BENCHMARKING A HARMONIOUS HEALTH SECTOR

The Health Ministry is resolved to set a standard and measure of harmony among health workers, writes PAUL A. OBI

“The labour movement was the principal force that transformed misery and despair into hope and progress”

Martin Luther King II

For many decades down the road, the Nigerian health sector has been plagued by the highest forms of discord, dispute and acrimony. So much so that, the negotiating power of the unions and the Nigerian state has been weakened from both ends. From the Nigerian Medical Association (NMA), Joint Health Sector Union (JOHESU), National Association of Nigerian Nurses and Midwives (NANNM), Medical and Health Workers’ Union of Nigeria (MHWUN), Association of Medical Laboratory Scientists of Nigeria (AMLSN), National Association of Resident Doctors (NARD) among others, the propensity to down tools, combat the federal government, inject agony on patients and healthcare seekers and wreck the health sector tend to define the character of unionism and social movement within the Nigerian health sector.  

With this trajectory, minister after minister, year after year, union after union in the health sector have all taken turns to either press home their workers’ demands or confront union leaders with the intention to blacklist the government, make untenable demands or put the administration in its place. Added to that, the back and forth between the unions and government on welfare and working conditions regrettably seems to be the most challenging aspect of the acrimonious relationship labour unions in the health sector and the Ministry of Health and Social Welfare have had to confront over the years. Another eyesore associated with some of these perennial conflicts stemmed from the continual cases of government reneging on agreements with the unions, including the strenuous issue of upgrading healthcare facilities across the country.

At present, the specifics of the challenges the Nigerian health faces and the highest triggers that often propel union leaders in the health sector to down their tools include Consolidated Health Salary Structure (CONHESS); implementation of new retirement age of 60 to 65, and 70 age for senior consultant; there is also the palaver of withheld salaries of Federal Medical Centre, Owerri, Jos University Teaching Hospital, Federal Medical Centre, Azare and Lagos University Teaching Hospital. Beyond these, the supremacy battles between the NMA – medical doctors and other health workers also remained a centrifugal force and source of health crises in the sector. In the past, Ministers of Health, who often have been dominated by medical doctors, tend to be perceived as protectionists of their turf who staked all policies against the rest of all other health workers.

Like with most sectors, in ministerial appointments, the president often headhunted professional insiders in order to smoothen situations and create a pathway for harmony where acrimony was the order of the day. In such circumstances, the bedrock of peaceful co-existence among unions in such a sector is primarily defined by the tenor of the top political appointee and his/her capacity to navigate the murky waters of sectoral politics without partisanship and prejudice.  A reasonable flair of thought in that regard evolved from ministerial and administrative heads of a strategic ministry and sector like health able to overcome the complexities of bickering and differentiation in policies, while standing firm on institutional building and administrative guardrails. This, invariably has become the order of the day with the Coordinating Minister of Health and Social Welfare, Prof Muhammad Ali Pate following his resolve to benchmark sectoral harmony among health workers in the ministry and beyond.

But in one of the ministry’s strategic summits in Abuja, Pate laid it bare regarding the paths in which the government and health workers were destined to follow within the Renewed Hope agenda for the health sector. According to Pate, “the issue with the health workers going on strike is an issue dating back so many years ago. This is linked to trust as we have met with four health workers’ associations and all their demands were very constructive,” the Coordinating Minister further explained that “we need to build trust among various actors and there are some specific outstanding issues that are in the process of being resolved. Some of these issues have been resolved,” he added. Granted, some of those issues dwelt more on wages and salaries, mostly domiciled with the Federal Ministry of Labour and Employment and the National Salaries, Incomes and Wages Commission. Still, some of those challenges need to be resolved at the ministerial level without the trouble associated with health workers striking and downing their tools.

Recently, at a parley between the minister and the NMA, the onerous task of creating the harmony bubble within the sector came at the forefront between Pate and the association led by the NMA President, Prof Bala Muhammed Audu. Throwing light on the turn of a new leave in the ministry, Pate assured the NMA and other health workers about the deep commitment to

advancing healthcare with a respectful and dignified work environment for the Nigerian health workforce. “We understand the challenges that remain and are focused on improving the quality of healthcare services for Nigerians,” he said. “We appreciate all health workers who are striving despite the obvious challenges we are facing as a country. However, the challenges are not insurmountable, as long as we keep the interest of Nigerians at heart and approach each other constructively,” the minister stated. However, the NMA President, Prof Audu harped on the need for the government to expedite action on a workable Universal Health Coverage, stressing that, “the full implementation of healthcare-related policies that are innovative and initiated; doubling the carrying capacity for training of the health workforce; national policy on healthcare workforce retention, and health facility regulation,” Audu submitted.

That said, beyond the cordiality between health workers and policymakers in the health sector, critical aspects of disagreement between workers and government need to be the central focus of policy in government at these exigent times. In a world caught up in an era of pandemics, the government needs to move far above being reactive in responding to labour unions’ issues to a readiness model that preempts conflicts in the sector in real time. In deepening a harmonious co-existence in the health sector, such moves should go beyond fettering the egos of health workers to a more thoughtfully executed plan that considers complete revamping of the health sector as a whole package. For there is no better way for a healthy nation and better life than one in which both the government and health workers are in consonance for workable and efficient health care delivery services. Therefore, the future of a well-run health sector should be defined by no other factors but by the benchmark of a harmonious sector hand-in-hand with state-of-the arts healthcare infrastructure.

Obi is a lecturer, journalist and researcher based in Abuja