By Moses Adeniyi
Issues over the ongoing strike of doctors under the aegis of the Nigerian Association of Resident Doctors (NARD) have continued to gather clouds of disagreements as resort to legal instruments to secure an order to force the doctors back to work has been faced with bottlenecks.
Disagreements between the body of doctors and the Government have continued to take course as irreconcilable differences keep taking heady dimensions as the offers of the later appear to be unsatisfying to the former.
Strike by Doctors in Nigeria have been a dominant feature in the Country’s health sector, which largely centres on conditions of work believed to be undesirable to health professionals, particularly those under the employment of the Government.
The demands informing the ongoing strike this time by NARD centres on the need to push the government to honour its agreement to pay arrears, hazard allowance as well as insurance benefits to families of doctors who have died of the COVID-19 virus. The Association has said doctors were ill-equipped and under-funded for the job while the facilities in state-run hospitals “are deplorable.”
The resident doctors again on Sunday declared their unyielding resolve not to call off the strike until their demands were met.
This followed a stakeholders meeting held with the Government where the Doctors said they declined to append their signature on a Memorandum of Understanding (MoU) presented at the instance of the Government.
The meeting was on the instance of President Muhammadu Buhari, who had directed the Minister of Labour and Employment, Senator Chris Ngige, to ensure all the contentious issues that led to the strike were resolved.
However, the aggrieved Doctors believe they were “being punished for the failure of the Federal Government.”
The National President of NARD, Dr Okhuaihesuyi Uyilawa, who spoke for the Association following the meeting said the meeting between the Association, the Nigerian Medical Association (NMA) as well as stakeholders in the medical sector and the Federal Government, declared the resolve of NARD having declined from signing the MoU, to continue the strike, while it will proceed with the court cases at the National Industrial Court.
Bottlenecks of Legal Restraint
It would be recalled that last week an attempt through an ex-parte application to the secure a court order to call back the striking doctors to work had failed.
The National Industrial Court sitting in Abuja on Thursday had rejected a request to order doctors under the aegis of NARD to suspend their nationwide strike.
The judge, John Targema, in rejecting an ex-parte application by a non-governmental organisation, Rights for All International, had said he would not issue such an order in the absence of the Doctors and other parties sued in the suit.
In addition to the National Association of Residence Doctors (NARD), its chairman, Uyilawa Okhuaihesuya, and the Nigerian Medical and Dental Association (NMDA), sued as defendants in the suit, others are the Minister of Health, Osagie Ehanire, the Ministry of Health, Minister of Labour and Productivity, Chris Ngige, and the Attorney General of the Federation and Minister Justice, Abubakar Malami (SAN).
The judge in his ruling said, issuing a restraining order against the Doctors to stop the strike without hearing the defendants would be in breach of their right to fair hearing.
A similar application earlier filed last Wednesday by the Federal Government alongside the Ministry of Health, was also mentioned in the court on Thursday but could not be heard due to non-compliance with procedures.
Rights For All International, an NGO that prides itself as a defender of human rights, had filed its ex-parte application on August 16, urging the court to restrain the members of NARD from continuing their strike, with a prayer to order them back to work.
As an ex-parte motion deployed majorly for cases considered urgent, the NGO’s application was on Thursday heard in the absence of the NARD and other defendants.
The judge consequently ordered that the application and the substantive suit alongside other documents filed by the applicant be served on the respondents.
As at the last sitting, an adjournment date to resume the case was however not fixed as Justice Targema, who heard the application as a vacation judge, said the next judge taking turn to sit, would fix a date for hearing.
A similar ex-parte application jointly filed by the Federal Ministry of Health and the Federal Government on August 18 where NARD is the sole defendant sued by the government in the suit could not be heard last Thursday.
The Government’s lawyer, D. E Kaswe, had drawn Justice Targema’s attention to the application, but the judge said it had yet to be officially assigned to him by the court’s president to be heard during the judge’s ongoing vacation.
According to the argument of the Government in the suit, members of the association “embarked on this strike without proper notice as provided by the extant law.”
It also argued that the association being of “essential services providers” are prohibited by law from embarking on strike.
“The continued and sustained industrial action by the defendant/respondent is contrary to public policy and equally endangers the lives of the citizenry,” it argued further.
Similarly, as at the last sitting, a date for hearing the case is yet to be fixed as only vacation judges could be affixed for determination of cases of urgency following the annual vacation embarked on by judges for the end of the court year session.
Government’s position on stakeholders’ meeting
Following the Sunday meeting, the Minister of Labour and Employment, Senator Ngige, disclosed that against the boycotting position of NARD, the Federal Government will commence the implementation of its MoU with the NMA on Monday.
Ngige who claimed they had reached agreements the previous night on all the 12 disputed issues, said NARD was expected to submit the list of the affected 114 affected officers for further verification and when confirmed that they are genuine, and their IPPIS particulars and BVN are in order, they would be paid in September with the outstanding arrears.
Ngige said the meeting noted that the non-payment of skipping allowance cuts across the entire health sector and therefore agreed that it was going to be handled holistically while awaiting the court judgment on the matter.
According to him, an agreement was reached on the Residency Training Fund outstanding for 2020 and 2021 after the Budget Office had explained that N617.4million was outstanding to be paid in 2020.
Ngige who said that the meeting agreed that on Friday, August 27, resident Doctors in institutions would have started getting their money, with each receiving about N542, 000, gave further details that: “There are reconciliations to be done here because 2020 was done with some errors. Some people who are not supposed to benefit from the fund got money and because of that, the number of genuine people that were not paid also came to that quantum of persons.
“So, reconciliation is being done and some monies are being returned. We have given a timeline for this reconciliation to be done.
“And for 2021, the money approved by Government is N4.802 billion. This money, like I said earlier, was contained in the 2021 Supplementary Budget, which the President signed on the eve of his departure to the UK for the meeting and medical check-up.
“So, between that time and now, it became a money law. The funds have now been sourced and it has gotten from the CBN to the Budget Office where we expect it to be processed in one week as undertaken by the Government side.”
Giving further details he said: “Coming to hazard allowance, everybody agreed that the discussion is still ongoing and therefore government wants to finish it up. We agreed with the NMA position that they don’t want to discuss holistically anymore as an association and that they have their own peculiarities that are not the same as other health workers.
“We are going to do two meetings, one for NMA and affiliates and one for JOHESU. But we are taking the meetings concurrently so that we don’t run into troubled quarters. We are starting next week.”
Ngige stated further that the NMA has been directed to submit a written position on the controversial withdrawing of NYSC doctors and house officers from the scheme of service to point out the anomaly in the circular, for onward transmission to the Head of Service of the Federation, who will look at the inputs given by NMA to the circular and process it to either the Council of Establishment or handle it administratively, if the issues are not such of fundamental nature to further clarify it, adding that a two-month timeline has been set for this.
Further reeling out outcomes of the meeting, he said: “We also agreed on the migration of Doctors on GFMIS from some university teaching hospitals, like University College Hospital Ibadan, University of Calabar Teaching Hospital and University of Port Harcourt Teaching Hospital which have recruited Doctors on GFMIS and were unable to pay them when GFMIS was tampered with.
“We can resume when we verify those people. They can be there until the recruitment is perfected in order to migrate them to IPPIS. In this wise, the Head of Service has granted waiver and revalidation of old waiver for University of Port Harcourt and waivers for University College Ibadan and Calabar, but this is not without reprimand for CMDS who have flouted government regulations by recruiting people into the service without fulfilling the requirements of circular on this.
“We also have an issue of hazard allowances for doctors in government hospitals that did not benefit from that 2020 payment. The Federal Ministry of Health has compiled a list and we said that the list should be forwarded back again to the Federal Ministry of Finance.
“For Doctors in university Clinics and the rest of them, we said they should route their own through the Federal Ministry of Education, their parent Ministry and Employer.
“On the controversial issue of NSIWC circular, removing Doctors in academia from CONMESS and also Doctors who are doubling as honorary consultants/lecturers from CONMESS to CONUAS, we have even before their request treated one leg of it by obeying the court order already gotten by them and in the spirit of dialogue, we said further discussions should continue with NSIWC.
“NMA has undertaken that they should tell the two members and their association to do an out of court settlement by withdrawing the matter from the industrial court until we finish the negotiation. We gave a time for negotiation.
“We have empanelled a committee with NMA leading, including NSIWC, Federal Ministry of Health, Federal Ministry of labour and others in the team. The first inaugural meeting is Tuesday August 31st, we are hopeful that this meeting will give us suggestion on how to resolve the matter.
“On the issues relating to states, there is no way the Federal Government will start pulling the states on the issue of domestication of Medical Residency Training Programme by their various Houses of Assembly and Government and issue of Medical Training Residency Fund. We also have the issue of Non-payment of COVID-19 allowances by some state governments and consequential minimum wage adjustments.
“We have before now made contact with the Governor’s Forum on these matters and the onus is now on us as the Ministry of Labour to talk to the Governors’ Forum and impress on them on the need for this to be done.
“The Medical Residency Training and accompanying Fund is already in the Act which the Federal Government has signed. We will impress it on them as part of strengthening the health system so that we are not starved of specialist Doctors. There is an urgent need for them to adopt that.
“This will also help us to stem the issue of brain drain. The Federal Government cannot employ everybody. We want state governments to pay more attention to secondary and tertiary health.”
Permutations
While Ngige has given hints of disclosure as resolutions reached at the stakeholders’ meeting with a declarative statement of commencing implementation of the Government’s driven MoU on Monday (Today), the affirmative position of NARD with a resolute opposition declining to append its approval on the MoU has brought dimensions of stronger controversies with perceived irreconcilable differences. With pending lawsuits seeking to take the contest to the end of bringing the strike to a halt by the force of legal injunction from an industrial court, the faces to the ongoing strike appear to be wearing deep seated dimensions. Awaited dynamics is perceived to take turn this week as the Federal Government moves to implement its MoU while NARD maintains its unyielding position.