The Acting Chairman, the Joint Health Workers Union, Dr Obinna Ogbonna, shares with AYOOLA OLASUPO the status quo on some of the issues embattling the health sector and their pressing demands from the government
There are reports that for years, JOHESU has been demanding salary parity with doctors, which doctors have consistently rejected, some people would ask, what is the motivation behind that request?
Those saying that are only trying to deceive the public. How can we ask for the same salary? It is wrong. They are just using that to make it sensational and to deceive people. We have different entry points. What they call relativity has already been taken care of at the entry point. They enter the workforce on grade level 12 as new graduates, while our people start with grade level 10. Along the line, if they pass their consultancy exam, they would go to grade level 15. Whereas, it will take our people who just entered the system an average of 12 to 15 years to get to that grade level 12, so before our people get to where they are they would have got to the peak of their career. And our allowances are not the same. For example, they take the lion’s share of our call-to-duty percentage. They take four per cent, while that of others is either two per cent or 1.75 per cent, so how do we say there should be pay equalisation? It cannot be, because that is just a fallacy and even a deceptive tendency because they know the truth but do not want to abide by it. Nobody should be deceived because we are not asking for an equal salary. What we are asking for is equity and there is a difference between equity and equality, fairness and justice. In 2009, we signed a collective bargaining agreement over CONHESS and the report says that whatever is applicable to one should be applicable to another. On January 3, 2014, the CONHESS salary was adjusted and we started the process of our own till now. For about nine and a half years ago, it has not been done while theirs have been upgraded about three times. Is there justice there? That is what people are angry with. The report says CONHESS should be upgraded and adjusted, and that was in the recommendations, but because the Federal Ministry of Health wants to use its advantaged position to stop it, that was why we said we would not accept that and we have approached Mr President.
Looking at the current economic realities, are you satisfied with the moves being made to increase salaries?
There is already a national process in terms of the minimum wage review every four years. Another one is due in 2024. However, due to the removal of fuel subsidy, the new government is trying to review the minimum wage, and when that is done there is something we call consequential adjustment that will be done to other salary structures, which CONHESS will benefit from.
Doctors and other health workers don’t do the same work, what do you think is behind this?
It is clear that we don’t do the same thing. Our training durations and functions are not the same but all of us in the health sector work as a team. Everybody is important, including the sweepers and the environmental people. So, nobody is saying we do the same type of job but if you are trained and you are a health professional in the system that means you are required to contribute meaningfully and efficiently in caring for your patients. We do not train for the same number of years, though some of our members like optometrists and other scientists like physiotherapists are now being trained for six years. As I explained, because medical practitioners use longer duration for their training when they want to enter the workforce they do not enter like other people. They enter from grade level 12, while others start from level 10 so can the salary of a level 10 person be the same as a level 12 person? They are giving the impression that the salaries for both levels are the same and that they want to collect salaries like them. It is a lie. What we are asking for is that when the person that started on level 10 gets to level 12 he or she should be paid the salary of the person that started from level 12 but they said no, the person should continue receiving level 10 salary. Before that person could get to that level 12, the person would have used 10 to 12 years before getting to that level 12. That is the fallacy they are trying to spread and we won’t take it because at the entry point relativity has been taken care of.
In the last strike by JOHESU, part of your demands was the immediate approval and implementation of the government’s technical committee report on CONHESS adjustment, could you tell us more about that?
During the process of engagement when we declared the trade dispute on adjustment of CONHESS salary as it was done in 2014, there was a technical committee which we referred to as the high-level body of the government, representatives, and federal agencies that were represented like the budget office, Ministry of Finance, Office of the Head of Service, Salaries and Wages Commission, Labour, Federal Ministry of Health and the JOHESU family. That was the technical report we spoke. After the meeting, they made two recommendations to the government that in order to adjust the CONHESS salary the government should pick and implement one from the two recommendations. That is where we are now and we are expecting the government to pick one. The federal ministry of health has written the budget office for them to pick one of the recommendations for onward transmission and implementation. We know that the second option will be more favourable, which we have also communicated. After seeing Mr President, we made an appeal during the NEC meeting and the NEC appreciated the President’s intervention but also gave a timeline. We are following up with the government so that the needful will be done and we will not have crisis on our hands.
You also demanded the immediate payment of the omission and shortfall in the Covid-19 hazard/inducement allowances for affected health workers in federal health institutions. Could you give us an idea of how much this is?
The total will be with the ministry of health because those who were omitted from various institutions were written to by the director of hospital services and they have generated their names, the percentage and how much it will be from the ministry for onward transmission to the agency that is concerned. Ours was to generate the names, the institutions and those beneficiaries.
Do you have an idea of the number of people affected?
The institutions were asked to write directly to the federal ministry of health. We have about 56 tertiary institutions in the country, so they will submit the names of the affected persons to the federal ministry.
You demanded the immediate and unconditional implementation of the pharmacist consultant cadre, unconditional payment of all withheld salaries of Federal Medical Centre, Owerri, Jos University Teaching Hospital, and the Lagos University Teaching Hospital, and outstanding April and May 2018 salaries of members at FMC, Azare. Could you expatiate on this?
For the pharmacy, consultancy cadre circular, the head of service has already released that. There are some lacuna which are supposed to be addressed. The federal ministry of health told us that they were already attending to it, so until we get to our next meeting. That is when we will know what has been done but we are hopeful that we will get an update in the next meeting.
Many professions are demanding extension of their retirement age, like we have seen for judges and teachers. You have demanded the speedy implementation of the increase in retirement age from 60 to 65 years and 70 years for consultants, why do you want the age increased, especially given the argument that such would limit the space available for new intakes?
It is not new to us that during the advent of Covid-19, you will discover that we were short-staffed in the health sector and during that episode, we started asking some of our retired colleagues to come back and help tackle the Covid-19 pandemic. With the japa syndrome, you can see many young people leaving the system and all our facilities are getting short-staffed with experienced personnel. We may have the young ones but if they do not have experience they will not be well guided and it will affect healthcare. In order to train the new ones, the retirement age should be elongated. It doesn’t stop the young ones or the new intakes because we need both the old and the new ones to have a good mix for an effective service delivery. That is why it is being advocated for and it is not compulsory that you must remain in the system. If you are 65 or 70 and you are not healthy or capable of staying, such a person will not be asked to stay. It is voluntary. We are not making it compulsory for the state if they are not ready to adopt it, but federal level first. Some states have even started the extension of retirement age so anybody can adopt it.
Why do you want it to be compulsory at the national level?
We need it at the national level because most of the tertiary health institutions do three things; consultation, research and training. Teaching is their priority while ours is consultancy but we both do research. It is also one of the ways to improve on the personnel shortage in the sector because of the young people leaving the system for greener pastures.
The ninth House of Representatives met with your union over your exclusion from the 40 per cent salary increase, what is the status now?
We had the information that the presidential committee on salaries already proactively looked into it and they are trying to do something about it. There are speculations that it could be 25 or 35 per cent. We do not have concrete evidence about that but we are assured that something is going on about that. We believe in the next meeting they will give us updates on it.
There are clamours to seek recognition of health workers in non-core hospital facilities in the payment of the hazard allowance, could you shed more light on this?
The people are making a legitimate request because the circular that changed the hazard allowance from N5,000 to what it is today says that those people who had hitherto enjoyed the N5,000 hazard allowance are entitled to the new one. So, if you have been there during the previous one and now they exclude you from the new one it is your right to ask questions. That is why some of those people agitating are not in the hospital environment; some of them are in the laboratory dealing with specimens. They also face hazards and they have been collecting the N5,000 but now the government is saying because they are not in the hospital environment they won’t enjoy it anymore.
How best do you think the Federal Government can approach infrastructural decay in the health sector?
With the new President (Bola Tinubu), we are ready to engage and give suggestions. The infrastructure is in two folds. You have the material infrastructure when we talk about the building but it does not stop with physical edifice. Equipment is also part of the infrastructure we are talking about because many of the ones we have are obsolete and there should be an improvement on them. Our hospitals should be upgraded to have the latest medical machines for them to effectively deliver services.
Your union once said that the minister of health and heads of hospitals do not have to be doctors, what is your advice to the President and governors as they form their cabinets?
We said they should not necessarily be health practitioners but seasoned administrators to take charge of the day-to-day running of the federal ministry of health and hospitals, because when you are there you are not practising medicine, pharmacy, physiotherapy and others. You are purely into administration, managing human beings and resources. It is not your professional calling that you use to dispense your duty and we have seen that even when medical practitioners are there today, Nigeria’s ranking in several indices is appalling. They are poor managers and that is because that is not what they are called to do. Their job is to manage and cure sick people so that they can get better. We have already sent our position to the President that he should put the round peg in a round hole and make sure that he puts those who are seasoned administrators who know it well in all of those positions while we go back to deliver our health care services. That will help and there will be no restrictions, discrimination or unnecessary favouritism of an advantaged group over others.
