Communique Issued at the End of the Meeting of Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA) at the Medical and Health Workers Union of Nigeria (MHWUN) Secretariat at No.12, Aba Close, Garki Abuja on 12th and 13th August 2014

Following the JOHESU/AHPA meeting with his excellency, the secretary to the government of the federation, senator anyim pius anyim, GCON, Honourable minister of labour and Productivity, Honourable Minister of state for health, chairman salaries, income and wages commission, permanent secretary, federal ministry of health, representative of the head of the civil service of the federation and other top government functionaries on 12th august, 2014, the JOHESU and AHPA held its meeting at MHWUN secretariat on 12th ad 13th august 2014 to extensively review the meeting with the government on the lingering and other issues between government and JOHESU and resolved as follows"

STATE OF THE NATION
A) EBOLA VIRUS DISEASE OUTBREAK
JOHESU observed the outbreak of ebola virus disease through patrick sawyer an american liberian. JOHESU commends the governemtn for the efforts put up so far to curtail the spread of the disease. however, JOHESU Observed that a lot still needed to be done in protecting the citizens especially the health workers.


JOHESU commensurate with the family of one of us (NURSE) who died in active service as a result of the ebola infection. We urge the government to adequately compensate the family of the deceased and make adequate provision for the protection of other health workers. The incident has further shown that members of JOHESU are more prone to hazards on the job. The death of the nursr also proves that a patient does not necessarily go to the hospital to see medical practitioner but to get treated.

B) NMA STRIKE
While not grudging the NMA Demands, we want to point out that the strike embarked upon by NMA is illegal. JOHESU noted with dismay that the injuction restraining the medical and dental consultants association from embarking on strike was not obeyed as it claims that their members are also NMA members. JOHESU Calls on NMA to observe the rule of law and call off the strike in the interest of the patients and the national emergency situation in the country.

2) LOPSIDEDNESS AND UNLAWFUL CONSTITUTION OF BOARDS OF MANAGEMENT OF VARIOUS TERTIARY HEALTH INSTITUTIONS
JOHESU/ AHPA noted that the lopsidedness in the constitution of the boards of various managements of tertiary health institutioins still exists. however, the appointment of NASU representative on the board of the federal medical center, owo and NANNM representative at FMC Jalingo and university of abuja teaching hospital gwagwalad was commendable. The JOHESU Requested that subsequent vacancies in the various boards should be filled by her nominees whose names are already submitted by the unions in JOHESU. Our union branches are to put JOHESU on notice whenever vacancies exists on the boards of various institutions.

3) UPWARD REVIEW OF RETIREMENT AGE FROM 60 TO 65 YEARS
Arising from the meeting, it was confirmed that the onosode white paper on retirement age has been authenticated by the secretary to the government of the federation and has been transmitted to the head o f the civil service of the federation for the use of the 12 man committee on national council on establishment for the conclusion of the assignment. it was therefore agreed that relevent circular on the subject matter be issued on or before the end of august 2014

4) CIRCULAR ON CONSULTANCY STATUS FOR OTHER HEALTH PROFESSIONALS
It was reemphasised at the meeting that government has not reneged on the agreement with JOHESU on the circular issued on this matter on the 16th of May 2014. However, the recent circular of 18th july 2014 signed by the honourable minister of state for health is of no effect as it contradictss itself and the 22nd july 2013 NICN pronouncement on this issue.

the government has agreed that the section 1 (iv) of the circular reference number: FH/PM/138/VOL 111/85 of 18th july 2014 would be expunged because it runs contrary to the NICN Judgement of 22nd july 2013. furthermore, JOHESU Frowned at the practise of the minister of state for health issuing and signing of circuars which is a usurpation of the right of the office of the head of civil service or permanent secretary, federal ministry of health as appropriate.

5) ABOLITION OF THE POST OF DEPUTY CHAIRMAN MEDICAL ADVISORY COMMITTEE (DCMAC)
JOHESU observed that the circular reference number HMH/ABJ/155/Viii/348 issued by the federal ministry of health on 14th july 2014 validating the continued appointment of DCMAC which earlier had been abolished. JOHESU Vehemently condemned its reintroduction and insisted that the position earlier agreed on should be sustained because the post is unlawful and an unestablished positon in the scheme of service, a shortcut to give advantage to university lecturers who are part time staff over the permanent staff of the hospitals, wast of scarce resources and meant to prevent the JOHESU members from attaining the position of directors as provided for in the schemes of service. Governemnt appealed to allow it to stay pending the outcome of yayale Ahmed Presidential committee.

6) CIRCULARIZATION OF PROPER PLACEMENT OF INTERN MEDICAL LABORATORY SCIENTIST ON CONHESS 8 STEP 2
Government has issued the circular placing medical laboratory scientist interns on CONHESS 8 STEP 2 as appropriate. However, JOHESU observed that there was no mention of post NYSC placement in the circular. Government agreed to include it as obtainable for other professions such as physiotherapy, pharmacy and radiography.

7) ADJUSTMENT OF SALARIES/ ALLOWNACES IN LINE WITH THE COLLECTIVE BARGAINING AGREEMENT OF 2009 AS IT WAS DONE FOR NMA IN THE SAME SECTOR IN JANUARY 2014
JOHESU was informed that there was a need to formaly inaugurate the committee to validate and do the needful on the financial implications of the adjustments and to capture it in the 2015 budget. The inauguration of the committee to be chaired by the ministry of finance will take place on 25th august 2014. The JOHESU considered this on the condition that the implementation of the circular issued for NMA in january 2014 on salary adjustment should also be deferred till 2015. Otherwise both groups should be treated equally without discrimination.

8) PAYMENT OF ARREARS OF SKIPPING OF CONHESS 10
The governemtn stressed the fact that there was paucity of fund, coupled with the national emergency situation that the country is going through. More importantly, there was no provison for it in 2014 budget. the JOHESU was not happy about this development and warned that the all or none law should be applied on this matter (i.e recent arrears on the adjustment of CONMESS which was approved in january 2014 should not be paid leaving that of CONHESS 10 skipping which has been lingering since 2011)

9) PROMOTION OF OFFICERS FROM CONHESS 14 TO 15 AS DIRECTORS
The meeting was alarmed when it saw the list of JOHESU Members who were deprived of their promotion ranging from 10 to 15 years in their various institutions. It was therefore decided that such officers be promoted without further delay while the defaulting institutions should be sanctioned by the government. The branches of our unions should endeavour to submit the list of stagnated members to JOHESU for onward delivery to the federal ministry of health for appropriate action.

10) ISSUES BEFORE YAYALE AHMED PRESIDENTIAL COMMITTEE
1) Appointment of CMDs/MDs of teaching hospitals in accordance with the extant laws and the need to give consideration to permanent staff of the hospital rather than the university based personnel

2) Advertorial for appointment of CMDs/ MDs should no longer be skewed in favour of one professional group but made open to all competent and qualified health professionals

The decision of govrnment to allow the current situation of appointmet to continue is unacceptable by JOHESU in the senst that the law which provided for medically qualified person to be appointed CMD does not approve the position solely for medical practioners. Pending the conclusion of yayale ahmed presidential committee, JOHESU members who are qualified should be equally considered.

11) APPROVAL OF RESIDENCY PROGRAM FOR OTHER HEALTHCARE PROFESSIONALS
JOHESU noticed that in 2010 Abdullahi Bello Presidentail panel was established to look into the disharmony in the health sector. One of its recommendations was that residency program should be established for other healthcare professionals as applicable to the medical and dental practitioner counterparts. up till now, nothing has been done. JOHESU therefore demands that residency training program should be estalished for her clinical professional members without further delay.

12) ULTIMATUM:
JOHESU Expects the governemnt to issue all the necessary circulars (upward review of retirement age from 60 to 65 years, modification of circular on consultancy for other health professionals dated 18th july 2014, circularization of proper placemnt of intern medical laboratory scientists on CONHESS 8 STEP 2) on or before 29th august 2014 to avert any industrial action

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NMA PRESS RELEASE.

OPEN LETTER TO THE SECRETARY TO THE GOVERNMENT OF THE FEDERATION

Senator Anyim Pius Anyim
Secretary to the Government of the Federation
Shehu Shagari Complex
Three Arms Zone
Abuja.

Your Excellency,

FACING THE CHALLENGES IN THE HEALTH SECTOR.RESOLUTIONS OF THE NIGERIAN MEDICAL ASSOCIATION (NMA) NATIONAL OFFICERS COMMITTEE (NOC) MEETING HELD ON THE 10TH OF JUNE, 2014 AT THE NATIONAL SECRETARIAT AND SUBMITTED TO THE OFFICE OF THESECRETARY OF THE GOVERNMENT OF THE FEDERATION WEDNESDAY 11TH JUNE 2014.

1.The post of Deputy Chairman Medical Advisory Committee (DCMAC) has been circularized and operational. Rather than abolish it, the NMA hereby demands that four (4) DCMACs for teaching hospitals and three (3) for the Federal Medical Centres beappointed forthwith to assist the CMACs whose statutory responsibilities are too heavy for any single individual to handle. Directors in other government agencies are supported by several Deputy Directors, why not the CMAC who is also a Director? Such a DCMAC must have same qualifications as the CMAC.

2.The NMA is opposed to the appointment of Directors in the Hospitals. This Position distorts thechain of command in the hospital, induces anarchy and exposes the patient to conflicting treatment and management directives with attendant negative consequences.

3.The NMA demands that grade level 12 (CONMESS 2) in the health sector MUST be SKIPPED for medical doctors. Consequently no medical/dental practitioners should be on that grade level anymore.

4.The title CONSULTANT in a hospital setting describes the relationship between the Specialist Medical Doctor and his patient. It will be a source of confusion if the title is applied to any other health worker who statutorily does not own patient. NMA therefore declares with unmitigated emphasis that if non-doctor consultants are appointed, it will lead to chaosand anarchy in the health sector. This should not happen.

5.Relativity in health sector is sacrosanct. The NMA hereby demands for immediate implementation of the January 3rd, 2014 circular. The NMA also demands the immediate payment of the arrears of the corrected relativity for 22 years during whichher members were short changed.Much as we are not against salary increase for any category of workers, either in health or elsewhere, the NMA demands for immediate adjustment of the doctors salary to maintain the relativity as agreed and documented once CONHESS is adjusted.

6.That Government should expedite the passage of the National Health Bill (NHB), and extend Universal Health Coverage to cover 100% of Nigerians and not 30% as currently prescribed byNational Health Insurance Scheme(NHIS).

7.Surgeon General of the Federation MUST be appointed with immediate effect.


8.The entry point of the House Officer should be corrected to CONMESS 1 step 4 as originally contained in MSS/MSSS while the Registrar/Medical Officer is moved to CONMESS 3 step 3.

9.Clinical duty allowance for Honorary Consultants should be increased by 90% of CONMESS

10.Adjust the specialist allowance as contained in the 2009 collective bargaining agreement. Additionally, ALL doctors on CONMESS 3 and above MUST be paid specialist allowance or its equivalent that is not less than 50% higher than what is paid to other health workers.

11.Hazard allowance MUST be at least N100, 000 per month for Medical Doctors.

12.Immediate release of the circular on rural posting, teaching and other allowances which MUST include house officers.

13.Immediate withdrawal of the CBN circular authorizing the Medical Laboratory Science Council of Nigeria (MLSCN) to approve licenses for the importation of In-Vitro Diagnostics (IVDs).

14.Immediate Release of Circular on retirement age for Medical Doctors as agreed with the FederalGovernment (FG)

15.The Federal Government through the Federal Ministry of Health should formalise and implement the report of the interagency committee on residency training as well as release the uniform template on appointment of Resident Doctors in line with earlier agreements. Moreover, a concrete Funding framework for residency training must be established. The Overseas clinical attachment must be fully restored and properly funded in the interest of the nation.

16.That in the interest of harmony in Federal Medical Centre, Owerri the government should pay the salaries of our members in the centre as agreed on 21st October, 2013.


17.Immediate concrete steps must be put in place for the reintegration of our members back into the IPPIS platform.

18.All attempts to coerce house officers not to join NARD must stop.

19.The orchestrated intimidation, harassment and physical assault of our members in departments ofPathology (Laboratory Medicine) by Laboratory Scientists which is being tolerated by the Federal Ministry of Health (FMOH) must stop.

20.The Endless circle of incomplete salary payment to our members in many hospitals in the name of shortfalls in personnel cost must stop.

21.Universal applicability of all establishment circulars on the remuneration and conditions of service for doctors at all levels of Government must be guaranteed.

22.Government should as a matter of urgency set up a health trust fund that will enhance the upgrading of all hospitals in Nigeria.

23.The position of Chief Medical Director/Medical Director must continue to be occupied by a Medical Doctor as contained in the Act establishing the tertiary Hospitals. This position remains sacrosanct and untouchable.

WHY DID THEY NOT ASK THAT THE POST OF VICE CHANCELLOR BE OPEN TO EVERYONE IN THE UNIVERSITY SINCE ASUU AND SANU ARE MADE UP OF GRADUATES

CAN YOU BE A JUDGE OF THE HIGH COURT OR COURT OF APPEAL IF YOU ARE NOT A LAWYER? WHY DO THEY THINK THE HOSPITALS WHERE LIVES ARE SAVED EVERYDAY SHOULD SACRIFICE THE ESTABLISHED LEADERSHIP I.E. CHIEF MEDICAL DIRECTOR?


24.The NMA henceforth shall not accept the continued violation of any of the terms of the 2009 Collective Bargaining Agreement. This is exemplified by the payment of Medical Physicists and Optometrists with OD (who are on CONHESS) call duty allowance using the CONMESS Circular. Similarly, the phrase Ministries, Departments and Agencies (MDA) in the said agreement should replace Federal Ministry of Health and other Federal Health Institutions as contained in the2009 CONMESS Circular.


In the light of the fore-going therefore, the NMA hereby gives government 14 days to meet all her demands as stated above or have her members called out for a resumption of the TOTAL and INDEFINITE withdrawal of service suspended on 5th January 2014.

The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted.

We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent.We hereby appeal to all Nigerians for their understanding and to press on Government to meet with our demands to avoid the STRIKE which is scheduled to start on the 1st of July 2014 from 00.10 hours GMT.

DR. Kayode OBEMBEDR.

Source: Secret Reporters.

Communique Issued at the End of a Two Day Meeting of The Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA) At the Medical and Health Workers Union of Nigeria (MHWUN) Secretariat at No. 12, Aba Close, Garki, Abuja on 5th - 6th June, 2014.


Following the JOHESU/AHPA meeting with his Excellency, the secretary to the government of the federation (SGF), Senator Anyim pius Anyim, GCON, Honourable Ministers of labour and productivity, Health, Chairman, salaries, income and wages commission, Head of the civil service of federation and other top government functionaries on 5th June 2014.

The JOHESU and AHPA held its meeting at MHWUN secretariat on 5th and 6th June, 2014 to extensively review the meeting with the government on the lingering issues between Government and JOHESU and resolved as follows:

1) ISSUANCE OF APPROPRIATE CIRCULAR ON CONSULTANCY FOR OTHER HEALTH PROFESSIONALS

JOHESU/AHPA expressed satisfaction over the circular number MH/PM/138/Vol.111/79 of 16th May, 2014 released by government formally restoring consultancy statues to other health care professionals and approving the payment of specialist allowance to deserving officers.

In furtherance to this, JOHESU/AHPA has therfore directed that all members who are due and satisfy the existing criteria, as upheld by the court judgement for consultancy position should apply for the payment of the allowance with its accrued arrears with effect from 1st January, 2010 in line with the CONHESS circular reference SWC/S/04/S.410/Vol.11/349 dated 8th december 2009.

2) ABOLITION OF THE POST OF DEPUTY CHAIRMAN MEDICAL ADVISORY COMMITTEE (DCMAC):

JOHESU/AHPA is delighted that Govt accepted the unions position that the creation of deputy CMAC is both unlawful and un-established and as such, no further appointment should be made into the post henceforth. Members of JOHESU nationwide are hereby directed to ensure tht this decision is enforced in all institution.

3: LOPSIDEDNESS AND UNLAWFUL CONSTITUTION OF BOARDS OF MANAGEMENT OF VARIOUS TERTIARY HEALTH INSTITUTIONS:

JOHESU/AHPA was vindicated that lopsidedness exists and must therefore be corrected. That a membership on the board of federal medical center, Owo who is not a nominee of JOHESU should be substituted as demanded by JOHESU while all unoccupied or vacant positions across all the boards should be identified for occupation by the nominees of the unions and the professional associations.

4) CIRCULARIZATION OF PROPER PLACEMENT OF INTERN MEDICAL LABORATORY SCIENTISTS ON CONHESS 8:

The eventual circularisation of the proper placement of intern medical laboratory scientists is a welcome development. However, JOHESU/AHPA appealed to government to amend the entry point to CONHESS 8 step 2 as applicable to other health professionals and that the new circular should include a provision that post NYSC officer shall be placed on CONHESS 9 step 2. This was accepted.

5) PROMOTION OF OFFICERS FROM CONHESS 14 TO 15 AS DIRECTORS:

Official circulars have been issued and government further reiterated that promotion from CONHESS 14 TO 15 is mandatory for all eligible officers and must be done procedurally. Deserving officers who are denied promotiions are urged to report any such denial to their respective board and union executives for appropriate action.

The meeting further resolved that federal ministry of health should accelerate the process of compliance by the CMDs and the MDs and where it is not carried out, the process of disciplinary action should commence and the case of non compliance by Jos university teaching hospital and others were mentioned by the unions

6)IMPLEMENTATION OF SKIPPING OF CONHESS 10 AND PAYMENT OF ITS ACCRUED ARREARS:

Government agreed that the affected members of JOHESU/AHPA will be paid the arrears and has equally calculated the cost implication which will be discussed at the meeting to be attended by FMOH, budget office and head of the civil service of the federation and the ministry of finance on 10th june, 2014 to realise this.JOHESU/AHPA therefore called on the concerned agencies of government to expedite action on the process to realise the payment of the accrued arrears without any further delay.

7) ISSUES TO BE HANDLED BY YAYALE AHMED COMMITTEE have been refered:The issues are:

1) Appointment of CMDs/MDs of teaching hospitals in accordance with the extant laws and the need to give consideration to permanent staff of the hospitals rather than the university based personnel

2) Advertorial for appointment of CMDs/MDs should no longer be skewed in favour of one professional group but made open to all competent and qualified health professionals

3) Job Evaluation report of year 2008

4) Abdullahi Bello presidential report on harmony in the health sector.

5) The interpretation of the phrase"medically qualified"

8) ADJUSTMENT OF COLLECTIVE BARGAINING AGREEMENT OF 2009 AS IT WAS DONE FOR NMA IN THE SAME SECTOR IN JANUARY, 2014:

The national salaries, income and wages commision informed the meeting that the financial implication of the adjusted collective bargaining agreement of 2009 has been calculated and that it has been forwarded by the ministry of health.

It is the expectation of JOHESU/AHPA that government shall issue circular on this matter within 30 days unfailingly.

We appeal to our members nationwide to remain calm and go about their normal duties and refuse to be provoked in any form and should remain steadfast and focused.

In conclusion, government should take note of the maturity, patience and understanding of JOHESU because, we would have been on strike over these issues. Therefore, all these outstanding issues must be addressed within the stated time frame of 30 days to avert industrial unrest.

Source: Nursing World Nigeria.

JOHESU issues 15-day ultimatum, threatens suit against doctors

A coalition of workers in the health sector have threatened nationwide strike if government does not begin implementing over the next 15 days agreements both sides reached on worker welfare and conditions of service.

Joint Health Sector Union (JOHESU), an umbrella for four different unions of healthworkers, also threatened legal action against Nigerian Medical Association if doctors go on strike over labour issues.

JOHESU insists the doctors association is not a registered union and has questioned its authority to strike or negotiate salaries with government.

The agreement between JOHESU and government was reached and signed in May 2012, including reconstitution of boards of health institutions, staff promotion from levels 14 to 15 on the consolidated health salary scale for directors, and review of retirement age from 60 to 65 years.

The union says government is yet to implement the report of a job evaluation ordered in 2008 and a separate report on harmony in the health sector presented by a presidential committee headed by Abdullahi Bello.

At a press briefing in Abuja, JOHESU president Ayuba Wabba said, “We had negotiated desirable adjustment to the 2009 CONHESS salary table and allowances as was done for the NMA in January 2014.

Ironically, government reneged because of the threat by the NMA.

”In comments delivered by Felix Faniran, president of Nigerian Union of Allied Health Professionals called government action “provocative, insulting and unjust in the worst dimension.”JOHESU accused NMA of repeatedly flouting judicial pronouncements about its lack of right to strike.

“It has refused to comply with this law. But if they continue, we will be forced to take them to court,” the union said.

Source: DailyTrust