'Govt has continually shortchanged resident doctors over the years’
Can you tell us the major challenges of resident doctors, and what has led to your industrial actions in recent years?
Some of the issues have lingered for over six years, and also led to the strike we had in September 2017. They include issues of decayed and dilapidated infrastructures, shortage of personnel, pension issue, enrolment of our members into Integrated Personal Payroll Information System (IPPIS), payment of incomplete salary and skipping arrears. Others include passage of Residency Training Bill and payment of paltry amount as hazard allowance. Everybody in the health sector including doctors is being paid a paltry sum of N5,000 monthly as hazard allowance making a total of N60,000 annually.
You will recall that, a couple of doctors have died in cases related to Lassa fever. We lost about five of our members to Lassa fever in the Federal Teaching Hospital Abakaliki alone. These are colleagues that we have lost due to health related hazards and it is unfortunate that beyond this N60,000, there is no concrete arrangement for them or their families.
Till date, there is no sign of commitment on the part government towards cushioning the damages suffered by doctors while serving Nigerians. There is also selective or haphazard implementation of government policies and circulars. Chief Executive Officers of some hospitals choose which circulars to implement or not, maybe to satisfy their political benefactors to the detriment of the health sector.
Another important issue is pension. Before 2013, resident doctors were having pension deductions, with counterpart funds being paid by government, but from 2013 till date, various Dr Ahmed Ganiyu Olanipekun is the acting president of the National Association of Resident Doctors (NARD). In this interview, he spoke on how the Federal government failed in its memorandum of terms of settlement signed with the association following the 2017 strike, the sack of Resident doctors in Jos University Teaching Hospital (JUTH) and their demands among others. inconsistent pronouncements were made through the Budget Office, Office of the Head of Service and sometimes by chief medical directors that resident doctors are not pensionable.
Part of the memorandum of terms of settlement reached with the Minister of Labour is that resident doctors are pensionable, and a letter was released from the office of the Head of Service to that effect.
The implementation of this was hinged on our enrolment back to the Integrated Personal Payroll Information System (IPPIS), but as I speak with you, pension deduction for resident doctors is yet to see the light of the day.
The agreement that we reached with government since last year, is still suffering set back, and a huge one indeed.
It was also agreed that government was going to enroll us into IPPIS. In January they started the process and they told us that initially not all centres were corporative.
As at our last meeting in March, with the director of IPPIS, we were told that over 90% of centres have registered which is a good number to start with, and the director of IPPIS gave us the assurance that we are going to have a trial by this month of April. But let me tell you that we seriously have doubt because the CMDs have told us that they are yet to be contacted by the IPPIS office to let them know that they are starting a trial payment in this month of April.
So you can see the effect of IPPIS on pension because it is when we are enrolled on IPPIS that our pension deduction will start and the counterpart fund added. Salary payment through IPPIS platform is yet to commence for residents and the pension arrangement is being stalled.
We have payment of salary shortfalls. Different centres were paid different fractions and different percentages of their salaries up till sometimes in August 2017. Also dearth of infrastructure and dilapidated existing infrastructures top the list of the challenges of resident doctors. This is central to residency training and healthcare service delivery. So their non-availability and poor state actually takes a toll on the effectiveness of service delivery and training.
We also have shortage of staff, and those on ground are overworked. We have institutions that have not recruited resident doctors in the last five years. Many resident doctors are also leaving the country. This further worsened the dearth of resident doctors in teaching hospitals.
To what extent has the government complied with some of the memorandum of terms of settlement with which you called off the strike last year?
In fact, majority of the salary short fall that led to the industrial action last year has not been paid. If something urgent is not done, industrial disharmony may be unavoidable. Part of the memorandum of terms of settlement was to pay us skipping arrears. Other health workers have enjoyed skipping for over a decade. I think precisely since 1998 till date. As at January 2018, we have all our members skipped but there are arrears owed between 2014 and 2017. There is no convincing evidence that government is sincere about paying these arrears. So we feel shortchanged and that government has continued to be manipulative. While other health workers have enjoyed their full salaries for decades, doctors have been denied and it appears as if government has continued to deny us our entitlements.
Resident doctors gave the Federal Government and Jos University Teaching Hospital, JUTH a 30-day ultimatum. Has government met your
demands?
Government is yet to meet our demands. In July 2014, a circular was issued to the medical directors and CMDs along with a template of employment which was meant to mitigate the challenges and irregularity in the terms of engagement of resident doctors and also bring about uniformity. That circular was reissued in April 2016 but JUTH is not complying with the circular. What JUTH management is operating currently, is a six-year document dated 2003.
That means, someone brought in for residency training in Neuro-surgery which requires about eight to nine years training will be given a letter of six years for training by JUTH. JUTH is operating an outdated policy and it is actually causing crises.
The little progress we have made is that our association met the newly inaugurated Board of JUTH because we are also committed to averting avoidable crisis. The board told us they will meet with the ministry, and report back but we are yet to get response from them.
What are your concerns about the Residency Training Bill?
Government has no budgetary planning for specialist training of doctors in Nigeria and from late 2015 till 2016, resident doctors came up with what residency training bill and financial implications should look like, and the recommendations were submitted to the Federal Ministry of Health. The Residency Training Bill has been sent to the National Assembly. It is still awaiting presidential assent and the delay in assenting to this bill has been a recipe for crises like we are witnessing in JUTH.