Disparity in salary is why crisis in health sector cannot be resolved —JOHESU Chairman

The Chairman of the Joint Health Sector Unions (JOHESU) and National President of the Medical and Health Workers Union of Nigeria (MHWUN), Comrade Joy Josiah Biobelemoye, speaks with SOJI-EZE FAGBEMI, on the perennial crisis in health sector, the on-going nationwide strike by the workers and why the crisis cannot be resolved except President Buhari intervenes.

There is a court injunction calling on your members to end the strike and go back to work while you continue negotiation. What is your reaction to this development?

I don’t know of any court injunction. I have not received one, neither my legal department has reported to me that they had a notice and so they are going to court. So, I am not aware.

What if it happened and you got the notice, how will you handle it, bearing the fact that there are many court judgements in favour of JOHESU against the government which have not been implemented?

That is one of the reasons I doubt if any court will even give such a reward to the Federal Ministry of Health, Federal Ministry of Labour or their proxies; because this very courts have given their rulings; between eight to nine rulings they have disrespected. So, I am not too sure they have the moral right to even go to court to approach the court, but if they have gone through the proxy, I believe the court would not even grant it because they have disobeyed the same court.

There is this issues generating argument between the NMA and JOHESU, that if your member as a graduate get into service like say on grade level eight, and he spent seven to eight years to get to level 12, and a fresh medical graduate enters same service directly at level 12, the NMA is still insisting that the basic salary of a fresh graduate Doctor who enters at grade level 12 must be higher than your member who has spent seven years gathering experience to get to that grade level. Is this the fact and can that be justified?

Certainly it cannot be justified. Service wide, people of equal grades in any sector earn equal basic value. What makes the difference is the peculiar allowances. For instance, if someone enters as a clerical officer, passes his promotion and confirmation exams and gets moving until he has additional qualifications, moves to executive cadre and gets to grade level 12, his own basic will be the same as any others who enters at grade level 12. Or like Architects, engineers and lawyers, if that man  gets to level nine, no separate basic is provided or produced for them because a junior cadre person has grown to level nine.

Now, if that is not possible, we are talking of graduates, two groups of graduates where some are trained for eight years, the doctors are trained for eight years, and the others are trained for between six and eight years under JOHESU. Nurses are trained for seven years, which is post NYSC. They are trained five years academic, one year internship and one year youth service. Doctors are trained six years academic, one year houseman-ship and one year youth service.  Optometric within JOHESU are trained for eight years too, six years academic, like doctors, one year internship and one year youth service.

Even these ones that are trained for equal years with the doctors are still not entering service at grade level 12. They are entering at grade level 10 which is CONHESS 9 and their salary is not equal to that of Doctor who just enters service even after they get promoted to level 12 after three years in service. For Nurses who enter at level eight, after nine years they get promoted to level 12, their salary is still lower than a fresh doctor who is employed today.

So, we begin to ask, what is the parity, giving this explanation in terms of figures. Let us take the upper limit, a doctor who is on CONMESS 7, which is the apex of their service progression goes home with N704,000 before the adjustment; whereas on our own side, someone on CONHESS 15 which is the apex was going home with N476, 000. Is there any parity there? No. Now, on their own part, when they have adjusted, they are taking about N1million and they are saying we should still remain at N476,000. Even with our own adjustment, ours will take N670, 000.

The Optometric who was trained for eight years will take close to N700,000. So, the doctors and these other officers have difference of about N300,000. Is that parity? That is not parity. If an architect, a lawyer who enters service at grade level 9; and executive officers who gets promoted after eight years to grade level nine are placed on the same basic salary, do you call that parity? Salary differential is not measured by basic salary only. It is measured by allowances, total emoluments. So, if you are taking total emolument of N500,000, and I am taking total emolument of N300,000, that makes our difference. In civil service, differential is determined by the next highest N1.

So, if you get promoted to the next grade, you are earning N100,000 and if the step above where you are earning the N100,000 is N101,000, that is your benefit; not to talk of a situation where you have above N100,000, N200,000 and N300,000 above and you are still claiming of parity. There is no parity. It is designed to mislead Nigerians so that Nigerians will say our struggle is not justified, and so turn the strike action against JOHESU, mislead Nigerians that the strike is not legitimate and not for genuine reasons. So, they will use that to boost their quest.

What is their quest?

It is simply to arm-twist the President to approve privatization of public health institutions. That is the main thing. Again, they know that when they create this avoidable situation of strike action, they believe that they have nothing to lose. When they force us, like we endure six months before we embarked on this strike now, after given them 66 days to avert the strike that they refused; and we went into this strike, their moribund private clinics will now thrive. So, it is a way of creating a situation to boost the business of their colleagues, because people would be forced to go there. That is why we have always been mindful. This thing started 2014, we signed an agreement last year, 30 September, and within the same month doctors signed the agreement with the government. Within 16 days, they implemented for doctors, coming to our own, they have not implemented, saying that there is no money.

The same people that says there is no money are now providing huge sums of money, over billions, about N2 billion to implement skipping illegally. The court clearly said it was ruled for us, the Salaries, Income and Wages Commission clearly said that skipping is for us only, doctors were not part of it. But the Federal Ministry of Health is owned by the doctors. The Minister is a doctor, Minister of State a doctor and in the recent past, the permanent secretary was a medical doctor. They decide to do everything the way they want, whether it is right or wrong. If it is for the doctors there would be money, if is for the other health workers and professionals, the money will not be there. It is a deliberate way of creating chaos in the system to support their call for privatisation so that they can enslave Nigerians.

A government agency, came up with a circular that the skipping is not meant for the doctors, why is the ministry paying the doctors, why those who went to court and got the judgement were not paid?

That is what we are saying until the ministry is properly manned. If the minister is a doctor, at least the minister of state should be from the other group that makes 95 per cent of the health  delivery system. Also we are saying that we should revert back to the success days of Nigeria health system where West African countries were coming to Nigeria.

The health tourism was inward in those days. What happened was because hospitals were not headed by the medical doctors, but by hospital administrators. Doctors also come to do their professional things, the nurses and others. Everybody concentrated on what to do. But giving hospitals into the hands of people that do not have the capacity to manage health services, people that are full of pride, ego to manage hospitals, that is why from then, when Late Olikoye Ransome Kuti made that mistake, the indices of health started nose-diving. We headed South until when a non-Doctor, Eyitayo Lambo was appointed minister of health, that period, the indices started traveling North again. But has he left and the doctors took over, they have started heading deep-deep South until perhaps the depth will be so much that we will not be able to salvage ourselves.

How do you think this perennial crisis can be resolved?

The strike issue, the major problem behind non resolution of this issue is that the people who are there to conciliate are all interested parties. The minister of health is a doctor; the minister of Labour is a medical doctor too. Between the two, one is fair but then, when they get back to the house, it must be the doctors’ family again. So, the only way we can really get justice is if President Muhammadu Buhari intervenes himself. I say this with all seriousness because history is about to repeat itself.

The same way in 2014, President Jonathan was not well briefed by the then minister and he was told different things. But close to the elections, he was touched to come in and he came in to the matter. It was when he intervened he got to know the truth of the matter. But then, it was too late to assuage the hanger, he pleaded because of the elections please, and that after the elections he will treat the matter; but it was too late to assuage the hanger of the health workers.

The JOHESU family is a big family, we are not insignificant. JOHESU family is over one million membership, the five registered trade unions and the professional health care associations; the Assembly of Health Care Professionals. We are over a million, and only with our spouses take us to two millions, with our children, you can imagine. So, I hope the President will not let it to go too late.

Are you in support of independent people or body, beside those in the ministries of health and Labour, to come in and resolve this issue?

Fine, if the President comes in and constitutes a body, like the other time, the Secretary to the Government of the Federation was involved. If the President can come into the matter, first he should speak with the JOHESU family, so that he will hear things first hand. After that, that will guide him properly to appoint those people and give the appropriate terms of reference to quickly resolve the issue.

This issue would have been resolved, we provided all the factors, simplified factors to resolve this issue, to avert the strike, but because of their interest, they wanted the strike to go on, hence, they refused to take to our advice. For instance, we told them the Salary, Incomes and Wages Commission has calculated N22 billion. This is per annum, breaking it into 12, it is N1.8 billion per month. N1.8 billion can easily be gotten, source like two months of it, pay it into our members account, then we can have time so that the ultimatum will be suspended and we can have time may be you need two, three months to find way of including it in the budget. They refused. We also asked them, 12 days to the 66 days ultimatum we have given; please can you bring the structure. You cannot get a financial implication without a structure, give us that structure you used, give it to us, let us take it to our members and see if it will assuage their hanger, they refused to give to us. That would have been a resource to also avert the strike action. We went to the National Assembly when we gave the first 21 days to see how National Assembly can intervene to find early solution; the same doctors wrote to National Assembly that they should not attend to us.

The Senate President, after approving a meeting with us, the morning of the meeting, the House of Reps said the Speaker can no longer meet with us. To be fair to him, he set up the House Committee on Health to meet with us. But for the Senate, that day we were meeting with House of Reps was the day we got the cancellation letter that the Senate President is not going to meet with us. So, we made the efforts to avert this strike action, but they did not. To show that there was a serious insincerity at ensuring averting this strike action, the minister sent a memo requesting that for harmony of the health sector, I recommend N22 billion, and they gave us that document which we used in showing to our members to remain calm for the long period. That memo was raised in December, but it will surprise you to know that the minister went to defend the budget of the ministry in February but did not include that N22 billion. So, can you see that there was deceit, dishonesty in finding solution to this problem?

Do you mean that it is the salary, wages and income commission that came up with that amount in the first place?

The N22 billion yes.