that as at June 28th 2010, in a meeting
held at JUTH GUEST HOUSE in Abuja all Chief
Medical Directors and Medical Directors under the
auspices of Committee of Chief Executives, Federal
Tertiary Aspect in Nigeria, unanimously agreed and
released a memo with the reference number
CCEHTH/SEC/V.1/86 on the 29th of June 2010
addressed to all Chief Executives of Federal Health
Institutions. Article 3 on the topic was-
implementation of circular on CONTISS forbidding
skipping of Grade Level 10 or any Grade level. The
decision taken was;-(1) Members decided that by
July this year (2010) all Federal Tertiary Hospital
should have fully implemented the circular with
effect from 1st April 2010.All officers who had
skipped Grade level 10 should be brought down by
one grade level except those occupying the
appointive posts of Director of Administration.(2)To
effect this all CF.Os should simultaneously issue a
circular to all affected staff on the 12th July,2010
informing them of the plan to implement the
circular in July. This memo was signed by M O.
Adeoba for: Chairman CCEFTH. Immediately this
directive was later implemented, the Health Sector
was thrown into chaos, JOHESU gave the
Government ultimatum to change her decisions
which was not workers friendly, but the Government
refused. Moreover the Government failed to
implement agreements signed with JOHESU since
2009. This was now followed with a Strike action by
JOHESU who accused, the Government of not
keeping with the principle of Collective Bargaining.
As a result of the crisis in the health Sector on the
9th of August 2011, The Minister of Labour waded
into the matter, but the Ministry of Health was not
satistisfied by the resolution, and the matter was
later taken to the National Industrial Court for
adjudication. After a legal battle between the
Ministry of Health and JOHESU, the Court ruled in
favour of JOHESU in 2013, that Government was
wrong to have denied JOHESU members her right.
And that JOHESU members appointed Consultants
were wrongfully stopped as consultants. After the
judgment, from nowhere, NMA/MDCAN who were
not a party to the suit, cried foul that the Court
Judgment should not be implemented. They as
usual were the one that hoodwinked the
Government, to have taken the wrong decision that
was upturned by the Court. Suddenly they started
accusing government of favouring JOHESU
members, and that they must skip, even though that
no JOHESU member was skipping. Now that the
Government is trying to muster the courage to do
what is right, NMA/MDCAN has chosen to fight the
Nigerian patients, by denying them services and
declaring a strike action. Note that it is the same
patient they have told the world that they own and
that all their actions is for the best interest of the
patient. Today NMA/MDCAN who insisted that they
must have a different salary structure are the ones
imposing on the Government what other employees
should earn .The same NMA/MDCAN that
wrongfully accused JOHESU members of skipping
and even lost this matter in court is the one, now
championing skipping for her members, even when
doctors scheme of service does not grant such.
What a double standard!
NMA/MDCAN AND CALCULATED SABOTAGE.
Since July 1st 2014,NMA AND MDCAN have denied
patients the right to treatment even when the
National Industrial Court had ruled that all parties
involved should maintain status quo ante. Dr
Obembe the leader of NMA, who also happens to be
a member of MDCAN has continued to defy Court
orders under the guise that it is MDCAN that went
to Court. One is forced to ask, “Is Dr Obembe not a
member of MDCAN”? Again, does NMA have the
moral justification to call for strike when she is not
a Trade Union? Can NMA go on strike on an issue
that is already before a Court of competent
jurisdiction? How does NMA think that the
Government will be negotiating with her on an issue
before the Court?

Now that the Hon. Min. of Health has
started seeing that NMA/MDCANS’ actions, are in
bad faith, he must be firm to right the structural
injustices in the Health Sector. So that he would
have lived up to his words, “that he would do
everything in his power to bring harmony in the
health sector.” The crisis in the health sector has
gotten to where it is today, because of the over
bearing attitude of some allopathic physicians, who
have forgotten that medicine is the art, act and
science of healing, whose scope is beyond
allopathic medicine. It is highly unfortunate that
NMA/MDCAN leadership personified in the person of
Dr Obembe has suddenly forgotten that the word
medical is an adjective which means related to the
art, act and science of healing. A situation, where
allopathic physicians in a false mindset sees only
themselves as being medical and other healthcare
experts as non medical breeds/creates a wrong
image. The future allopathic physicians must be
nursed and nurtured to have a mind set of medical
humanism to give a good medical image that does
not thrive on rancor, falsehood and a doctored
ideology. The word medical is not a synonym for a
doctor, for if it were, it would not be seen placed in
front of the word doctor as in the term “medical
doctor” for that will be tautology. Every healthcare
professional involved with the act, art and science
related to healing are all medical personnel. So the
word medical is not an exclusive term to designate
allopathic physicians but all that is involved with
healing and healthcare services.
Conclusion
Now that it is so glaring that NMA/MDCAN strike is
sabotage against the state, because they are
causing untold hardship to the citizens of Nigeria.
This as a result of their ego driven demands. And
have failed to obey Government orders, because
most hospital Chief Executives being members of
MDCAN are in sympathy with them. They have
failed to call NMA/MDCAN to order to suspend the
strike, even when there is a court order. As a result
of the death of Nigerians, based on this sabotage,
the Federal Government should invoke the powers
conferred on her in section 18(1) and 18(2) of
University Teaching Hospitals (Reconstruction of
Boards, etc) Act CAP 463 LFN which states 18(1)
“The President may, notwithstanding any provision
of this Act, take such measures as occasion may
warrant in order to improve the efficiency or due
administration of the teaching hospitals specified in
the Schedule to this Act.”
18(2) “ For the purpose of section (1 )of this
section, the President may appoint or give such
authority for the appointment of Military
Commandments to take charge of administration of
any of the teaching hospitals specified in this Act
for such period as may be stipulated in the
authority.
Again, section 19 of the act, on the definition of
hospital states “Hospital includes all institutions
(however called) controlled by the board.”
Government should as a matter of urgency bring
sanity into the system by making sure; that this
sabotage by allopathic doctors is stopped. The
Government should declare their actions illegal. As
the Health Sector moves towards TOPHET a symbol
of collapse, we must do all it takes to salvage her,
by doing what is right!
AJUFO,BENJAMIN CHUKWUNONSO. WRITES FROM
ASABA IS the Secretary Association of Medical
laboratory Scientists Delta State Branch.
16/7/14

Nice and well articulated post. Mod front page please