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Crisis looms as health workers begin indefinite strike today

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.Okowa tasks medical personnel on efficient services

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Just few days that the National Association of Resident Doctors ,(NARD,) suspended its 5-day warning strike, the health workers under the umbrella of the joint health sector Unions ( JOHESU) have commenced an indefinite strike .
The union while addressing press conference in Abuja yesterday, said the strike will begin at 12 midnight on Thursday.
Acting National Secretary, Medical health workers Union, M.O Ajorutu, who read the text of the press conference said government was adamant on its stand on the workers demands.
The strike is coming after the expiration of a fifteen day Ultimatum is to demand for implementation of the technical report on the Consolidated Health Salary structure (CONHESS) Adjustment, Payment Of Peculiar Allowances to health workers under the aegis of The Joint Health Sector Unions (JOHESU) and Assembly Of Health Care Professionals Association (AHPA), Speedy adjustment of retirement age from 60 to 65 among others.
The affiliate Unions involved in the strike are The Senior Staff Association of Universities, Teaching Hospitals, Research Institutes and Associated institutions ( SSAUTHRIAL) , The Medical And Health Workers Union Of Nigeria ( MHWUN) ,The Non Academic Staff Union Of Educational and Associated institutes ( NASU) And the national Union Of Allied Health Professionals NUAHP
State health workers with unresolved trade dispute and outstanding demands are also to join.
The acting National Secretary, at the event said: “I find it necessary to intimate our members across Federal Health Institutions (FHIs) nationwide and members of the public about the declaration of Trade Dispute in the Health Sector and issues in dispute between the Federal Government of Nigeria and Health Workers under the aegis of Joint Health Sectors Unions (JOHESU) comprising of the aforementioned four affiliate unions and all Professional Associations (AHPA).
“Consequent upon the non-challant, bias and lackadaisical attitude of the Federal Ministry of Health against JOHESU members and the resolution of the expanded National Executive Council (NEC) meeting of the Joint Health Sector Unions (JOHESU) held on Monday, 8th May, 2023, our members in Federal Health Institutions nationwide are hereby directed to withdraw their services indefinitely commencing from 00:00 hour on Thursday, 25th May, 2023.
“For ease of understanding, the issues in dispute are as follows:
Adjustment of Consolidated Health Salary Structure (CONHESS).
Payment of peculiar allowances to health workers under the aegis of JOHESU/AHPA.
Immediate and Unconditional Implementation of the Consultant Cadre Circular for Pharmacists in all Federal Health Institutions (FHIs).
Payment of all withheld salaries of our members in Federal Medical Centre (FMC), Owerri, Jos University Teaching Hospital (JUTH), Lagos University Teaching Hospital (LUTH) and outstanding April and May, 2018 salaries of members in Federal Medical Centre (FMC), Azare.
“Payment of health workers excluded in the payment of new Hazard Allowances.
“Adjustment of CONHESS Scale as was Done with CONMESS Scale:
In 2009, the Federal Government committed itself to a Memorandum of Understanding (MoU) on relativity in the two salary structures that were introduced viz Consolidated Health Salary Structure (CONHESS) for all health workers except Physicians and Consolidated Medical Salary Structure (CONMESS) for Physicians.  The express implication of the MoU was that any adjustment on any of the salary structures will transcend to the automatic tinkering of the other structure by a commensurate ratio.
“On January 2nd, 2014, the Federal Government adjusted the CONMESS Scale holistically and further adjusted selectively for Physicians in 2017 without adjusting that of CONHESS for other health workers.  During negotiations on this matter in 2018 with a team of Federal Government officials led by the Honourable Minister of Labour and Employment, Dr. Chris Ngige, CON, and the then Minister of Health, Prof. Isaac Adewole, who incidentally are Physicians, it was impossible to break the impasse which has lasted up till today.
“At the peak of negotiations with the Federal Government team, it offered N6.5billion which was rejected because it was grossly below the N22.6billion prepared by the National Salaries, Incomes and Wages Commission (NSIWC) as agreed in the 2017 Terms of Settlement.  An intervention was also brokered by the leadership of the National Assembly, who promised to accommodate Federal Government approvals for CONHESS through supplementary budget.
“It is imperative to put on record that contrary to the information that it was President Muhammadu Buhari, GCFR who refused to approve the N22.6billion from NSIWC, the estimate from NSIWC was never presented for President Approval.  At least, it was the High Level Body (HLB) Command of the Federal Government that refused to okay the estimate of N22.6billion to cater for the adjustment of CONHESS Scale as was done with CONMESS Scale.  This particular development confirms that the rings of Physicians who preside over the Federal Ministry of Health (FMoH) are clever users of untruth.
“They have been manipulating events and dropping the name of President Buhari to have their professional interest dominate proceeding in the Health Sector.
“These moves were never scaled before events took us to the Alternative Dispute Resolution (ADR) Centre of the National Industrial Court (NICN), where to the chagrin of JOHESU leaders, the Federal Ministry of Health (FMoH) now claimed it could only offer N2billion at a time N6.5billion had been earlier rejected.  At this stage, it was obvious the Federal Ministry of Health team to the Mediation which stretched proceedings to over three (3) months on flimsy excuses of seeking the Finance Minister’s approval for a realistic vote was playing games to wear us out which was why the matter of CONHESS adjustment suffered a deadlock at the ADR Centre.
In 2021, JOHESU/AHPA picked the gauntlet again by demanding the implementation of the adjustment of CONHESS by declaring a trade dispute through issuance of a strike action notice to Federal Government.
“The Honourable Minister of Labour and Employment, Dr. Chris Ngige (Chief Conciliator of the Federation) apprehended the dispute and it was resolved at a conciliating meeting on 7th September, 2021, that directed the Federal Ministry of Health and Joint Health Sector Unions/Assembly of Health Professional Associations re-negotiate with a caveat to update him as necessary or refer the matter back to the Office of the Minister of Labour and Employment if the parties failed to agree on the modalities of implementation.
“The FMoH set up a Technical Committee comprising of the NSIWC in steering role through its Chairman.  Other strategic arms of the FG including FML&E, AGoF, Budget Office, IPPIS, Office of HOCSF, OSGF, FMoH and JOHESU were represented.  During deliberations at the Technical Committee representative of the FMoH through the Department of Hospital Services which is the main Physician hatched tool in the FMoH took the age long position of the NMA which has been entrenched in the last three (3) day dispensations of Physician Health Ministers at FMoH as epitomized by the leadership of Prof. Christian Chukwu, Prof. Isaac Adewole and now Dr. Osagie Enahire that an adjustment of CONHESS will distort relativity in the CONHESS and CONMESS structure.”,.
He further explained that: “The Technical Committee chaired by the Chairman, NSIWC produced a report recommending cost implication of adjusting CONHESS in December, 2021.  The basis of the report was that relativity had been entrenched at the point of entry for personnel in the public civil service.  Despite this the Dr. Osagie Ehanire led FMoH officially blackmailed all other stakeholders that except they provided funds for adjustment of CONHESS, it was an impossible task to achieve apart from it’s cooked up claims of distorted relativity.  In a major twist last week and on specifically, this same FMoH entered agreement with NARD to again adjust CONMESS for a record 3rd time since January 2nd, 2014 and has proceeded to transmit the financial implications to appropriate arms of the FG for payment.  For the records it is actually the Federal Ministry of Health and its partners in NMA that distorted the relativities in the CONHESS and CONMESS scale which was established in 2009 when both salaries scales were instituted.   Any matter connected with establishing relativities must therefore take cognizance of the 2009 figures on both salaries scales.   As a matter fact the entry point of Physicians as also been adjusted to equivalent Grade Level 13 instead of 12 while the entry of all others Health Workers including Pharmacists who hitherto enjoined the same grade level entry points with Physicians have remain stagnant thus widen the relativity between CONHESS and CONMESS.
“The consequential adjustment of 2018 earlier refer to created further distortion on Physician on CONMESS scale were among those prohibited from benefiting from the guideline of because CONMESS had been adjusted in 2014, but the trio of Head of the Civil service of the Federation the Minister of Health, Prof. Isaac Adewole and Labour Minister, Dr. Chris Ngige who are Physicians smuggled CONMESS into the beneficiary list this created a further increase in disparity between 20 – 50 percent in favour of CONMES.
“For us in JOHESU it is a matter of the beat goes on and we are determined to pit a halt to this nauseating manipulation of Physicians in the FMoH.  In tandem with the reality that when injustice becomes law, resistance becomes a duty we shall insist that justice be served us as bonafide and free born citizens of the Federal Republic of Nigeria.  There shall be no going back on the adjustment of CONHESS, because it is now or never.
“Payment of Shortfall Arising from the Implementation of COVID-19 Special Inducement Allowance:
JOHESU is forced to draw attention to the deliberate short-changing of our members in the payment of COVID-19 Inducement Allowances.  The Federal Ministry of Health (FMoH) ought to redress and supervise the adherence to payment of 40% or 50% COVID-19 Special Inducement Allowances as appropriate to all health workers in Isolation Centres, the FHIs or other related Health facilities without discrimination bordering on clinical or non-clinical status in consonance with our MoU of 21st April, 2020, and as admitted by the Federal Ministry of Health at a meeting held 1st July, 2020, that the payment of 10% was done in error.
“Consequently, FMoH agreed to correct the anomaly and pay the outstanding balances of shortfall to affected health workers for the period covering April and May, 2020.
“The Federal Government did not ensure total and full implementation of the July 1st, 2020 agreement between JOHESU and the Federal Government when it disbursed June, 2020 payment.  This has created rumbles and grumbles across our membership and has now constituted the challenge of assuaging the affected members that have become restive and thus making it impossible to guarantee industrial harmony within the generality of JOHESU members.  It is rational logic that corona virus or other infectious diseases will not decipher who a clinical or non-clinical staff is in the various Health Institutions before striking the would-be victims.
“This is why this discrimination in payment is an embarrassment to the nation.  We find it imperative to draw attention to the exclusion of health workers on the CONHESS who are now excluded from the New Hazard Allowances in research institutes and other non-hospital based work places.
“Withheld Salaries of JOHESU Members:
We find it extremely necessary to inform the general public about challenges of withheld salaries of our members in FMC, Owerri, LUTH, JUTH and April/May, 2018, for all our members in FHIs nationwide.  This was hinged on a selective “No Work No Pay” discriminatory policy of the Federal Government.
“Once again we refer the stakeholders in Nation building to the 2017 terms of settlement we had with the Federal Government on September 30th, 2017, where it was agreed that no form of victimization will be visited on JOHESU members who participated in the strike action.  However, our members were victimized with “No Work No Pay” for re-activating the suspended strike action in April/May, 2018, which was a direct consequences of the failure of the Federal Government to implement the Terms of Settlement that should have been completed within five (5) weeks.
“At the meting of stakeholders held on 8th June, 2020; comprising Federal Government officials, Unions and Professional Associations in the Health Sector, the Honourable Minister of Labour and Employment (FML&E) pronounced that all withheld salaries of our members in FMC, Owerri, LUTH, JUTH including the withheld April and May 2018, salaries of JOHESU members, shall be paid by the Federal Government.
“Our teeming members had expected that after the level of interactions with the Presidency and other officials of the FG, following JOHESU National Officials courtesy visit to President Muhammadu Buhari, GCFR in March 2020, where he specifically directed the Federal Ministry of Health (FMoH) and Federal Ministry of Labour and Employment (FML&E) to amicably resolve all contentious issues affecting our members, we had expected that His Excellency’s kind intervention will make way for a breakthrough.  Unfortunately, the Federal Ministry of Health (FMoH) and Federal Ministry of Labour and Employment (FML&E) have continued to dilly dally on these contentious issues against the President’s directive.
“Speedy Adjustment of Retirement Age from 60 – 65 years and 70 years for Consultants in the Health Profession:
JOHESU/AHP continues to review the handling of the retirement age of health workers from 60 – 65 years and 70 years for Consultants in the health professions.
“We observe that the disposition of representatives of State Government at the National Council on Establishment (NEC) has continued to slow down this demand.
“We, therefore, urge the Federal Ministry of Labour and Employment to devise other favourable tactics which are acceptable within the realm of normative civility to catalyze this demand in the public interest.
“Payment of Peculiar Allowance to Health Workers Under the Aegis of JOHESU/AHPA:
The JOHESU/AHPA finds it important to invoke the spirit of its Collective Bargaining Agreement (CBA) with the Federal Government to determine consequential adjustment of CONHESS on the basis of the 2023 review of CONMESS.  A proposal to apply a 25% review on CONHESS is clearly designed to widen the relativity between CONHESS and CONMESS.
“In arithmetical progression the acceptable review on CONHESS will employ the application of ratios in the main salaries and other allowances that health workers on CONHESS are entitled to.
“We recommend that the NSIWC be mandated to work this out alongside the Technical Committee report earlier referred to.
“Immediate and Unconditional Implementation of the Approved Consultation Cadre Circular of Pharmacists in all FHIs and Payment of Specialist Allowances to Deserving Health Professionals:
One of the areas that has showcased the reign of tyranny of Physician – Health Minister in contemporary times is the disgraceful methodology with which they have suppressed every attempt of non-physician health professionals to diversify and expand their knowledge base by refusing to accord them recognition when they bag Post-graduate Degrees and Fellowship.
“In 2021, Dr. Osagie Ehanire gave directives to the UCH, Ibadan Board to terminate the Consultant status of all non-physician health professionals.  Pharmacists went through the entire gamut of due process having secured approvals of the National Council on Establishment as far back as 2011 for their Consultant cadre.
“In 2020 and 2021, official circulars were issued from the Office of the Head of the Civil service of the Federation (OHCSF) who is also a Physician and the Federal Ministry of Health through its immediate past Permanent Secretary who was rated as one of the most seasoned bureaucrats of his generation to further boost the Consultant cadre in pharmacy practice.
“The Niger State Government introduced the Consultant cadre in Pharmacy practice as far back as 2013.  Other States like Edo, Osun have followed suit.  Two Pharmacists Consultants were appointed at the Aso Rock Villa Clinic in May, 2023 Dr. Enahire has confirmed with the precedence’s of the inglorious era of Prof. Christian Chukwu and Prof. Isaac Adewole to insist that ONLY Physicians can be Consultants in Federal Health Institutions by issuing a ridiculous Circular through the infamous Department of Hospital Services that ties the appointment of Pharmacists Consultants to vacancies which must be created by the Federal Ministry of Health.
“JOHESU/AHPA has critically appraised this development and moving forward we demand in tune with the official circulars for Consultants cadre in Pharmacy practice in the public sector, all the Federal Health Institutions must appoint at lease fifteen (15) Pharmacists Consultants in each Teaching Hospital, while the Federal Medical Centre and its equivalents must have at least ten (10) Pharmacist Consultants.
“JOHESU Demands:-
Immediate Approval and Implementation of the Technical Committee report on CONHESS adjustment by FG.
“Immediate payment of the omission and Shortfall in the COVID-19 Hazard/Inducement Allowances of affected Health Workers in the Federal Health Institutions (FHIs) and recognition of Health Workers in non-core hospital facilities in the payment of new hazard allowance.
Payment and Inculcation of Peculiar Allowances to Health Workers under the aegis of JOHESU/AHPA.
“Immediate and Unconditional Implementation of the Pharmacist Consultant cadre.
Unconditional Payment of all withheld salaries of Federal Medical Centre, Owerri, JUTH, LUTH and April and May, 2018 salaries of members at NOFIC, Azare.
“Speedy Implementation of the Increase in Retirement Age from 60 – 65 years and 70 years for Consultants in the health professions.
“Gentlemen of the Press, it becomes imperative to inform you that since the Federal Government is yet to met these demands, our members have been directed by the JOHESU National Executive Council (NEC) to proceed on an indefinite strike action upon expiration of the ultimatum by mid-night of 25th May, 2023.
,”JOHESU reiterates its commitment to continue to work with the Federal Government and all stakeholders in its bid to improve the ailing and over-stretched health system with necessary reforms in public interest.
“It is on record that we have shown enough patriotism in the last four years of this Administration and in public interest by not embarking on any industrial action even though our counterparts like the NMA and NARD have gone on strike severally during the life span of this administration only to be rewarded for their unending wrecklessness.
“We solicit the understanding of consumers of health pending when acceptable redress of our demands will be met”, he stated.

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