Industrial Disputes in the Nigerian Health Sector: A Need to check the Rising Trend

This piece was first published in June 2009 edition of The Health Advocate, the magazine of the Nigerian Medical Association (NMA). 

Labour unions exist in every sector of the economy and are recognized worldwide as a platform through which workers seek to improve their general well being as well as that of the society. The health sector is not left out as we have the Nigerian Medical Association for medical doctors, Nigerian Dental Association for dentists, National Association of Nigerian Nurses and Midwives, Medical and Health Workers Union of Nigeria, Pharmaceutical Society of Nigeria, Nigerian Association of Physiotherapists among others. The primary goal of these labour unions in the health sector is to ensure the welfare of her members which would eventually result into better services at the various health institutions.

In fact, industrial disputes are inevitable as it is normal to have employers and their employees take different positions on policies or matters bothering on the welfare of the later. What is important is for such disputes to be resolved timely and amicably through dialogue and mutual respect. Unfortunately, this has not been the case in recent times in the Nigerian health sector. Even when agreements are reached, government at times does not implement them and in some instances suspend or abrogate policies emanating there from. 

As I write, the entire health workforce in Ebonyi State University Teaching Hospital are on the eleventh week of an indefinite strike action over the failure of the hospital management and state government to implement an agreement to improve staff welfare and provide adequate facilities in the hospital. The resident doctors in same hospital had embarked on strike for three weeks over same issue last September and were also forced to down tools for four days in February this year over the state of insecurity in the same hospital. In a related development, doctors under the employment of Lagos State government went on strike twice within the last the last six months; their counterparts in Anambra State had just suspended an almost eight month old strike a few months ago. Edo State doctors also had dispute with the state government over an alleged outrageous taxation imposed on private hospitals in the state.

Furthermore, resident doctors in Federal Medical Centre, Abeokuta reportedly downed tools because of an arrest of one of their colleagues by an anti-graft agency while on duty post. Doctors in Ladoke Akintola University Teaching Hospital, Oshogbo have also embarked on strike on at least two occasions within the last couple of years. In Abia State University Teaching Hospital, Aba, resident doctors were also on strike over the failure of the state government to implement the consolidated tertiary institutions salary scale (CONTISS). It could be recalled that a few years ago, doctors in the same hospital downed tools over an alleged physical assault on their colleague by a spouse of one of the political top shots in the state. Also in Oyo and Imo State, some health workers in the state were recently reported to be on strike. I could go on and on.

As if the above were not enough, the federal government inaction over the restoration of MSS/MSSS she unilaterally suspended about eleven years ago compelled the National Executive Council (NEC) of NMA to issue a 28 working the ultimatum to do so or face a nationwide withdrawal of services by doctors. But for the success of the negotiations between NMA and FG, Nigeria with her terrible health indices would have been left without the services of doctors for some time. However, only the timely implementation of the agreement would completely avert an industrial action.

The upsurge of industrial disputes and withdrawal of services by health workers is so alarming and not expected in any society with a people-oriented, responsible and responsive government. The contributions of Nigerian doctors and other health workers to national development cannot be over emphasized despite poor remunerations and unconducive working environment. Without sounding immodest, no other sector or group of workers make as much sacrifice like health workers. When people go to a health institution for care, they would of course want to be attended to by well trained and up-to-date health professionals with appropriate diagnostic and therapeutic equipment and also in good time, anything short of this is not acceptable. Ironically, same people criticize health workers when they withdraw services to compel the government to make the hospitals better equipped and more conducive for patients care. 

Nigerian doctors are very diligent, dedicated and go extra mile to care for their patients. We contribute money and sometimes donate blood to save our patients, even when the patient’s relatives may have abandoned them. This situation is commonly encountered in paediatrics department where children usually present as emergency with life threatening ailments and severe financial constraints on the part of the parents. I am sure that doctors detest withdrawal of services. NMA rarely go on strike. This is recently demonstrated in Ebonyi State where the state chapter of NMA despite the unacceptable treatment of her colleagues in the teaching hospital and sustained provocations by political jobbers in the state refused to be compelled to embark on statewide withdrawal of services. Similarly, the National Executive Council of NMA recently suspended her planned withdrawal of services to allow the federal government act on their agreement over restoration of MSS/MSSS.

It should be noted that the health sector alone cannot thrive when other sectors are also torn apart by regular industrial disputes, therefore, government must equally meet the demands of the Nigerian Labour Congress, Academic Staff Union of Universities, Nigerian Union of Teachers, NUPENG/PENGASSAN, etc to move the nation forward.

Nevertheless, the ugly consequences such as loss of lives resulting from industrial disputes in the health sector are unquantifiable. Also, the adverse effects of the strikes in the education and other sectors on manpower and socioeconomic development of the nation are better imagined. The persistence of these regular industrial actions would not only undermine the efforts to improve the nation’s health indices but would also make the achievement of the Seven-point agenda, Vision 20-20 or the UN millennium development goals a wild goose chase. 

In conclusion, prevention is better than cure; therefore, industrial action of any form should be avoided especially in the health sector. This can only be possible if government at various levels demonstrate strong political will by improving the situation of health in Nigeria through motivation of health workers, provision of modern diagnostic and therapeutic facilities in the hospitals as well as providing a qualitative and affordable education at all levels; to say the least.