Friday, 11 July 2014

The Hippocratic oath is not a pledge to eternal slavery. Dr Dagba Maxwell

Who would serve under any condition? Members of the NMA will not be subjected to insulting or untoward conditions of service on account of a distorted view of the Hippocratic oath. Should they work with an employer who refuses to honour agreements? Function in an environment consumed by hostility and unnecessary rivalry? Allow those who have not taken any oaths to create a neo-environment in Nigeria where there is no disparity in the wages of workers, irrespective of training and qualifications? Attempt to 'save lives' in a milieu where multiple 'consultants' of all sorts effect contradictory lines of management on a single human for the same disease condition? To whose benefit? 

The Hippocratic oath is not a pledge to eternal slavery. And if we swore before God to do anything for our patients, we did not also swear to do anything for our employers. Or to accept disrespect from other health professionals and the allied health professions. Saving lives in Nigeria is not only done in the emergency rooms, theatres, clinics and wards of government institutions. As we speak, Nigerian doctors are still saving lives - just not in that environment of madness. They are at work in some Mission Hospitals and Private Hospitals. Are they treating Germans or Vietnamese there? Surely, they are saving Nigerians like you and me.

So the NMA still stands on her words. No amount of cheap blackmail, 'emotional appeals' on the pages of newspapers, or empty government circulars will reverse this resolve. 

I will now propose a permanent solution. Let us put the strike aside for a moment. Whether before or after the NMA strike, the government needs to invite the NMA and her affiliates along with JOHESU and its constituent unions to a round table. This conference, as I will refer to it, should be broadcast live on all major TV and radio stations in the country. Government should also invite experts from at least two countries in each of the six continents of the world to that conference. These experts should include health ministry officials in those countries, as well as Medical Consultants and Specialists (Consultants or otherwise) in other health professions - Pharmacy, Nursing and Medical Laboratory Science. Also present should be representatives of the media, the senate, the house of representatives, the salaries an wages commission, the Ministry of Health, the presidency and representatives of the state governors. These experts should educate Nigerians on the way health systems are run in those countries. Pertinent questions to be asked at that conference will include the following: Who heads a hospital? What is the role of the Surgeon-General in those Countries, if they have? Is there not a Surgeon-General apart from a Health Minister? Who has the ultimate responsibility for patient care? What are the exact roles of non-doctor consultants in a health sector? Do these other 'consultants' have the right to interfere with the management plan of the doctor? is there a difference in wages between health professionals? what is the magnitude of the difference, if any? It will also help if someone from the Civil Service Commission gives a talk on structure of the federal civil service and promotions (especially to Director cadre).

Many other questions should be proposed by the unions, other stakeholders and Nigerians as a whole. 

When we have answered all these questions and the veil of ignorance has been lifted from the faces of all, the government should then sit down and use its brains to come up with a reasonable health sector policy framework which will capture job descriptions, remuneration, and appointment to offices. Needless to say that this framework should be in line with international practices as exposed during the conference. This can then be subjected to scrutiny by the national assembly and given legal backing. From then on, any further arguments about wages, appointments or job description should refer to the said document. Any deviants should be treated as offenders of the law.

Call this the Dagba solution. But without this approach or something similar, I see the hundredth generation after us still embroiled in continuous fracas over these same issues.

God save us

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