Nigeria needs a sustainable solution to resident doctors’ strike 

The nationwide strike embarked upon recently by the Nigerian Association of Resident Doctors (NARD) may have been suspended, but there is little to cheer about; and in any event, the damage has been done to hapless Nigerians who may have died or suffered terribly while the strike lasted. The association’s national president, Innocent Orji confirmed the suspension of the strike Friday evening, saying work would resume the next day.

Nigerians, however, have cause to worry because the strike can be resumed anytime. The crisis in the medical sector has proven to be a recurring problem that the government is either unable to solve or lacks the will to resolve. The major medical challenges have been identified as non-competitive remuneration, inadequate social security benefits, inhumane workplace, dilapidated infrastructures, ill-equipped facilities, acute manpower shortage amongst others. These lacunae are significantly responsible for the continuous exodus of the country’s medical experts to better climes in search of greener pastures thereby further weakening our healthcare system.

The doctors embarked on a nationwide indefinite strike action over the failure of the government to meet its demands. The medical body is demanding a review of the Consolidated Medical Salary Structure (CONMESS), payment of the 2023 Medical Residency Training Fund (MRTF), immediate issuance of a circular by the Federal Ministry of Health for replacement of clinical staff in public hospitals, payment of outstanding salary arrears, improvement in hazard allowance by state governments, consequential adjustment of the minimum wage, among others.

Addressing the press, the President of NARD, Dr. Emeka Orji, expressed the common frustration of resident doctors over the passive disposition of the Federal Government in fulfilling their mutual terms of agreement.  In his words: “Hospitals are massively depleted and our members there are having a hard time coping with the enormity of work required of them. They are breaking down and some are dying. We know that this is because of the burnout effect of the overwork they are having.

The government came out with a policy in February of how to quickly replace doctors and nurses as they leave. What was going to happen was that that policy was going to be backed up by a circular. The conciliatory meeting agreed that the Office of the Head of the Civil Service of the Federation would release the implementation guideline on or before 5th June 2023 for onward transmission to the Tertiary Hospitals for implementation. This is almost the end of July, and nothing has happened.”

In reaction, the Nigerian government directed the management of federal tertiary hospitals to commence the enforcement of the “no work, no pay” policy against the striking resident doctors. This means that the concerned doctors will not receive their regular salaries during the industrial action. However, the doctors are not perturbed by the directive as they remain committed to their cause while insisting that the government has no moral justification for its action.

The strike action yet again is a pointer that qualitative healthcare service delivery is not a priority to the government. The punitive stance of government officials not only betrays their poor dispute-resolution skills but also reinforces the contempt with which they treat issues that do not affect them personally.

Although, medical consultants and dental doctors, nurses, and other health workers offered health services to cushion the effect of the strike, public healthcare service was substantially paralysed as resident doctors make up the bulk of the doctors in Nigeria’s tertiary hospitals.  During the strike, patients bore the brunt as some of them were denied access to medical attention while others were summarily discharged to seek health care in private health facilities. In all of these, the government maintains indifference. The fundamental question is: What is the purpose of government if not for the welfare and safety of the people?

When the medical sector is accorded scant attention and the welfare of public medical personnel is neglected or trivialised, the entire nation suffers for it. Nigeria has the potential and capacity to boast of world-class hospices, if only the government accords healthcare the attention and respect it deserves. Besides, there is no justifiable reason for the government not to honour its promise to NARD to replace the doctors that have ‘fled’ the country. It is public knowledge that the current medical workforce is lean and overstretched; hence the urgent need for adequate recruitment.

Therefore, rather than resorting to threats, the present administration should engage NARD in the amicable resolution of the raging controversy so that full medical services can resume in public tertiary health facilities in the overriding interest of the nation, and the suspended strike does not resume. Ordinarily, issues bordering on the security and welfare of the people should not be stalled by the undue flexing of executive might.

Adequate medical and health facilities for all persons; just and humane work conditions and competitive incentives of medical personnel remain the exclusive responsibility of the government at all levels. If the small-sized (underperforming) members of the political class can enjoy humongous remuneration and robust allowances, including vacation “tokens” for the federal legislators who assumed office merely two months ago, then the Federal Government should accede to the demands of NARD without further delay.

Nigeria continues to lose her best hands to advanced countries across all sectors of the economy. During the cash crunch saga earlier in the year, the e-payment channels failed only because ICT specialists in the country had ‘fled’ the country. Lecturers are also leaving in their droves as the educational sector is not immune to the systemic failure of the country. To remedy the instant issue, at least to a reasonable extent, the government should prohibit or restrict foreign medical tourism by public officers. Perchance, if the public elites who call the shots at governmental level are made to share the same medical facility with ordinary Nigerians, then the government will be compelled to reform the country’s healthcare system.