•There has to be a permanent solution to frequent strikes by doctors
At any given time in Nigeria, doctors are either serving notice of a strike or carrying out an actual strike to back their demands for better pay and conditions. The on-going nationwide strike by resident doctors is only the latest episode in a cycle, of which the health of the entire nation is the casualty.
It is time to break this destructive cycle.
It is notorious that facilities and working conditions even in the most prestigious public medical facilities are far from adequate. World-class medical specialists abound, but the advanced equipment and technology they need are either not available or are in disrepair. Since political officials and top government functionaries can travel abroad at public expense to seek medical treatment, the parlous condition of the nation’s hospitals has not been their priority.
It is a shame that in all the years of military rule when the authorities controlled vast oil revenues they did not have to account for, they could not even create a world-class hospital for the armed forces. It is also a shame that the National Hospital in Abuja, with all the resources it commands, has remained a Third World facility decades after it was set up.
The Federal Government should regard it as a national imperative to establish a world-class hospital in Abuja, and in each of the so-called geo-political zones to engage our highly-regarded specialists, curb the brain drain, and serve as platforms for training and re-training medical professionals.
But even the most advanced facilities will not function optimally with demoralised staff. And the truth is that the morale of doctors in the public health care delivery system is low. There is little motivation. As in much of the public service, salaries are rarely paid on schedule. Even as the latest strike paralysed hospital services, the Kogi State Government was urging doctors in its employment to settle for just one-half of their salaries.
Incentives promised are rarely delivered. Career paths are uncertain, and so advancement. Arbitrariness runs though the system.
These, at any rate, are the complaints of the resident doctors who serve a six-year apprenticeship required for appointment as consultants, and who carry out the grunt work of providing basic medical services.
The charges have merit.
The system is over-bureaucratised. There are too many centres of authority, each guarding its own turf jealously, with scant regard for the smooth and efficient running of the system. According to a former permanent secretary in the Federal Ministry of Labour and Employment, Dr Clement Iloh, rivalry among administrators and professionals results in the indiscriminate issuance of directives and guidelines that often confuse rather than clarify what the actual policy is.
These are the issues that will have to be addressed if the ugly cycle of industrial strife in a sector so strategic to the well-being of the nation is to be broken. There should be greater coordination within the system. Complaints should be investigated promptly.
All parties should negotiate in good faith, bearing in mind, as Dr Iloh has suggested, what is affordable and sustainable. In the end, an agreement entered into for the sake of buying time, regardless of whether it can be sustained, will serve no lasting purpose.
It follows that any agreement reached should also be implemented in good faith. A permanent mechanism for monitoring the implementation of agreements should be established.
Even in pursuing their legitimate grievances, doctors should be mindful of the Hippocratic Oath: Above all, do no harm. They cannot be indifferent to the great suffering the public experiences when they go on strike. They should eschew rigidity in their demands.
But those who are so fond of invoking the Hippocratic Oath to castigate striking doctors must themselves do nothing to harm the morale, finances and career prospects of doctors.