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When Will Medical Doctors Stop Going On Strike?

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By Bola Bolawole

Between doctors who habitually go on strike, with the attendant costs in lives and limbs, to draw attention to the parlous state of the country’s health sector and the indifference of the authorities, and the authorities that act like Rome’s King Nero – which is to be preferred? Thousands of Nigerian doctors have adopted the same indifference mode as the authorities by either voting with their feet to seek greener pastures abroad or turning a blind spot to the rot around them while taking advantage to feather their own nest. While the health sector deteriorates, our leaders avail themselves of the best medical facilities and expertise abroad – and at the public expense to boot. A recent example is President Muhammadu Buhari and the APC leader, Bola Ahmed Tinubu!

This column today reflects the views of a seasoned Labour leader, an intellectual of the Leftist tradition, and a recent Buhari appointee on the incessant doctors’ strike. Titled “Doctors’ Strike: Time for Talk and Training”, Comrade Issa Aremu (mni), Director-General, Michael Imoudu National Institute for Labour Studies (MINILS), Ilorin, Kwara State, seeks a way out of the perpetual impasse. Hear him: When two elephants fight, it’s the grass that suffers; so goes the received wisdom. Note: grass “suffers” not “dies”. But when two Honourable ministers of health (both doctors!) disagree (as they often do!) with some 16,000 resident trainee doctors, the nation agonizes, counting dead bodies. According to the Honourable Health Minister, Nigeria has lost more lives to the ongoing round of strikes by the doctors than the ruthless ubiquitous deadly opportunistic Covid-19 with its new and notorious Delta variant. As the strike by resident doctors enters the second week, it’s time for immediate talk by all parties to address all issues in dispute. In doing so, some time-tested principles of industrial relations must be reaffirmed for all stakeholders in the health sector.

First is the realization that industrial or work relations are relations between humans (in this case, doctors and the relevant health authority chieftains) to advance the welfare of striking doctors and, invariably, the well-being of Nigerians through good health service delivery by motivated doctors. Mohammed bin Rashidi Al Maktoum, the Vice President of the United Arab Emirates (UAE) and the constitutional monarch of Dubai, observed (and I agree with him) that “Human beings are the most precious assets of all nations and the most important factors in the progress of countries” The point cannot be overstated about the primacy of human resources for national development.

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Between 2015 and 2020, oil prices plunged into an all-time low, followed by two successive economic recessions. Buoyed by Covid lockdowns, the pressure on the Naira felled the rate from N196.5 in 2015 to N411.25 in 2021. The concerns and outcry about falling Naira value had been strident, necessitating CBN’s serial creative interventions for rate stability. Conversely, resident doctors across the country are on strike for the fourth time since the start of the pandemic. “We are having a strike for the third time this year” disclosed the Minister of Health, Dr. Osagie Ehanire. The pains, man-hour losses and, above all, loss of lives are well documented. Sadly, the frenzy and national outrage that trailed the fall of Naira value or rise in inflation figure eluded the avoidable serial losses of lives at the teaching hospitals, which shows where our heart is: With Naira value, not necessarily human value!

Nigeria must urgently overcome the scandalous crisis of wage compensation for the valued workforce. Return on money investment is almost calculated instantaneously. Why, then, should the salaries of doctors, paid monthly, be delayed? Delayed payment of salaries of medical personnel (such as doctors and nurses) as well as of teachers’ amount to wage theft, manifesting both corporate and public poor governance. Pay agreements must be sacrosanct on those who freely signed them. In 2019, President Muhammadu Buhari rightly expressed outrage at non-payment of salaries by some state governors. “I wonder how these governors are able to sleep knowing that they have refused to pay workers their wages. These workers have families to cater for, they pay rent, pay school fees, hospital bills and food for their families.” he said. The President then thought and acted outside the Federal box, offering serial bail-outs for the states to meet their salary obligations.

I support the President’s demand that state Governors, ministers and MDAs pursue Decent Work Agenda (DWA). Prompt and adequate compensation for working men and women is a critical success factor for labour motivation, productivity, labour discipline, growth and national development. I agree with Vice President Yemi Osinbajo that ongoing civil service reforms should be “bold and big that will make a difference” with respect to the welfare of public servants. It is also gratifying that the Head of Service, Mrs. Yemi-Esan, has identified staff welfare, particularly remuneration and housing, as areas that require better focus and urgent intervention in the Federal Civil Service Strategy and Implementation Plan 2021-2025. Pope John Paul II once sermonized: “Ask not whether a man is useful in his work but whether the work is useful to him”. The same Pope John Paul II also questioned the validity of economic orthodoxy that elevates economic fundamentals (external reserves, GDP, inflation rates, etc) above human welfare. According to him, ‘A just wage for the worker is the ultimate test of whether any economic system is performing justly’.

But with the best of efforts the world of work is inherently vulnerable to occasional disputes. Happily, Nigeria again parades robust labour market institutions for collective bargaining, representation, mediation and adjudication to manage and contain inevitable crises. There are the National Arbitration Panels (IAP), National Industrial Court (NIC), and the tripartite National Labour Advisory Council (NLAC). There are bargaining councils in both private and public sectors. There are also hundreds of vibrant trade unions and associations affiliated to the NLC and TUC. Of course there is the oldest supervising Ministry: The Federal Ministry of Labour and Employment, established in 1939, with rich documented records of mediation and reconciliation.

Buhari is the first president to appoint two Ministers of labour in appreciation of the vastness and importance of labour market issues of productivity, training and capacity-building, and social security for all stakeholders. Both Ministers – Senator Chris Ngige and Mr. Festus Kyamo, SAN – have been commendably apprehending the crises arising from other relevant ministries, in this case the health sector. Both the National Association of Resident Doctors of Nigeria (NARD) and the health authorities should take advantage of the existing labour dispute structures and stop the current avoidable haemorrhage in man-hours and lives in the sector. There is an urgent need for reform of the industrial relations system in the country’s health sector for sustainable peace and service delivery.

I agree with Samuel Gompers when he said “Show me the country that has no strikes and I’II show you the country in which there is no liberty”. Nigeria practices robust industrial democracy. Our Labour laws allow for freedom of associations and unions as well as rights to collective bargaining and right to strike as sanctioned by the 1999 constitution and the relevant ILO Conventions Numbers 87 and 98. But this progressive labour regulatory framework puts enormous responsibility on the stakeholders, namely employers (private and public) and workers alike. A strike is NOT war; certainly not a nuclear, mutually-assured destructive war as we are witnessing in Nigeria. Strike is ‘a temporary stoppage of work by a group of employees in order to express a grievance or enforce a demand’; the workers intend that at its conclusion they should return to work.

It’s time all parties suspend the existing unhelpful actions and return to negotiations. All stakeholders in the health sector must play by the knowledge-based rules of collective bargaining, social dialogue, mediation and conciliation to prevent incessant work stoppages in hospitals with attendant costs to lives. The bitter lessons of the recent days point to the attractiveness of accommodative strategy for both the doctors and the health authorities. The Michael Imoudu National Institute for Labour Studies (MINILS) is set to bridge the existing abysmal knowledge gap about labour market issues with respect to trade unionism, conflict resolution, strikes and strike management in critical sectors like the education and health sectors”

Well said, Comrade! The training must start with our leaders. The reason for the lack of empathy on the part of striking doctors is because they have seen the lack of sincerity on the part of government that does not honour agreements; that does not patronise our hospitals; and that votes humongous sums for hospitals (e.g. Aso Villa’s Presidential Clinic) but turns round to embezzle the votes. They have seen the government’s misplaced priorities in budget allocations (e. g. billions voted for National Assembly renovation, yet the roof leaks; billions wasted on presidential jets that Candidate Buhari had promised to sell off)! The corruption of the Buhari/APC regime beggars belief. In the face of all of these, we cannot preach patriotism to doctors when the very leaders who swore on the Bible or Quran to be patriotic have failed to do so. We cannot hold doctors to their own Hippocratic Oath when our leaders have so flagrantly shunned their own oath of office. A fish rots from the head!

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