‘Solution to incessant strike actions in health sector’

Dr. Dare Godiya Ishaya, a specialist in Internal Medicine at Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, was over the weekend elected as the new President, National Association of Resident Doctors (NARD). Ishaya in an online interview with The Guardian among other things proffered solution to incessant strike actions in the health sector and how to improve healthcare delivery in the country. CHUKWUMA MUANYA writes.

•Govt officials, politicians should be banned from medical tourism for services available in country
•Seeks more funding to improve infrastructure, remuneration for healthcare workers

Congratulations as the new President of NARD. What is your blueprint?
Our blueprint is a four-pronged approach to solving the problems of the association, namely welfare, State Tertiary Health Institutions (STHIs), consolidation and collaboration.

Welfare: The welfare of our members is a top priority, hence we aim to raise it to the highest standards possible, through the establishment of comprehensive welfare schemes to assist members with dire financial emergencies. We also hope to improve remuneration to resident doctors in terms of ensuring smooth yearly payment of the already existing Medical Residency Training Funds (MRTF), negotiation for hazard and specialist allowances, and reduced taxation on the salaries of resident doctors.

STHIs: We aim to improve service conditions for our members in State Tertiary Health Institutions (STHIs) in terms of proper placement on the Consolidated Medical Salary Scale (CONMESS) salary structure, payment of arrears of salaries, regular payment of salaries, the domestication of the Medical Residency Training Act (MRTA) and subsequent funding by their respective state governments.

Consolidation: This has to do with running, improving and in some instances, completion of past projects of the association. Existing ones include The Doctors Reach Out Programme (T-DROP), Housing Project, eLibrary Project, NARD journal, and Research and Statistics Committee (RSC). The NARD cooperative society is a new project that we plan to establish.

Collaboration: This involves initiating and improving intra- and inter-sectoral collaborations with Government Ministries, Departments and Agencies. It also includes collaboration with organisations such as the Nigeria Medical Association (NMA), Medical and Dental Consultants Association of Nigeria (MDCAN), Medical Women Association of Nigeria (MWAN) etc. We are also open to collaboration with multinational companies and non-governmental organisations (NGOs) within and outside the country.

How do you intend to resolve frequent strike actions especially by NARD in the health sector?
Strike actions are last resorts when government fails to honour agreements after repeated negotiations. At our end, this leadership, through robust collaboration, will work to envisage, present and solve challenges well ahead of time. However, if antecedents are anything to go by, the most important solution to incessant strike actions in the health sector will be a show of commitment from the Government especially by increasing funding to the sector and also honouring their promises and agreements with health workers.

What efforts are you making to resolve this 60-day old strike?
We are a new leadership, barely 72 hours on board, but we have to hit the ground running in a bid to solve the problems that are at hand. We plan to meet with all the stakeholders, appraise and resolve the issues. We think it’s time to sit down together and begin a roll back, and redirection to the path of finding solutions rather than creating more technicalities. On our side, we stated in our press briefing following our Annual General Meeting (AGM) held last week in Bauchi, that the Federal Government should reverse the unnecessary actions they took during this period of the strike which includes withholding of August & September 2021 salaries and also withdrawal of the court case instituted against our association. The government should also commence payment of the Medical Residency Training Fund (MRTF) and also salary arrears of resident doctors owed on the GIFMIS platform. Resident doctors under the employment of Abia, Imo, Ekiti and Ondo State Governments who are currently being owed 20, six, four and four months salaries respectively, should be paid. If these are done, it will show the governments commitment to the welfare of our members and we will reciprocate the gesture by ending the strike action. We are always open and ready for meetings and negotiations in this direction.

The ongoing strike action has worsened the issues of brain drain and medical tourism. How bad is the situation and what are your recommendations?
The issue of medical tourism outside the shores of this country is very unfortunate. The latest World Health Organisation survey ranks Nigeria’s healthcare system as the fourth-worst in the world, and this can be attributed to poor funding. Our annual budgetary allocation to health has consistently fallen short of the 15 per cent agreed by African countries at the “Abuja Declaration” in April 2001 (20 years ago). This continual lack of investment in the sector has resulted in a deplorable state of the healthcare system in terms of health infrastructure such as medical equipment and reusable materials, and remuneration to health workers in terms of salaries, wages and allowances.

Poor health infrastructure has made it impossible for the sector to grow and compete with the standard of healthcare available in other countries. Pantry remuneration to healthcare workers who on the other hand led to the massive efflux of our best brains (brain drain) to other countries in search of greener pastures.

61 years after, President Muhammadu Buhari is still going abroad for medical treatment and Nigeria has one of the worst health indices in the world. I want you to review the situation and proffer solutions?
Nigeria, as things stand at the moment, is in double jeopardy; losing at both ends of the spectrum. We are losing health workers with over 8,000 medical doctors of Nigerian origin working in the United Kingdom (UK), even as hundreds are being flown out to Saudi Arabia and other middle eastern countries.

At another end, we are also losing money as experts say the country could be losing more than N576 billion ($1.2 billion) yearly to medical tourism.

The solutions are as the problems are. The healthcare sector needs more funding to improve the infrastructure and remuneration to healthcare workers. Nigeria’s annual budgetary allocation should be at least 15 per cent as recommended. With improved infrastructure and remuneration, patients will have confidence in our hospitals and also workers will have better job satisfaction.

Also, government officials and politicians should be banned from medical tourism especially for services that are available in the country. This will encourage the government to put more effort into improving the healthcare system in the country because their lives will depend on it directly.