ozo13:
Hmmm

please give me the link to download this stuff. is this the yayale they've been talking about

worlexy:

If that is the case then there's anarchy in the health sector if their request is granted but if I were the FG I will do either of these
1. Do some findings on how things are done in the US and in the UK and follow suit, those two countries are the si unit of how things should normally run

2. if johesu insist on being consultants because of the monetary gain attached to the title consultants then they must be responsible for their actions/inactions as the case may be. The patient will be well educated and given the options to choose which consultants they want to be attended to by and any consultants they choose is responsible for the success or failure of their treatment

3. Doctors that didn't go through Residency should be appointed as consultants too as soon as they spend a specified number of years in service, the ones that went through residency should drop the title "consultants " for every other person, they should simply be bearing the name of the field of their specialty like Gynecologist, Paediatrician, Surgeon, Neurosurgeon and so on

4. People should be paid based on the number of hours they work and importance of their jobs. if you're a neurosurgeon that works and operate for hours, you should earn higher than the man that only sits down in the hospital to dispense drugs instead of working in big pharmaceutical companies to be researching and producing drugs that will help treat diseases. One thing that baffles me till date is how someone will spend many years in the University only to graduate and start dispensing drugs in the hospital. Some category of people simply don't know their worth.

Don't be an ignoramus by ur comment. Why did you further ur education from primary to tetiary level, if you did? Why did ur older sibling(s), that is if you're not the oldest, not stop you from becoming a graduate like them so they only can be called & reffered to as the only graduates of ur father's children, that is if you are? When you make demands about ur education to ur father, do you stop ur older or younger sibling(s) from making their demands just so that urs only must/will be met?
Think well with ur brain. JOHESU's demand is not somuch as about the monetary value only but it is all encompassing.

frank41:
They are lucky self....just relieve them of their jobs and fix another capable hands that will displace them.

What are you wait for? Why waste ur time commenting here? Go seek a court injunction to relieve/sack them and employ/replace them.

What do you even know about RIGHTs, even ur Rights as a Nigeria citizen?

Danaire:


What are you wait for? Why waste ur time commenting here? Go seek a court injunction to relieve/sack them and employ/replace them.

What do you even know about RIGHTs, even ur Rights as a Nigeria citizen?

Please don't be angry with him and his likes, they are just ignorant of the real issues surrounding the strike and they are being fed lies by the doctors.

Pepsi101:

They are paid already.

So ignorant, yet confident..No Johesu member has been paid April Salary even though we worked for 17days before the strike started.

JEHUSITES, a conglomerates of unequals in animal farm. They want parity with doctors but in their rank and file is repulsive discrimination, segregation, and apartheid.

It baffles me how a group of folks would come together with the aim of making unrealistic demands... Some commenters above are arguing ignorantly about the strike not being financially motivated... You want to be paid same salary as the doctors in your level, where in this world is that practicable... You work in shifts get numerous nights off and in turn want to earn same as the man whose call hour runs from hours to days mostly at the detriment of his family and loved ones...

now they've been granted consultant nursing and consultant lab technicians, just to cause more strife within themselves...

All I see is some inferiority complex plagued individuals struggling for titles for which they are ignorant of the meaning

And who the Bleep told you they want EQUAL PAY?!!

DrAdonis:
This whole JOHESU thing is tiring. They are just fighting an unjust battle which is an eternally lost one. They just want to further destroy the healthcare in Nigeria.

Let me just explain one or two of what they are clamouring for to those that are not very medically inclined

1. Just because doctors are appointed consultants, they want same. Let us examine who a consultant is in the hospital setting and his responsibilities.

A consultant is a medical doctor who finished medical school, did housemanship and NYSC then writes an exam called primaries which is very tough and competitive with an average pass rate of 20% (not cause majority fail but they choose the top scores as pass) then work as a medical officer for varying years (some more than 10 years) before starting residency. The residency is the postgraduate studies to be come consultants in various specialities like neurosurgery, plastic surgery, Paediatrics etc.
The residency training is a rigorous one and the resident doctor works for no less than 68 hours in a week, runs the emergency, clinics, do ward rounds, teach medical students and even nursing and other students. The resident doctor also does case and seminar presentations carries out researches, writes academic papers and does a thesis (all these and more are necessary prerequisites to become a consultant). This residency takes 6 to 12 years depending on the specialty and it also incorporates very tough specialty exams.

Also take note that a doctor that does not do residency but has 20 years of work and surgical experience is not decorated a consultant.
So for a pharmacist, nurse or medical record personnel to just wake up and say because they have 10 years experience they should be decorated consultants is very laughable and shows myopia, greed and the entitlement mentality that defines JOHESU.

Also, and more importantly, the consultant is the person in charge of patient care and determines what tests, what drugs, what nursing care the patient needs and is indisputably the head of the team. He plays a vital central lead role and he determines who needs to see a pharmacist or a nurse or a lab technician. This comes with its challenges too, for instance, if any thing goes wrong in patient care, it is the consultant that carries the medicolegal burden. So of what use is the consultant pharmacist or nurse in this setting? The patient will only suffer and the standard of care will further depreciate as there will be confusion due to the many unnecessary captains of the ship who can do nothing more.


2. The want equal pay. This is in no way reasonable to any right thinking person as doctors don't do same work or add same value as any other person in the health sector. Is it in the emergency room, theatre or even laboratory?

Let me paint a scenario here. A 55year old doctor with say 25years experience that is a neurosurgeon, for instance, will frequently stand long hours doing very complex surgeries despite his rank, age and status. But a nurse, pharmacist or lab person with similar age and experience will just sit in the ward, pharmacy or lab bossing and tossing the younger ones about, doing absolutely nothing. They add little to no value and are no match in competency or ability but want same pay and remuneration, what an irritating greed and entitlement mentality. All these can only happen in Nigeria

Attached is a comparison of the ratio of the average earnings of healthcare professionals in different countries. In most cases, doctors earn x2 of what pharmacists and others earn but because of a difference of 20 - 50k naira at different levels, they keep going on strike.

You are just misleading the public, you don't even know what they are fighting for.

to NBA and JOHESU

to NMA and JOHESU

Pepsi101:
They are paid already.

No they haven't been paid...Its no work no pay.

thorpido:
Don't be like the average ignorant medical doctor.
Johesu members do NOT want the same thing doctors have.They DO NOT(as ignorantly broadcast everywhere) want the SAME salary as doctors.
They however WANT to advance their careers and ask for opportunities to do so.In developed countries,there are opportunities to become specialists/consultants in the allied health professions.There are consultant pharmacists abroad for example.
The clamour will set up postgraduate colleges that will provide postgraduate trainings that can enable health workers attain consultancy/specialist status.No one will become a consultant while doing youth service!
No confusion will come in the health sector.It has worked abroad,it can work in Nigeria too.Specialists can work as a team with each individual member making contribution to the team.There will be a leader who is still the doctor.

The NMA actually feel Johesu is going to drag positions with them and feel threatened. Not necessarily.It is a team work.
Erroneously,many doctors feel nurses,pharmacists,lab personnel etc work FOR THEM.No!Everyone contributes to patient care.There just must be a leader.

You are talking sense.

Are sure they are greedy? Please I will advise you study trend of Johesu strike and all strike in Nigeria.

theconsortium:
Greedy health workers

eendy:
It baffles me how a group of folks would come together with the aim of making unrealistic demands... Some commenters above are arguing ignorantly about the strike not being financially motivated... You want to be paid same salary as the doctors in your level, where in this world is that practicable... You work in shifts get numerous nights off and in turn want to earn same as the man whose call hour runs from hours to days mostly at the detriment of his family and loved ones...

now they've been granted consultant nursing and consultant lab technicians, just to cause more strife within themselves...

All I see is some inferiority complex plagued individuals struggling for titles for which they are ignorant of the meaning

You do not sound smart. Do you ever think a Nurse would earn equal pay as a doctor

But you can lie o, there is currently no work no pay policy in implementation. I guess you are a doctor

Pepsi101:

They are paid already.

Does it mean you have not study their demands, then compare with that of NMA? please take your time and study their demands thoroughly. You will then understand Johesu is not seeking equality but ability to grow on their part. Let me shock now, do you know that even if FG implements Johesu monetary demands is still does not equal a doctors salary? Please take your time and educate yourself on this.

eendy:
It baffles me how a group of folks would come together with the aim of making unrealistic demands... Some commenters above are arguing ignorantly about the strike not being financially motivated... You want to be paid same salary as the doctors in your level, where in this world is that practicable... You work in shifts get numerous nights off and in turn want to earn same as the man whose call hour runs from hours to days mostly at the detriment of his family and loved ones...

now they've been granted consultant nursing and consultant lab technicians, just to cause more strife within themselves...

All I see is some inferiority complex plagued individuals struggling for titles for which they are ignorant of the meaning

PLEASE TAKE A LOOK TO OLD COMESS AND OLD CONHESS BEFORE YOU BELIEVE NMA

COMESS 3 (which is the starting point for doctors) #260,865.58
CONHESS 7 (which is the starting point for some health workers like accountant etc) #118,765.
(difference of #142,100.00) 120% difference.

CONHESS 9 (which is another starting point for health workers eg pharmacist etc) #161,670.33.
(difference 99,195.25) 61% difference.

NOW LETS STILL COMPARE THE SALARY OF A NEWLY EMPLOYED DOCTOR ABOVE WITH A HEALTH WORKERS THAT HAVE SPENT 6 TO 9 YEARS IN SERVICE WHICH IS CONHESS 11.

CONHESS 11:#223,345.58 (difference of #37,520.00) 17% difference.

ABOVE IS FOR OLD CONMESS AND OLD CONHESS....

TAKE A LOOK AT THE NEW CONMESS AND PROPOSED CONHESS BY JOHESU, PLS SIR I WILL STILL WANT YOU TO COMPARE THIS NEW CONMESS WITH THE OLD CONHESS THAT JOHESU IS PRESENTLY RECEIVING NOW....

NEW CONMESS 3 :# 312,944.83.

PROPOSED CONHESS 7: #165,541.08
(difference of #147,403.75)
89%difference.

PROPOSED CONHESS 9: #190,227.25 (difference of #122,717.58)
65% difference.

PROPOSED CONHESS 11:
#255,184.83.
(difference of #57,760.00)
23% difference.

I WANT TO ALSO WRITE THAT OF THE ZENITH OF BOTH PROFESSION :

OLD CONMESS 7: #704,209.08
OLD CONHESS 15: #476,855.00

(DIFFERENCE #227,354.08)
48% DIFFERENCE.

NEW CONMESS 7:
#999,698.50
PROPOSED CONHESS 15:
#697,024,42.
(difference of #302,674.08)
43% Difference

now did NMA see the parity they have been singing with

I TOOK OUT MY PRECIOUS TIME TO HIGHLIGHT THIS FIGURES OUT because WHEN I AM TALKING I LIKE WORKING WITH FACT because THE TRUTH CAN'T BE HIDDEN.

heykinzbobo:


I can't believe you took your time to write this fallacy. Equal pay? You must be joking. Mind you, I'm a Physiotherapist.

Then go and carry out the doctor's order. I mean to do some massage for stroke patient.
Do not try to outshine your master.

Jukinom:
PLEASE TAKE A LOOK TO OLD COMESS AND OLD CONHESS BEFORE YOU BELIEVE NMA

COMESS 3 (which is the starting point for doctors) #260,865.58
CONHESS 7 (which is the starting point for some health workers like accountant etc) #118,765.
(difference of #142,100.00) 120% difference.

CONHESS 9 (which is another starting point for health workers eg pharmacist etc) #161,670.33.
(difference 99,195.25) 61% difference.

NOW LETS STILL COMPARE THE SALARY OF A NEWLY EMPLOYED DOCTOR ABOVE WITH A HEALTH WORKERS THAT HAVE SPENT 6 TO 9 YEARS IN SERVICE WHICH IS CONHESS 11.

CONHESS 11:#223,345.58 (difference of #37,520.00) 17% difference.

ABOVE IS FOR OLD CONMESS AND OLD CONHESS....

TAKE A LOOK AT THE NEW CONMESS AND PROPOSED CONHESS BY JOHESU, PLS SIR I WILL STILL WANT YOU TO COMPARE THIS NEW CONMESS WITH THE OLD CONHESS THAT JOHESU IS PRESENTLY RECEIVING NOW....

NEW CONMESS 3 :# 312,944.83.

PROPOSED CONHESS 7: #165,541.08
(difference of #147,403.75)
89%difference.

PROPOSED CONHESS 9: #190,227.25 (difference of #122,717.58)
65% difference.

PROPOSED CONHESS 11:
#255,184.83.
(difference of #57,760.00)
23% difference.

I WANT TO ALSO WRITE THAT OF THE ZENITH OF BOTH PROFESSION :

OLD CONMESS 7: #704,209.08
OLD CONHESS 15: #476,855.00

(DIFFERENCE #227,354.08)
48% DIFFERENCE.

NEW CONMESS 7:
#999,698.50
PROPOSED CONHESS 15:
#697,024,42.
(difference of #302,674.08)
43% Difference

now did NMA see the parity they have been singing with

I TOOK OUT MY PRECIOUS TIME TO HIGHLIGHT THIS FIGURES OUT because WHEN I AM TALKING I LIKE WORKING WITH FACT because THE TRUTH CAN'T BE HIDDEN.

Why wasting your brain to compare commissioned officer with non commissioned officer?
They were never trained to be the same.

Revisiting The NMA Strike -*
The Candid Opinion Of A UK-Based Doctor
By *Dr. Ijabla Raymond*
Although I practise abroad, I should point out
that this strike affects me too. My family and
friends all live in Nigeria.
I feel compelled to write on this subject
because of its seriousness and the dearth of
objective analyses on our social media. It is
an emotive subject for both *NMA* and
*JOHESU* members, and I can understand
why punches fly around, but both parties must
rise above petty and emotional considerations
if we are to find a way forward.
For clarification purposes, the *NMA*
represents medical doctors whilst *JOHESU*
is a union of all health workers who are not
doctors.
The NMA has a list of *24 demands* but I will
limit myself to the most contentious ones. At
this stage, it is probably best that I introduce
myself. _*I am medical doctor of Nigerian
heritage practising in the UK.*_
*WHO SHOULD HEAD THE HOSPITAL*
There is no contention – the medical doctor is
the head of the *clinical team.* He/she leads
the ward rounds, clinics, surgical operations,
multidisciplinary meetings and so on because
the ultimate and final responsibility for patient
care rests in his/her hands.
The headship of the hospital is a different
matter. This is an *administrative* office,
which needs not be occupied by a medical
doctor. This job is better in the hands of
people who have administrative or business
management skills. _This is the case in
countries like the UK, Canada and the US,_
which heavily influence our health system.
Therefore, it is difficult to reason with the
NMA why this job should be the exclusive
right of medical doctors.
*NON-MEDICAL CONSULTANTS*
The doctor-patient ratio in Nigeria is
_dangerously low._ In my view, the roles of
non-medical professionals such as nurses,
physiotherapists, pharmacists etc need to
expand to cope with the demands on doctors.
It is important that this is done in a _safe
way_ by providing the appropriate level of
training for these individuals. *This is the case
in countries such as the UK, Canada and the
US where consultant nurses, pharmacists etc
have existed for a few decades now.* I do not
see any problem with non-medical consultants
as long as these individuals are appropriately
trained and can practise both competently and
safely within an *agreed framework* . These
professionals have separate (but
complimentary) job descriptions and their
roles are not designed to replace or dispense
with the services of the doctor. If this
arrangement enhances patient care, then
where is the problem with it? The NMA needs
to demonstrate to the public and to the
government how the creation of these non-
medical consultant positions will adversely
affect patient care, otherwise, its demands will
be perceived as obstructing the professional
development of JOHESU members, and I don’t
think this is helpful to anybody.
*HAZARD ALLOWANCE*
The types of hazard and the level to which
healthcare workers are exposed vary
considerably and depend on the type of job
they do. For instance, psychiatrists are hardly
exposed to body fluids and their risks for
contracting diseases like HIV and hepatitis are
much less than for a theatre scrub nurse. The
risk of physical assault by a patient is higher
for a psychiatrist than for a surgeon. And
because psychiatric nurses spend more time
with patients, their risks of assault are
arguably higher than those of consultant
psychiatrists.
The people who work in radiology
departments such as radiologists,
radiographers, nurses, porters and so on have
greater exposure to radioactive materials than
everyone else in the hospital.
The current health hazard allowance of
N5,000 is unconscionable – it needs to
increase. However, I think it is imperative to
get an independent risk assessor for impartial
advice.

MISCELLANEOUS*
I have read far too many emotional arguments
on these issues and very little of an objective
discourse. It is important that I draw your
attention to a few of these.
What has become obvious is the lack of
understanding of the *concept of teamwork* .
There is a pervasive notion among doctors
that the other healthcare workers are there to
serve them. JOHESU members think that
doctors have become too conceited for their
own good and are determined to put them in
their “places”. *The most important person in
the hospital is the patient* – it is *not* the
_doctor_ , _nurse_ , _pharmacist_ or
_laboratory scientist_ or anyone else. Every
team member is important and must be
respected, including the people who do the
least clinical jobs like cleaning. I don’t
imagine that any hospital will remain open for
longer than a week if its cleaners went on
strike and dirt was allowed to accumulate to
the point where it constitutes a health risk.
I have heard so many anecdotal accounts of
nurses not joining doctors on ward rounds or
pharmacists altering prescriptions without first
discussing these with the prescribing doctors
or laboratory scientist slapping doctors; and
these accounts are being given as reasons
why doctors must continue to head hospitals.
These are *disciplinary matters,* which should
be managed according to existing procedures.
These excuses are emotional and should not
be used to block the professional development
of others.
The other reason I have heard doctors give for
not wanting our non-medical colleagues to
bear the "consultant" title is the fear that
patients will confuse them or anybody else in
a white-coat for a doctor and give such people
an excuse for autonomous practice.
This reason is *not good enough* because
this problem can be solved by wearing names
badges and/or colour coded uniforms. Also
health professionals should introduce
themselves to patients at the start of
consultations. But more significantly, this can
be an issue of regulation - any one found to
be (criminally) practising over and beyond
their job description, competence level or
professional registration becomes liable to
disciplinary procedures.
Our health system suffers from poor
regulation. This is why anyone can open a
chemist and dole out antibiotics
indiscriminately. It is the reason doctors are
scared that consultant pharmacists, nurses
and physiotherapists will steal their patients.
But it is also the reason why doctors may
recommend an operation to a patient where
none is necessary just so they can charge
more. This is a problem that is in urgent need
of attention.
I hope that this something both NMA &
JOHESU will flag up in the near future.
Another recurrent theme in these debates is
the abuse of junior doctors by both medical
and non-medical staff, which appears to be
endemic. There is a consistent narrative of
junior doctors being asked to do other
people’s jobs such as collecting blood from
blood banks, taking samples to laboratories
etc. In extreme cases, these doctors are asked
to undertake non-clinical tasks by more senior
doctors. This is simply unacceptable! I think it
is fair to place the blame for this at the hands
of consultants who are supposed to be
responsible for junior doctors. But this in
itself is not a good argument for blocking
JOHESU members from becoming consultants
in their specialties or for stopping them from
heading hospitals if they have the right
qualifications.
I am concerned that the NMA is losing public
sympathy. Increasingly, I hear people describe
doctors as selfish and heartless. This is very
sad and rather unfortunate. They say doctors
do not have any motivation to end the strike
because patients are forced to pay exorbitant
fees to them in their private hospitals. Those
patients who cannot afford these fees are left
to suffer or die. If the NMA has made any
efforts to change this public perception, then
these do not appear to have been effective.

CONCLUSION*
The current strategy (i.e., recurrent strikes) is
not working. Over the last decade or two, the
NMA and non-medical health workers (more
recently represented by JOHESU) have taken
turns to go on strikes. Perhaps, it is time for
both parties to sit together, talk to each other
and resolve these contentious issues once
and for all. _It’s pointless for the government
to enter into agreements with one party
knowing fully well that the other party will ask
for a reversal of those agreements._
I think the time has come to incorporate
Ethics, Teamwork and Communications into
undergraduate curricula. The various online
comments I have read from medical and non-
medical colleagues show that whilst many
easily mouth off "team work", a practical
understanding of what this means is lacking.
Disciplinary procedures are there for a reason.
They must be followed when necessary.
Although I practise abroad, I should point out
that this strike affects me too. My family and
friends all live in Nigeria. And who says I am
not planning to come home to practise?
Lastly, we must all be mindful of our own
mortality. Most of us will be ill someday.
And when this happens, the only thing that
will matter to us is to be looked after by
caring and competent health-workers
regardless of their individual specialisation.
We can create that environment if we forget
our individual egos and work as a team.
*Ijabla Raymond,* a medical doctor of
Nigerian heritage writes from the UK. Contact:
_ijabla.raymond@facebook.com._

DrAdonis:
This whole JOHESU thing is tiring. They are just fighting an unjust battle which is an eternally lost one. They just want to further destroy the healthcare in Nigeria.

Let me just explain one or two of what they are clamouring for to those that are not very medically inclined

1. Just because doctors are appointed consultants, they want same. Let us examine who a consultant is in the hospital setting and his responsibilities.


A consultant is a medical doctor who finished medical school, did housemanship and NYSC then writes an exam called primaries which is very tough and competitive with an average pass rate of 20% (not cause majority fail but they choose the top scores as pass) then work as a medical officer for varying years (some more than 10 years) before starting residency. The residency is the postgraduate studies to be come consultants in various specialities like neurosurgery, plastic surgery, Paediatrics etc.
The residency training is a rigorous one and the resident doctor works for no less than 68 hours in a week, runs the emergency, clinics, do ward rounds, teach medical students and even nursing and other students. The resident doctor also does case and seminar presentations carries out researches, writes academic papers and does a thesis (all these and more are necessary prerequisites to become a consultant). This residency takes 6 to 12 years depending on the specialty and it also incorporates very tough specialty exams.

Also take note that a doctor that does not do residency but has 20 years of work and surgical experience is not decorated a consultant.
So for a pharmacist, nurse or medical record personnel to just wake up and say because they have 10 years experience they should be decorated consultants is very laughable and shows myopia, greed and the entitlement mentality that defines JOHESU.

Also, and more importantly, the consultant is the person in charge of patient care and determines what tests, what drugs, what nursing care the patient needs and is indisputably the head of the team. He plays a vital central lead role and he determines who needs to see a pharmacist or a nurse or a lab technician. This comes with its challenges too, for instance, if any thing goes wrong in patient care, it is the consultant that carries the medicolegal burden. So of what use is the consultant pharmacist or nurse in this setting? The patient will only suffer and the standard of care will further depreciate as there will be confusion due to the many unnecessary captains of the ship who can do nothing more.


2. The want equal pay. This is in no way reasonable to any right thinking person as doctors don't do same work or add same value as any other person in the health sector. Is it in the emergency room, theatre or even laboratory?

Let me paint a scenario here. A 55year old doctor with say 25years experience that is a neurosurgeon, for instance, will frequently stand long hours doing very complex surgeries despite his rank, age and status. But a nurse, pharmacist or lab person with similar age and experience will just sit in the ward, pharmacy or lab bossing and tossing the younger ones about, doing absolutely nothing. They add little to no value and are no match in competency or ability but want same pay and remuneration, what an irritating greed and entitlement mentality. All these can only happen in Nigeria

Attached is a comparison of the ratio of the average earnings of healthcare professionals in different countries. In most cases, doctors earn x2 of what pharmacists and others earn but because of a difference of 20 - 50k naira at different levels, they keep going on strike.

Useless post to misinform Nigerians.

This issues ought to be decided by those in the know. I suggest that the FG should seek the resolution of this matter by emulating best practices in other parts of the world

OboOlora:
The only question I have is; will they be paid for the time they didn’t work?

nope ...they didn't pay last month am sure they won't pay this month either

Pepsi101:
They are paid already.

says who I have not seen alert oh

tsmat:


you must be madt

Okay Mr. Crazy

Revisiting The NMA Strike -*
The Candid Opinion Of A UK-Based Doctor
By *Dr. Ijabla Raymond*
Although I practise abroad, I should point out
that this strike affects me too. My family and
friends all live in Nigeria.
I feel compelled to write on this subject
because of its seriousness and the dearth of
objective analyses on our social media. It is
an emotive subject for both *NMA* and
*JOHESU* members, and I can understand
why punches fly around, but both parties must
rise above petty and emotional considerations
if we are to find a way forward.
For clarification purposes, the *NMA*
represents medical doctors whilst *JOHESU*
is a union of all health workers who are not
doctors.
The NMA has a list of *24 demands* but I will
limit myself to the most contentious ones. At
this stage, it is probably best that I introduce
myself. _*I am medical doctor of Nigerian
heritage practising in the UK.*_
*WHO SHOULD HEAD THE HOSPITAL*
There is no contention – the medical doctor is
the head of the *clinical team.* He/she leads
the ward rounds, clinics, surgical operations,
multidisciplinary meetings and so on because
the ultimate and final responsibility for patient
care rests in his/her hands.
The headship of the hospital is a different
matter. This is an *administrative* office,
which needs not be occupied by a medical
doctor. This job is better in the hands of
people who have administrative or business
management skills. _This is the case in
countries like the UK, Canada and the US,_
which heavily influence our health system.
Therefore, it is difficult to reason with the
NMA why this job should be the exclusive
right of medical doctors.
*NON-MEDICAL CONSULTANTS*
The doctor-patient ratio in Nigeria is
_dangerously low._ In my view, the roles of
non-medical professionals such as nurses,
physiotherapists, pharmacists etc need to
expand to cope with the demands on doctors.
It is important that this is done in a _safe
way_ by providing the appropriate level of
training for these individuals. *This is the case
in countries such as the UK, Canada and the
US where consultant nurses, pharmacists etc
have existed for a few decades now.* I do not
see any problem with non-medical consultants
as long as these individuals are appropriately
trained and can practise both competently and
safely within an *agreed framework* . These
professionals have separate (but
complimentary) job descriptions and their
roles are not designed to replace or dispense
with the services of the doctor. If this
arrangement enhances patient care, then
where is the problem with it? The NMA needs
to demonstrate to the public and to the
government how the creation of these non-
medical consultant positions will adversely
affect patient care, otherwise, its demands will
be perceived as obstructing the professional
development of JOHESU members, and I don’t
think this is helpful to anybody.
*HAZARD ALLOWANCE*
The types of hazard and the level to which
healthcare workers are exposed vary
considerably and depend on the type of job
they do. For instance, psychiatrists are hardly
exposed to body fluids and their risks for
contracting diseases like HIV and hepatitis are
much less than for a theatre scrub nurse. The
risk of physical assault by a patient is higher
for a psychiatrist than for a surgeon. And
because psychiatric nurses spend more time
with patients, their risks of assault are
arguably higher than those of consultant
psychiatrists.
The people who work in radiology
departments such as radiologists,
radiographers, nurses, porters and so on have
greater exposure to radioactive materials than
everyone else in the hospital.
The current health hazard allowance of
N5,000 is unconscionable – it needs to
increase. However, I think it is imperative to
get an independent risk assessor for impartial
advice.
*MISCELLANEOUS*
I have read far too many emotional arguments
on these issues and very little of an objective
discourse. It is important that I draw your
attention to a few of these.
What has become obvious is the lack of
understanding of the *concept of teamwork* .
There is a pervasive notion among doctors
that the other healthcare workers are there to
serve them. JOHESU members think that
doctors have become too conceited for their
own good and are determined to put them in
their “places”. *The most important person in
the hospital is the patient* – it is *not* the
_doctor_ , _nurse_ , _pharmacist_ or
_laboratory scientist_ or anyone else. Every
team member is important and must be
respected, including the people who do the
least clinical jobs like cleaning. I don’t
imagine that any hospital will remain open for
longer than a week if its cleaners went on
strike and dirt was allowed to accumulate to
the point where it constitutes a health risk.
I have heard so many anecdotal accounts of
nurses not joining doctors on ward rounds or
pharmacists altering prescriptions without first
discussing these with the prescribing doctors
or laboratory scientist slapping doctors; and
these accounts are being given as reasons
why doctors must continue to head hospitals.
These are *disciplinary matters,* which should
be managed according to existing procedures.
These excuses are emotional and should not
be used to block the professional development
of others.
The other reason I have heard doctors give for
not wanting our non-medical colleagues to
bear the "consultant" title is the fear that
patients will confuse them or anybody else in
a white-coat for a doctor and give such people
an excuse for autonomous practice.
This reason is *not good enough* because
this problem can be solved by wearing names
badges and/or colour coded uniforms. Also
health professionals should introduce
themselves to patients at the start of
consultations. But more significantly, this can
be an issue of regulation - any one found to
be (criminally) practising over and beyond
their job description, competence level or
professional registration becomes liable to
disciplinary procedures.
Our health system suffers from poor
regulation. This is why anyone can open a
chemist and dole out antibiotics
indiscriminately. It is the reason doctors are
scared that consultant pharmacists, nurses
and physiotherapists will steal their patients.
But it is also the reason why doctors may
recommend an operation to a patient where
none is necessary just so they can charge
more. This is a problem that is in urgent need
of attention.
I hope that this something both NMA &
JOHESU will flag up in the near future.
Another recurrent theme in these debates is
the abuse of junior doctors by both medical
and non-medical staff, which appears to be
endemic. There is a consistent narrative of
junior doctors being asked to do other
people’s jobs such as collecting blood from
blood banks, taking samples to laboratories
etc. In extreme cases, these doctors are asked
to undertake non-clinical tasks by more senior
doctors. This is simply unacceptable! I think it
is fair to place the blame for this at the hands
of consultants who are supposed to be
responsible for junior doctors. But this in
itself is not a good argument for blocking
JOHESU members from becoming consultants
in their specialties or for stopping them from
heading hospitals if they have the right
qualifications.
I am concerned that the NMA is losing public
sympathy. Increasingly, I hear people describe
doctors as selfish and heartless. This is very
sad and rather unfortunate. They say doctors
do not have any motivation to end the strike
because patients are forced to pay exorbitant
fees to them in their private hospitals. Those
patients who cannot afford these fees are left
to suffer or die. If the NMA has made any
efforts to change this public perception, then
these do not appear to have been effective.
*CONCLUSION*
The current strategy (i.e., recurrent strikes) is
not working. Over the last decade or two, the
NMA and non-medical health workers (more
recently represented by JOHESU) have taken
turns to go on strikes. Perhaps, it is time for
both parties to sit together, talk to each other
and resolve these contentious issues once
and for all. _It’s pointless for the government
to enter into agreements with one party
knowing fully well that the other party will ask
for a reversal of those agreements._
I think the time has come to incorporate
Ethics, Teamwork and Communications into
undergraduate curricula. The various online
comments I have read from medical and non-
medical colleagues show that whilst many
easily mouth off "team work", a practical
understanding of what this means is lacking.
Disciplinary procedures are there for a reason.
They must be followed when necessary.
Although I practise abroad, I should point out
that this strike affects me too. My family and
friends all live in Nigeria. And who says I am
not planning to come home to practise?
Lastly, we must all be mindful of our own
mortality. Most of us will be ill someday.
And when this happens, the only thing that
will matter to us is to be looked after by
caring and competent health-workers
regardless of their individual specialisation.
We can create that environment if we forget
our individual egos and work as a team.
*Ijabla Raymond,* a medical doctor of
Nigerian heritage writes from the UK. Contact:
_ijabla.raymond@facebook.com._



So many ignorant Doctors, am so ashamed of this people.

oxon:
nope ...they didn't pay last month am sure they won't pay this month either

Thanks. Someone responded earlier that they paid

I honestly hope they don’t pay for the times they weren’t at work, people need to learn how to be lenient. It’s a professional health body for Bubu’s sake not some funny charity club!

There is a great disparity between what health workers earn compare to their peer in the Civil Service. How will someone who could not pass JAMB be collecting my salaries than a graduate because he attended school of school of hygiene. Because Government is their greatest employees they will hold the State to ransom when they can justify the huge salaries they are collecting.

JOHESU had nine(9) court Judgment the FG haven't honour a single one,So who is fooling who?