RAGING feud between Medical and Dental Council of Nigeria (MDCN) and chief medical directors (CMDs) of tertiary health institutions in Nigeria took a toll on house officers in the country who were owed salaries for three months.
The feud, which began in December 2020, left house officers without December to February salaries. They only began to receive their three months’ salaries on March 12, 2021.
Investigation by The ICIR revealed that the house officers had been engaged and paid by the hospitals until recently when the federal government took over the posting and payment of the doctors to avert alleged abuse.
Government’s decision did not go down well with the CMDs who then refused to forward the list of the interns to MDCN for vetting and onward salary payment.
House officers are graduates of medical schools who are employed for the purpose of receiving further training for a period of one year. The process, known as housemanship, enables the interns to acquire more practical knowledge by working in hospitals and getting paid. The housemanship programme is required to enable doctors to participate in the compulsory one-year National Youth Service Corps (NYSC) programme. Experience garnered during the housemanship helps the practitioners to excel in places of their primary assignment.
Checks by The ICIR showed that many of the doctors went through pains while being owed their salaries. A picture of Okorie Venetus, one of the interns, went viral on social media on Saturday March 6, after he reportedly collapsed at the University of Port Harcourt Teaching Hospital, Rivers State. He was said to have worked uninterruptedly for 72 hours, yet was owed three months’ salaries.
Uyilawa Okhuaihesuyi, president of National Association of Resident Doctors (NARD), an umbrella body of medical practitioners that cater to the welfare and other needs of the interns in Nigeria, told The ICIR that Venetus was just one out of many house officers who had bitter experiences during the period.
He accused some heads of public tertiary hospitals of refusing to submit the list of interns in their facilities to the MDCN for vetting and onward transfer to appropriate authorities for payment of their emolument – an attitude he alleged spanned three months.
His allegation was confirmed to The ICIR by Yusuf Sununu, chairman, House Committee
on Health Care Service, who chaired the meeting of stakeholders where a directive on immediate payment for the interns was issued.
The NARD president said, following failed efforts to get the attention of government to ensure that the interns were paid, after engaging different means to end the stalemate, including writing to the National Assembly, leaders of NARD resorted to embarking on strike.
In order to avert the strike, the House of Representatives, through Femi Gbajabiamila, its speaker, convened a meeting of stakeholders which eventually made some resolutions on the crisis. The meeting took place between Tuesday, March 9 and Wednesday, March 10, 2021, at the National Assembly Complex.
A major resolution made at the meeting was immediate payment of the trainee doctors. The majority of them had got their salaries as of the time of filing this report on Saturday, NARD president said.
More accusations from NARD
According to Okhuaihesuyi, there was a shortage of house officers which he said stemmed from the feud between the MDCN and the CMDs.
The rift “is more like a rift between the chief medical directors and the MDCN. Because of that, they have not paid the house officers for over three months. We have written to federal ministries of health and labour, speaker of the House of Representatives and the Senate president,” he said.
According to him, there should be between 10 and 15 house officers in each unit of hospitals, but there were only about two.
He confirmed that the doctor who reportedly collapsed in Port Harcourt worked much more than the duration he should work, resulting in his collapse.
Uyilawa further alleged that the CMDs were “more like sabotaging the Federal Ministry of Health and the MDCN so that they can reverse the payment to them.”
“The CMDs know that if they do not submit the list, the house officers would not be paid. If they are not paid, the CMDs know that the house officers will react and will probably call for a strike,” he said, adding that “that is their aim. They know that with that, they will reverse the payment to the CMDs.”
He said only 19 of the CMDs submitted names of their officers for payment.
According to him, there were 2,136 house officers affected by the payment delay.
He also said only 5, 000 naira was being paid to doctors by the federal government as hazard allowance, while federal lawmakers were getting over a million naira.
Reaction by Sununu, Chairman, House Committee on Health Care Services
The lawmaker told The ICIR in a telephone interview that his committee was able to mediate in the matter within the first sitting because of the confidence that NARD had in the leadership of the House of Representatives.
He said: “When they came, we were able to find out what the problem was. The problem was based on the policy of the federal government to centralise recruitment and posting of house officers because many house officers were roaming the street and were not employed. Federal government moved posting and recruitment to Medical and Dental Council of Nigeria because of that.
“However, there was a delay by committee of CMDs and MDs to submit the list of the serving house officers to Medical and Dental Council of Nigeria so that the council can identify those who were recruited and were to be paid.
“And then, the MDCN issued a circular to stop payment of house officers. So, we now had two crises, not employing house officers and not paying those who were recruited. Based on that, the NEC (of NARD) resolved to go on strike.”
Following those actions, he said his committee invited the stakeholders namely, the Federal Ministry of Health; Budget Office of the Federation; Medical and Dental Council of Nigeria;Committee of CMDs; Nigerian Medical Association, and NARD to a meeting.
At that meeting, he said the committee “sounded a strong warning that all the CMDs must submit the list to the Medical and Dental Council of Nigeria within 48 hours, and all those in hospitals that were delaying should immediately be paid since there is budgetary allocation to that.” He vowed that the committee would follow its decision up with sanctions on any erring party.
According to him, the trainee doctors were paid within 24 hours after the committee’s directive.
But he advised that government must always conclude all processes involved in any subsisting programme before switching to another.
Reacting to allegation of doctors being paid 5,000 naira hazard allowance, he said: “We were all frank, especially before Mr. Speaker that N5,000 hazard allowance is not acceptable, and that we are working with the Federal Ministry of Health, Ministry of Labour and National Salary and Wages Commission to ensure they review the hazard allowance. Not only that, recently, you will also note a lot of brain drain in the country, and even the Ministry of Labour identified that as a major challenge.” He noted that “the need to review the hazard allowance cannot be over-emphasised.”
He revealed that COVID-19 led to brain drain of doctors in the country, resulting in vacuums in public health institutions. He said recruitment was ongoing and that government had been getting doctors to assist.
“Then, the other issue is (that) there is embargo on employment. Employment is only following waiver and there are a lot of bottlenecks. The hospitals need to obtain waiver for them to recruit, and it can take you more than six months to obtain a waiver,” Sununu stated.
Asked to express his view about the general health care system in the country, the lawmaker said the health system “is weak” and that a lot needed to be done to ensure that quality health care services were offered to people in the nation.
Response from Registrar, MDCN
After parrying questions from our reporter during a telephone interview, Tajudeen Sanusi, registrar, MDCN, said his organisation had no issue with anybody. He insisted he would not respond to our reporter’s question which sought his reaction on the issues.
After much prevarication, he said, “Do not force words into my mouth. MDCN did not say ‘transfer this to us.’ There were problems and government wanted to resolve these problems. That was why they said MDCN should take over. MDCN taking over is not that they give us money. No, our own is to scrutinise the list and forward to the Accountant-General Office where further action would be taken on the interns’ payment.”
“There are quotas allotted to these people. You see, if you have a quota of 40 and you go and employ 80, what do you want me to do? That is the situation. You have a quota of 40, you are employing 80. The quotas were allotted based on available human and material resources, and they have no right to adjust the quota themselves unless they invite Council for re-accreditation. Let us get things right in our society. People should not indulge themselves in acts of illegality, trying to legitimise the act of illegality. No, our Council will never allow that. That is just it. “
Chairman, CMDs group in Nigeria speaks
Jaf Momoh, chairman of CMDs and chief medical director, National Hospital, Abuja, said in an interview with The ICIR that nobody would accuse the CMDs of training medical doctors to enable them get their licences.
His words: “Nobody can accuse us of trying to train a medical doctor for his licence and that you are over-recruiting. What happened to those who have finished training? So, they should go and roam the streets? A doctor who spent seven years training, his training should not be completed? It’s only one year. That is why the federal government decided that the training should be centralised, that everybody will be absorbed. The responsibility of MDCN is to get placement for all of them.”
He then spoke on the new resolutions of the Sanunu-chaired mediation team of the House of Representatives: “MDCN has been given three months by the National Assembly to get placement for all of them. There can be no issue of over-placement. It is like NYSC, it is one year. Are you going to say NYSC corps members are being over-placed? Everybody who is due is supposed to get a placement. People are misunderstanding it, thinking that it is employment – it is not employment.”
Momoh denied accusations by NARD and House of Representatives committee which said some hospitals having house officers failed to forward their names to the authorities to enable them get paid.
Immediate past NARD president gives more insight into crisis
Meanwhile, Aliyu Sokomba, immediate past president of NARD, gave more insight into the crisis.
He said the new policy emerged because government wanted to centrally place house officers as they did to graduates participating in the National Youth Service Corps in the country.
He said NARD felt there was a need for government to do a proper planning before implementing the decision.
He said government stopped sending emolument of the house officers to hospitals and decided to be paying them by itself without any concrete arrangement on ground.
Sokomba explained that government had stopped recruitment of new doctors, leading to an acute shortage of house officers in hospitals.
He said there could only be two house officers in a hospital, causing them to work uninterruptedly for many days.
He suggested that if government could not pay the doctors in the new plan, it should revert to the old method where hospitals paid.
NARD had embarked on a strike in June 2020 over lack of personal protective equipment (PPE) and poor welfare for its members amid the nation’s fight against COVID-19. The group also proceeded on similar action in September 2020 over unpaid allowances.