Nigeria’s healthcare delivery sector may be plunged into crisis if the workers under the auspices of the Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA) make good their threats to embark on industrial action over welfare demands.

The workers are aggrieved over the failure of the federal government to resolve a decade old issues, warning that they are ready to down tools before the forthcoming general election if it failed to resolve the lingering dispute.

In a letter to the Minister of Health, titled ‘Looming Industrial Action Over Non-Implementation of Adjusted Consolidated Health Salary Structure (CONHESS) And Other Pending Demands’, JOHESU and AHPA urged the federal government to expedite action on the matter to avert an imminent crisis.

JOHESU/AHPA drew the attention of the minister to the omission of its members during the payment of COVID-19 Hazard Inducement Allowance in 2020. According to the document, the joint professional bodies had written several letters to the Federal Ministry of Health on the lingering issues without positive response.

“We find it necessary to remind the federal government that Hazard Allowances were approved after months of negotiation for a total of 13 months. While nine out of 13 months have been paid, we request the immediate payment of the outstanding four months which are pending,” the letter signed by the Acting National Secretary, Comrade Matthew Ajurotu on behalf of Josiah Biobelemoye, the National Chairman, read in part.

JOHESU/AHPA noted with concern efforts by the government to streamline wages of health workers on the CONHESS and CONMESS, and requested an all inclusive approach in the exercise.

“This effort might jeopardise the pre-January 2, 2014 relativity in the wages of workers on the CONHESS and CONMESS because there has been an adjustment at least on three occasions on the CONMESS without a corresponding increase contrary to the 2014 Collective Bargaining Agreement (CBA) between the Federal Government and JOHESU.

“We therefore demand that any salary review of Health Workers must take cognisance of factoring the three increments on CONMESS which we were not privileged to enjoy for sake of justice and equity.”

The bodies also called for the approval and implementation of a new retirement age for health workers.

“We strongly urge you to once again facilitate the implementation of the increase in the retirement age of health workers from 60 to 65 years while that of Healthcare Professional Consultants be increased to 70 years. This is the format in the Education Sector where all Federal Tertiary Health Institutions (FTHIs) are affiliated to and should be regularised to enhance delivery and retention of experienced hands to the trending brain drain in the Health Sector.”

They claimed that since the workers associations suspended the industrial action in 2021, the government had taken their patriotic decision to allow for re-negotiations for granted, and not in any way bothered by their genuine demands.

“The delay on this matter is already heating up the peaceful atmosphere in the public health institutions which has been sustained since JOHESU/AHPA suspended its industrial action in 2021 to allow for re-negotiation of CONHESS adjustment and other issues contained in the strike notice to the federal government. This patriotic gesture is gradually being eroded by the slow-paced approach in which the federal government through the Federal Ministry of Health is handling this matter.’’

They advised the Minister of Health to intervene in the matter by convening an urgent meeting with the association to resolve the CONHESS issue. “JOHESU/AHPA requests for your intervention to urgently convene a High-Level Body (HLB) meeting to put to rest the CONHESS adjustment matter that has been responsible for major trade disputes in the health sector.”

The professional bodies have already instructed their states and federal health institutions chapters to get ready to mobilise its members for strike action within the first quarter of 2023, “possibly before the Presidential elections if the federal government does not come up with unambiguous insight into how it will meet the lingering demands.’’

They further drew the attention of the government to delay the implementation of Consultant Cadre for pharmacists and the creation of a Directorate of Medical Laboratory Science in the public service.

“The Consultant Cadre was first approved by the National Council on Establishment in 2011. Various attempts were made to sabotage this approval but we held on until the office of the Head of Service of the Federation confirmed to the FMOH on March 6, 2020, in a letter ref no. HCSF/SPSO/ODD/NCE/CND.100/S.8/39 that the NCE had approved Pharmacist Consultant Cadre again.”

It explained that “The FMoH referred to the National Salaries, Incomes and Wages Commission in a letter of May 13, 2020 ref no. C.400/11/217/T/21 to develop the appropriate benefits package based on the memo from the HOSOF.”

According to the document, “The National Salaries, Incomes and Wages Commission responded to the FMoH via a letter of June 17, 2020 ref no. SWC/S/04/S.218/T//9. In the letter, the NSWIC stated that “the salary structure of Medical Professionals, including Consultant Pharmacists has since been developed.”

“Consultant Pharmacists are entitled to be paid relevant allowances including Specialist Allowances as contained in Circular No. SWC/S/04/S.410/Vol 11/349 dated December 8, 2009,’’ it said.

“In view of the fact that due process had been met, the OHCSF on September 13, 2020, finally released the circular ref no. HCSF/CSO/HRM/1274/T3 for the Pharmacists Consultant Cadre. The immediate past Permanent Secretary of the FMoH on March 18, 2021, issued an internal circular to all Heads of Departments, FHIs, Agencies/Parastatals, and Regulatory Bodies directing the immediate implementation of the approved scheme by the OHSOF.”

It further stated, “In yet another internal circular ref no. FMH/FDS/CSPTH/1/95 of August 2, 2021, while citing precedents in the creation of cadres in Civil Service clarified the mode of application of the Consultant Pharmacist Cadre.

“It hinged this on the Fellowship of the WAPCP for officers already in the Directorate Cadre or the equivalent of GL 15 and above stating without ambiguity that such officers shall transit to the corresponding GL as Consultants without stepping down any grade. We put on record that it is only a few FHIs (less than 5) that have honourably respected the OHSOF’s circular, etc, to implement this Consultant Cadre in Nigeria,” it added.

JOHESU/AHPA similarly lamented the withheld April and May 2018 salaries of its members in Federal Medical Centre, Owerri (FMC) Jos University Teaching Hospital(JUTH) and Lagos University Teaching Hospital(LUTH), who had challenges with their management.

It said, “This development is worrisome as it continues to generate entropy in those facilities,” even as it complained of non-payment of hazard inducement allowance 2022 and outstanding four months of hazard allowance to its members.

It hinged this on the fellowship of the WAPCP for officers already in the Directorate Cadre or the equivalent of Grade Level 15 and above, stating without ambiguity that such officers shall transit to the corresponding Grade Level as Consultants without stepping down any grade. “We put on record that it is only a few FHIs (less than 5) that have honourably respected the OHSOF’s circular, etc, and are to implement this Consultant Cadre in Nigeria.

“We call on the Presidency to facilitate release of funds to cover payment of withheld salaries of JOHESU members at FMC, Owerri, JUTH, and LUTH, payment of omitted inducement and hazard allowances outstanding from 2022.

The bodies said the Federal Ministry of Health should be held responsible for any industrial dispute in the health sector due to the ministry’s insensitivity and double standards in handling the CONHESS adjustment matter and other demands.

They advised the federal government to promptly “checkmate the dark clouds gathering over the Health Sector in Nigeria before it is too late.’’ (Text, excluding headline, THISDAY)

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