Doctors’ Strike: Addressing recurring industrial actions with lasting solutions

The report of another nationwide indefinite strike by the National Association of Resident Doctors (NARD) on Monday, August 2nd, 2021, is once again the resurfacing of a recurring event which has become apparently infused in the system of the Country’s health sector. Sporadic strike by health workers in the Country has become deep seated to such height that the profile of instability in the system has grown to put pregnant questions over what has been so herculean that the Government has found impossible on its side to fix? The return to strike by health workers, from time to time, after negotiations with the Government has raised questions over the willingness of the Government to really bring an end to the issues constituting the straws of inconsistencies in the system.

The public health system in the Country is known to be riddled with depths of deficiencies which practitioners have continued to lament about. The grievances have, times without number, raised issues of intended and actual industrial actions. The failure on the part of the Government to honour agreements reached during negotiations with the stakeholders amidst industrial actions, has over time created the sensations of distrust. Those who have become depressed having lost confidence in the Government, have continued to flee the Country for greener pastures in other nations where health workers are well celebratedhr, against the apparent disdainful treatment that obtains in Nigeria.

On the recent industrial action, the Association was reported to have embarked on the strike 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 said doctors were ill-equipped and under-funded for the job while the facilities in state-run hospitals “are deplorable.” The grievances centre largely over payment of death-in-service-insurance for all health workers who died as a result of COVID-19 infection or other infectious diseases in the country and payment of Salary shortfalls of 2014, 2015 and 2016 to members in all federal institutions including state-owned institutions as earlier agreed with NARD, among others.

In the build up towards the strike, NARD, had following its National Executive Council meeting, held on Saturday in Umuahia, the Abia State capital, announced the commencement of the indefinite strike action on Monday August 2, 2021. The National President of NARD, Dr. Okhuaihesuyi Uyilawa, had mentioned that the decision was borne out of the inability of the Federal Government to implement the agreements it entered with the union 113 days after it suspended the previous strike. Uyilawa who said that poor working environment in public hospitals, irregular payment of doctors’ salaries and hazard allowances of N5,000 monthly, which was reviewed last in 1991, were some of the issues under contention between the union and the Federal and state governments. According to him, as part of a memorandum of action with the Federal Government, it was agreed that NARD members should enroll with the integrated personal payroll information systems, to prevent shortfalls in salary. He lamented that the agreement did not go as planned as a result of an embargo from the office of Head of Service of Federation. He further lamented that only one out of 19 families of medical doctors who died while treating COVID-19 patients had received their death-in-service insurance after assurances from the Minister of Health, Dr. Ehanire Osagie; and Minister of Labour & Employment, Dr. Chris Ngige.

He was quoted, “We ask Nigerians, when will our government become responsible enough to solve the challenges facing the health sector? Even with all these problems, only four percent of the total budget is allocated to the health sector, while 25-50 percent goes into payment of those in power. That shows that priority lies more on the interest of those in power than on Nigerian citizens. While we apologise to Nigerian citizens for the impact of the impending strike action on them, we want the government to implement all the agreements we have had with it for over a decade’s standing to improve the health sector and doctors’ welfare.”

Similarly, the Taraba state chapter of the Association, on Wednesday wrote the State governor, Darius Ishaku, demanding an improvement in the working condition for doctors under the state’s payroll. As contained in a letter signed by the State President and Secretary of ARD, Dr. Ahmed Uba and Dr. Sabo Rimamde, some of their requests include; “implementation and payment of arrears of doctors recently promoted; Payment of correct amount of equivalent to grade level for all medical students on bond as stipulated by the bond signed with the State government; Correction of the under payment of members and provision of running cost for health facilities and hospitals in the State.” Others are to domesticate the Medical Residency Training Act, and the commencement of internship programme at the State Specialist Hospital for Medical House Officers, Nurses, Laboratory Scientists and Pharmacists. The State Chapter of the  Association had also urged the state government to redeem the pledge to medical workers on COVID-19 inducement and hazard allowance.

The resonating expression of similar or same grievances, over time, has become a tradition in the discourse of the state of the public health sector in the Country.  Mid July, resident doctors at the Ekiti State University Teaching Hospital, Ado Ekiti, had embarked on strike over what they described as the irregularities in the payment of their salaries attributed to alleged reduction in the monthly subvention to the hospital by government. The Association’s president in the State, Dr Olaniyi Olaoye,  had said that since 2018, resident doctors have been subjected to hardship due to the payment of only their net salary as against the gross. It would be recalled that earlier on Thursday, 1st April, NARD had embarked on a nationwide strike disregarding appeals by the Federal Government. The strike was then at the instance of unpaid salaries and allowances of members.

It has become sacrosanct that the Government must awake to addressing the troubles of the public health sector in the Country with all sincerity. The disposition of the Government with breaches of agreements with the stakeholders, has over time reflected nothing, but an apparent lack of political will to check matters into shape by attending firmly to the demands of the sector. The posture has only resulted into deepening the depression of health workers, as many continue to long for greener pastures; a development that has continued to entrench the phenomenon of brain drain. The intermittent character of the working profile of the public health sector in the Country owing to grievances leading to recurring industrial actions, has continued to leave an atmosphere of disruptions which has made reliability in the system a facade. It is known that the resort of even top government functionaries to health tour outside the Country, boils down to the unreliable character of health system in the Country.

The status of the health profile of a population remains germane to national development. Where the Government talks about socio-economic development without paying attention to the healthiness of the Country’s population, is a loss of rational thought. It is therefore imperative for the Government, involving the Federal and the component units, to arise to giving  lasting solutions to the outcries in the public health system, which have constituted eyesores to the stakeholders. This is sacrosanct to changing the narrative of the disruptions of recurring industrial actions spurred by apparent insensitive posture to demands – a disposition which has contributed to rendering the Country’s public health system unreliable.