Discourse over the health sector in Nigeria has continually remained on the radar of inconsistencies with the clustering clogs of instabilities which have saturated the public health system. It is resonating how the incessant records of industrial actions have been a definite character of the public health system in the Country. The infinite counts of strikes from time to time spurred by grievances left unsettled over years, remain an eyesore to many Nigerians. The recurring expression of unmet demands have been a major grounds why health practitioners within the four walls of public health system has continued to resort to industrial actions taking recourse to several breaches of promises by the Government.
It is no doubt that the health sector remains on the front burner where labour reactions have continued to attract pronounced recurrence. It is pathetic that at the expense of thousands of Nigerians who usually fall at the receiving end of the brunt of such industrial actions, the Government has failed over the years to proffer lasting solutions to the factors informing such industrial actions which have coloured the public health system in the Country with the profile of instability.
Since the public health system dominates and overwhelms the health sector in the Country, the populace have been left with no other choice than to be cut in the midst of ravages which industrial actions pose. It is known that even outside strikes, the system is overburdened such that many are left stranded without medical attention. Imagining what many Nigerians would be made to suffer under industrial actions would be much inconceivable.
While this trend have been reccurring over-time, it is known that the workings are usually characterised with intrigues of so many kinds. Negotiation attempts are known, over-time, to have been characterised with efforts by Government trying to push health workers to shift grounds by making promises which more or less, to a larger extent, have been breached than fulfilled. The reneging posture of the Government have only created a feeling and, more strongly, perception of distrust and loss of confidence in the Government. Hence, the perception by experience, has pushed labour unions generally and the bodies of health practitioners particularly, to become more hardened in their positions while negotiations goes on with the Government. The lingering of the ongoing strike by the Nigerian Association of Resident Doctors (NARD) reflects succinctly the prevailing perception. The strike now lingering for about 10 days having commenced on Monday, August 2nd, 2021, is another industrial actions informed by failed promises. 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 has said doctors were ill-equipped and under-funded for the job while the facilities in state-run hospitals “are deplorable.”
Governors of the All Progressives Congress (APC) under the aegis of the Progressive Governors’ Forum (PGF) following a meeting held in Abuja on Wednesday, could only arrive at pacfying the Doctors to end their protracted strike and negotiate with their respective State Governments. The position of the Governors contained in a communique issued at the end of the meeting signed by the Chairman of the forum, Governor Abubakar Bagudu of Kebbi State, centered mainly on appeal to the health professionals to sheathe their sword and engage in specific negotiations with individual State Governments and the Federal government for members in the employment of the central government. The communique read partly: “Noting that most of the grievances of the Resident Doctors are with State Governments, Forum appealed to the Resident Doctors to negotiate with individual State Governments and issues affecting Resident Doctors in Federal establishments should be negotiated with the relevant structures of the Federal Government.”
The intrigues painting the ongoing strike,as expected, have been coloured with unsavoury dramas. It is pathetIc that against facing, squarely, the necessity of addressing the lacunas and deficiencies spurring the grievances preventing a return to work, the political arrowheads have been found rather counting scores of allegations and counter allegations than hopeful development. The Minister of Labour and Employment, Senator Chris Ngige, had on Tuesday in response to the criticism of the Director-General of the Progressive Governors Forum (PGF), Salihu Moh Lukman, slammed the later in what he described as “expression of grave ignorance and crass emptiness” on the ongoing strike of NARD and the face-off between Kaduna State Government and the organised labour. It would be recalled that Lukman had in a statement ascribed the ongoing strike to the lethargic responses of the Minister of Labour and Employment, Ngige, and his counterpart overseeing the Health sector, Dr Osagie Enahire, which according him, as climaxed into the strikes in the Health Sector and consequent loss of lives. Lukman in a statement issued on Sunday had said in qoute that: “Given the cost to human lives from strikes by health workers, it is quite alarming that strikes in a sector as important as health would be taking place at all.
“This is a sector that by every standard should be classified as essential, based on which there should be special legal restrictions regarding labour actions such as strikes. Similarly, in the case of the current indefinite strike by NARD, the dispute is large with state governments and specifically, Abia, Imo, Ondo and Ekiti States have been identified as the states with poor conditions. States that are yet to domesticate the MRT Act 2017 are also known. Of course, there are also issues between members of NARD employed in Federal Governments. But those issues could hardly justify why the NARD should lump every all state and federal establishments in a single basket of dispute.
“Part of what is clearly a major crisis is the fact that although in most cases, disputes between workers and employers are limited mainly to some few State Governments, somehow, in complete violation of legal provisions or industrial relations practices and conventions, wildcat national strikes beyond the organisations affected are declared. Even when strikes produce human casualties, including deaths, both leaders of unions and employers, including governments behave as if it is normal. It is difficult to avoid the question, why should demands for job protection, better conditions of service and higher remuneration become more important than human life in Nigeria?
“Above all, the Code of Medical Ethics in Nigeria provided by the Medical and Dental Council of Nigeria, under Part B (Professional Conduct) defined professional negligence to include ‘Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so.’ How can this important ethical requirement be reconciled with the whimsical disposition of Resident Doctors in Nigeria to go on strike, including what is clearly a solidarity strike?”
“It is quite frustrating, when political appointees, such as Ministers of Labour and Health are unable to proactively pre-empt strikes of health workers in the country. As loyal members of APC, being the governing party, we must appeal to our Ministers of Labour and Health to wake up to their responsibilities and end this political embarrassment coming with huge costs to the lives of citizens. Ministers of Labour, Health and all stakeholders must as a matter of urgency lock themselves in the most qualitative form of negotiations with all workers in the health sector to restore some minimum standards in the sector. This is not simply about negotiating terms and conditions of services of health workers in the country. It is more about creatively ensuring that these are sectors that are essential services sectors with commensurate benefits that is beyond monetary provisions.
“Over the years, however, conciliation and mediation, as functions of labour administration, have greatly declined due to lethargic factors largely because of indecisiveness of Ministry of Labour. For instance, the processes for access to both the Industrial Arbitration Panel ( IAP) and National Industrial Court NIC, being the two legal bodies with the primary responsibility of dispute settlement that is legally binding are mainly through the Minister of Labour It is curious to ask, out of all the plethora of industrial disputes leading to strikes, how many have been filed before the IAP and NIC to pre-empt strikes?
“In addition, given that awards by both IAP and NIC are not made directly to the parties but through the Minister, who has the right to refer the parties back to both the IAP and NIC, how many judgements have been obtained and to what extent has the Minister or his representatives taken actions to refer parties back to IAP and NIC to enforce existing judgements and therefore avoid strikes? Without going into all the legal technicalities, which are the vocation of lawyers, in several cases, the Ministry of Labour is laid back and hardly intervenes to prevent strikes from taking place through brokering negotiations between workers’ and employers’ organisations until strike commences. Two of the most recently celebrated strike actions in the country may have been averted had the Ministry of Labour enforced provisions of the relevant laws in the country to compel resumption of negotiations between unions and employers, including government in the country.
“It is possible that the Ministry has had some consultations and initiated processes of dispute settlement that are not reported. Be that as it may, to the extent that they were unable to pre-empt the strikes, they were ineffective. Being ineffective also made it possible for leaders of unions and workers to the organisation to concentrate more in terms of power struggles between them and the government than engage in collective bargaining negotiations. As a result, disputes between states governments and their workers are made disputes involving Federal Government and citizens, which also cover employees in the private sector.”
Meanwhile, Ngige in his scathing reaction on Tuesday had described the statement as “nauseating, malicious and nonsensical” and a display of “his shallow knowledge of labour dispute resolution and management.” In a statement by his media office signed by Emmanuel Nzomiwu, the Minister had said: “The PGF DG must have spoken either out of ignorance or malicious intent to smear the two respected members of the Federal cabinet who had put in sleepless nights, engaging in meaningful negotiations, to ensure industrial peace in the Health Sector at this critical period of COVID-19 pandemic. It is shocking and outrageously incredible for somebody in his right mind to say that the two Ministers, who are both experienced medical doctors, were unable to proactively pre-empt strikes in the Health Sector. Dr Ngige apart from his medical training as a medical doctor did Postgraduate training in Health System and Hospital Administration and while at the Directorate Cadre position, manned the medical training in the Federal Ministry of Health. There was no strike notice from NARD in accordance with the Trade Disputes Act as there was nothing like resumption of a suspended strike. Hence invoking Section 43 of the Act, which states in part that for the period a worker withdraws his services, his employers have the right not to pay his wages is in order. The ILO principles at work, further supports this. Mr. Lukman has therefore displayed his shallow knowledge of labour dispute resolution and management by alleging that the Ministers, Ngige and Ehanire could have proactively stopped this strike and even went further to castigate Ngige over the Kaduna State Government/NLC dispute, which led to a four-day strike.”
“The Minister of Labour is alive to his responsibilities. He deserves commendation rather than vilification, for making sure that industrial disputes do not escalate to the point of going to either the Industrial Arbitration Panel (IAP) or National Industrial Court of Nigeria (NICN). Instead of Lukman praising the successes of a Minister of APC, his jaundiced eyes didn’t permit him.”
Giving priorities to matters by significance is paramount to measure due diligence. It is incontestable that Nigerians suffering the brunt of the ongoing strike and needs solution to recall health practitioners to resume duty, than the trading of scathing allegations and counter allegations. Nigerians would much more appreciate and be interested not only in the immediate remedy to the lingering strike, but also, lasting solutions to the prevailing order of incessant industrial actions which have characterised the health system in the Country. This, by and large, would be of satisfying interest to the masses, against mere exchange of scathing attacks to score political points. Hence, it is paramount for the political stakeholders who are the arrowheads of negotiations to muster strength on addressing the lingering strike, while brainstorming to proffer lasting solutions to change the narrative of incessant strikes by health professionals in the Country.
Nigerians who have been exposed to unsavoury conditions by continuous strikes in the public health system are in their numbers. Many have suffered preventable losses. It is pertinent for all relevant public officers to use their offices in the rationality of good faith to propel the course of changing the prevailing narratives against the disposition of trading blames.