My attention was drawn to the specific details of the interview of Dr. Osahon Enabulele President, Nigerian Medical Association published in your sister publication, Saturday PUNCH, November 9, 2013.
In the reckoning of Enabulele, hospitals run by doctors do better than those run by other health professionals. It appears he did not know the golden era in public hospital management up till the early 80’s when hospital administrators were in charge in Nigeria. The University College Hospital, Ibadan was led by an administrator designated a Hospital Governor. In that era, the UCH was rated as one of the best hospitals in the commonwealth before it was destroyed by those who facilitated disaffection in the health sector with the infamous University Teaching Hospital Act 10 of 1985 which today tends to consign other care-providers to houseboy status through discriminatory privileges, structures, training and wages. Ironically, that is one of my sins for which he has always ventilated invectives against me and pharmacists.
The cycle of delinquency and redundancy in our health system certainly does not support this. Under the watch of Nigerian doctors, our worsening health indices indicate that Nigeria and India alone account for 40 per cent of child and maternal mortality in the world, while Nigeria’s major contribution to health care is the exportation of the oral polio virus to the rest of the world because doctors play politics of exclusion that denies relevant care providers a role in immunisation endeaoctor–CEOs have depleted the Drug Revolving Fund account of many federal health institutions. Corruption abounds and many doctors including past ministers have been arraigned in courts and investigated by anti-corruption agencies for fraud related charges as heads of hospitals in Nigeria.
The United Nations rated Nigeria’s health system a shameful 187th out of 191 health systems in the world. The other legacies are the incessant strikes obviously orchestrated from the top by consultants and the NMA leadership through the National Association of Resident Doctors which is ordinarily not a registered trade union, but is today the umbrella template designed to execute the unholy and unlawful agenda of congressional hypocrisy of Nigerian doctors when it comes to negotiating wages, salaries and privileges.
In recent days, the Medical and Dental Consultants of Nigeria in furtherance of the “destroy other health workers” agenda, approached the Nigerian Industrial Court to void the appointment or approvals given any health care provider other than doctors in Nigeria to become consultants. Globally, pharmacists have always been designated as specialists and consultants just like you have in engineering, architecture, law and other decent professions. Nigerian doctors have never given hint on how these privileges intrude into their professional rights or latitudes, but rather continue to advance these acts through the instrument of the Federal Ministry of Health and State Ministry of Health which they dominate albeit unjustly.
Enabulele also compares the Federal Ministry of Health, which is a multidisciplinary sector with a plethora of health workers, to the judicial sector when he declared that the lawyer heads that sector and produces the Permanent Secretary despite the fact that “there are other paralegal professionals in the judiciary”. Who are these imaginary paralegal professionals in the Enabulele’s imagination who compares a multidisciplinary health sector with the glaringly obvious judicial sector dominated by only lawyers? The only other multidisciplinary sector comparable to the health sector is the building/works sector encompassing architects who train for an average of seven years, engineers, estate managers, quantity surveyors and others who usually train for five years.
This takes me to my latest “sin” of declaring that consultant doctors earn so much for doing very little. In yet another celebration of falsehood, Enabulele takes a position that no hospital consultant earns money in the range of a million naira which is a tragedy. Everybody in the health sector knows that the Chief Medical Directors of Federal Health Institutions in Nigeria earn about N1.5 million monthly, while the top consultants earn between N750,000 and N1 million depending on the FHIs. In the Nigerian public service, the apex is at GL 17. Other cadres outside the health sector on GL 17 earn just an average of 300,000 monthly, so any consultant doctor even on GL 15 on CONMESS 13 earns at least 150 per cent over these cadres who would have put in over 30 years in public service. I challenge anyone to deny this.
My travails with some Nigerian Doctors in the last few months is hinged on my decision to lead a crusade to challenge their serpentine depth of machinations. When I took over as President of Pharmaceutical Society of Nigeria, I resolved to work with other players to redress the various contraptions in health care which were assuming frightening labyrinth of complexities.
It was on this score I attended the Maiden Doctors Summit in Asaba, Delta State in January, 2013, where I was accorded a decent reception.
This discourse will not be complete if I do not draw attention of the reading public to new realities in health care at global level.
One good index that vindicates that modern day health care is about teamwork and devoid of attempts to denigrate or put some stakeholders down was the Monday, October 7, 2013, pronouncement by the Nobel Committee that Americans, James Rothman and Randy Schekman, and German born researcher Thomas Suedhof, won the 2013 Nobel prize in medicine for new discoveries on how hormones, enzymes and other key substances are transported within the cells. The key lesson in the scenario is that these men are not doctors or physicians but research scientists who through a dint of hard work have contributed to the development of medicine for the benefit of mankind.
The World Health Organisatioormal;”>Unlocking international best practices in the management of public health workers lies in the recognition and appreciation of the skills, expertise and experience of every health professional and indeed non – professionals in so far as these contribute to th missed it see it here http://www.punchng.com/feature/hotseat/pharmacists-nurses-others-should-stop-competing-with-doctors-nma-president/