Striking resident doctors have called the Federal Government’s bluff for invoking the no-work-no-pay policy by stopping their salaries.
However, there were indications that states across the country might also adopt the Federal Government policy by equally denying the protesting doctors their salaries.
But the doctors said rather than being intimidated by the Federal Government’s action and indications that states might also join in the action, the development had further strengthened their resolve to persist until their demands were met.
The resident doctors spoke in separate interviews with Saturday PUNCH on Friday.
The Vice President of the Nigerian Association of Resident Doctors, Adejo Arome, said rather than ending the strike, government’s decision to implement the no-work-no-pay policy had further ignited the fight for freedom among resident doctors.
Arome alleged that the striking doctors were aware that the government did not care about their welfare, adding that the action of the government had made the doctors more united.
He said the doctors were happy that the threat of no-work-no-pay had come to an end with the government’s action.
He said the government had always owed the striking doctors, wondering why it refused to take action or engage them (striking doctors) immediately they went on strike.
Arome said, “We know they don’t care about us. We also do not care again. We are not even worried because, for the first time in the history of Nigerian doctors, we are united.
“At this point, we are saying enough is enough. Everybody is tired and we have to speak up. Enough of the threat of no-work-no-pay by the government.
“You didn’t pay for four, five months; we begged you and you didn’t answer, all of a sudden when we went on strike, instead of you to call us in the first two days, you did nothing.
“You waited till the 20th (day) simply because you had plans. We know what they are doing. We know their plans and we are resolute.
“They will pay this August salary and they will also pay the arrears and then migrate our members to the IPPIS platform. We will not return until they do these things.”
The Minister of State for Health, Olorunnimbe Mamora, said on Thursday that there was no quick fix to the doctors’ demands.
He also identified funding as being responsible for the numerous challenges facing the health sector in Nigeria.
The minister, who is also a medical doctor, spoke during a meeting of state commissioners for health and federal MDAs and development partners in Abuja.
He had said, “Basically, it has to do with the need for us to increase funding to the health sector because when you look at the challenges in the health sector, the basic underlying factor is funding.
“Even if you have the appropriate and adequate number of human resources in the healthcare sector, you need to take care of emoluments, incentives and other things and you need funding. That is why we need to find ways of increasing funding in the health sector.”
Mamora also appealed to striking resident doctors to return to work and added that in the civil service, there was no such thing as a “quick fix.”
States stop payment of doctors’ salaries – NARD President
The NARD President, Uyilawa Okhuaihesuyi, also said members of the association were ready for the strike and that stopping their salaries would not dampen their morale.
He said he was aware that state institutions had also invoked the no-work-no-pay policy adopted by the Federal Government.
He, however, said the association’s members were not moved by the development.
The Federal Government had earlier written to Chief Medical Directors and Managing Directors of federal tertiary hospitals, asking them to begin the implementation of no-work, no-pay policy concerning the striking doctors.
The government’s directive was contained in a letter dated August 26, 2021, signed by the Director of Hospital Services, Federal Ministry of Health, Dr Adebimpe Adebiyi.
The letter was titled “Application of Section 43(1) (A) of the Trade Dispute Act, Cap T8, Law of the Federation of Nigeria (LGN) 2004 (no work no pay) partly.”
It read, “The ministry is in receipt of the letter from the Ministry of Labour and Employment informing the ministry of the laws governing the ongoing strike by the Nigerian Association of Resident Doctors and the need to immediately apply the provisions of the Section 43 (1) (a) of the Trade Dispute Act on ‘special provision with respect to payment of wages during strike and lockouts’ known in labour parlance as no-work-no-pay with effect from Monday, August 2, 2021, when the strike was commenced by NARD members.
“Consequently on the above, I am directed to inform you to commence the implementation of the no-work, no-pay policy on the striking doctors including other workers that may embark on strike consequently.”
The letter said the directive was in line with Section 43 (1) (a) of the trade dispute act which inter alia states “where any worker takes part in a strike, he shall not be entitled to any wages or remuneration for the period of the strike.”
The government directed the CMDs to compute the financial implications of the no-work-no-pay from the salaries of resident doctors and any other health worker that participated in the strike.
But the striking doctors, according to the president of their association, said they were not perturbed with the directive, even when states had allegedly copied the Federal Government’s policy.
Okhuaihesuyi said that two weeks after the Federal Government signed Memorandum of Understanding with the association and the Nigeria Medical Association, nothing had been achieved.
He said “All states institutions have also given directives for the no-work-no-pay policy.
“Our members are not shaken by this. In fact, it has made them more determined to go on with the strike.
“It is over two weeks since the Memorandum of Understanding was signed with the Nigerian Medical Association and since then, nothing has been done. Our members are willing to go all the way.”
Another resident doctor, who spoke on condition of anonymity for fear of victimisation, said he would rather starve than let the government win the ‘fight.’
He said, “We have reached the point that we would rather starve than let the government win this time round.
“States owe salaries. Imo owes us 15 months salaries; Abia owes 20 months; Ondo pays 50 per cent; Anambra pays 70 per cent. So, it is that bad.
“For me, I am already used to it and I know some other colleagues who are also determined.
“The government sees this as a punishment but the truth is this punishment is not new. They have always owed us even when there was no no-work-no-pay policy.”
Nonetheless, it was difficult to get the actual situation across the county concerning the alleged implementation of the no-work-no-pay policy by states as claimed by the resident doctors.
However, there were claims that some states had started implementing the policy.
Akwa-Ibom not paying us again – Udo
In Akwa Ibom State, the chairman of Association of the Resident Doctors, Dr Ekemimi Udoh, said that no-work-no-pay implementation had commenced in the state.
Udoh, who said doctors were not deterred by such implementation, however, lamented that some of their members worked in January, February and March without payment only for the government to enforce the implementation when they decided to embark on strike.
He said, “We have not received our August salary yet, so it means that implementation has been effected. That is the situation now. We should have received August salary by now (if the no-work-no-pay policy had not been implemented) but we have not received it.
“We have members who worked in January, February and March, they did not get their salaries, only for us to down tool and they want to implement no-work-no-pay. What about the work we have done and we were not paid? It’s not good, but we’re not deterred by that.”
We won’t take issues with doctors, says Ondo
On its part, the Ondo State Government said it would not take issues with the resident doctors over the issue of percentage salary payment or total stoppage of doctors’ salaries.
The state Commissioner for Information and Orientation, Mr Donald Ojogo, stated this in his reaction to the allegations made by the doctors.
He said, “There is no time limit to engagements, whether at the level of industrial or political disputes. We won’t take issues with them because it is believed that all and sundry are aware of the prevailing challenges that are not peculiar to Ondo State.”
In Katsina State, investigations conducted by Saturday PUNCH showed that August salary had yet to be paid to civil servants in the state, but the situation in Kano State was not clear.
In Katsina, two members of the Association of Resident Doctors who spoke on condition of anonymity confirmed the development that August salary had yet to be paid in the state.
One of the ARD members said, “As we are discussing, we have yet to receive alerts for August salary. Although, virtually all members of staff have not too. But you can contact the President (ARD) for clarification.”
The ARD President at the Federal Medical Centre, Dr Salihu Bolakale, could not be reached for comments as his telephone lines were not reachable.
The SMS sent to his telephone line on the development had also yet to be replied as of press time.
In Kano, calls made to the number of the state Commissioner for Health, Dr Ibrahim Tsanyawa, were not answered.
But when contacted, the Public Relations Officer in the ministry, Hadiza Namadi, said she was not competent to speak on the issue and referred Saturday PUNCH to the Public Relations Officer of the State Hospital Management Board, Ibrahim Abdullahi.
Abdullahi also said he was not aware of the development.
“I don’t have information or details on the issue you raised. Therefore, I cannot confirm or deny it. I need to know the situation of things before making any comment,” he said.
‘Imo owes us six months’ salaries’
The Imo State government on Friday denied that it owed resident doctors in the state 15 months arrears of salaries.
The Commissioner for Information and Strategy, Declan Emelumba, told one of our correspondents in Owerri that it was not also untrue that the state government didn’t care about the state’s healthcare system.
The commissioner, who could not state how many months the state government owed the striking resident doctors, said that the government was committed to providing adequate healthcare to the people of the state.
Emelumba said, “It is not true that we owe Resident Doctors 15 months arrears of salaries. It is not true that the state government does not care about the healthcare of its citizens. That report couldn’t be true because we have revived Imo State University Teaching hospital in Orlu.”
But the President of Association of Resident Doctor at IMSUTH in Orlu, Edward Una, told Saturday PUNCH that the state government owed the striking doctors six months’ salaries.
Una, however, also said the state government hadn’t implemented no-work-no – pay policy in the state for the striking doctors.
He said, “We are being owed six months of salaries. They are July, August, and September of 2019. Then, we have also not been paid for the months of January, February and April of 2021.
“Then, we got incomplete salaries in November and December, 2020, and March and May 2021 as well. They are still paying us with 2011 salary schedules. There is no no-work- no-pay policy yet. We received our salaries in June and July but we have not been paid for August.”
Ekiti, Enugu not withholding salaries – Doctors
Resident doctors in Ekiti and Enugu states said the two states had yet to implement no-work-on-pay policy on the striking doctors in the state teaching hospitals.
The chairman, Enugu State branch of Nigerian Medical Association, J.O.T Onyia, told one of our correspondents that the state had not implemented the policy.
Efforts to get the position of ARD Enugu State Teaching Hospital, Parklane, through its chairman, Dr Chima Edeoga, were unsuccessful as he did not answer his calls.
Also the state Commissioner for Health, Dr Ikechukwu Obi, didn’t pick calls made to his mobile.
In his reaction, the President, NARD Ekiti State University, Ado Ekiti, Dr Olaniyi Olaoye, said Ekiti State Government was not applying the ‘no-work, no-pay rule’ to the striking doctors.
Olaoye said, “The ‘no-work-no-pay rule’ is applicable for those working with the Federal Government. Ekiti State Government is not implementing it.”
The state governor had on Tuesday announced that “payment of 100 per cent subvention to Ekiti State University Teaching Hospital has been restored.”
The slash in the subvention to the institution was principal among reasons the resident doctors in the institution went on strike even before the ongoing NARD nationwide strike.
‘Non-payment of salaries, opportunity for doctors to jet out’
However, the NARD Caucus Leader (South-West), Dr Taofeek Sanni, who works at Federal Teaching Hospital, Ido Ekiti, said that salaries of resident doctors in all federal institutions had been stopped.
Sanni, who said workers of FETHI, who ought to have received their salaries had not been paid as at Friday morning, noted, “The delay in the payment to workers is because they are trying to remove resident doctors’ names before payment so that we would not be paid.
“They had told the Chief Medical Director to send our names for them for removal so that we would not be paid. They are making attempt to execute the ‘no-work-no-pay’. But if they don’t pay, we won’t resume. We won’t resume until they pay us all our money.
“Many of us who want to travel will use the opportunity to travel out of the country. By the time we resume, there would have been a very serious shortage of doctors in Nigeria.
“It is Nigerians who will suffer it. That is why the people are supposed to be speaking out now so that the government will do the needful for this thing to end.”
No-work-no-pay rule commences in federal institutions
The no-work-no-pay rule adopted by the Federal Government to compel striking resident doctors to call off their strike has taken effect in federal institutions.
For example, the chairman of the Cross River State chapter of the association, Dr Godwin Udoh, confirmed that salaries of members of the association had been withheld and their names removed from the payroll.
“I think they have started to implement it. I got an unconfirmed report that we (resident doctors) were asked to be removed from the payroll this month. All resident doctors had not been paid. The no-work-no-pay rule took effect from August 2, but the strike continues,” he said.
Also, the Chairman of the association in Ebonyi State, Dr Chidubem-Philip Osuagwu, said members of the association had not been paid their August salary as well.
Noting that he was not sure if it had to do with the no-work-no-pay directive by the Federal Ministry of Health, he added that aside from doctors, other health workers also joined in the strike to show solidarity.
Osuagwu stated this in a telephone interview with one of our correspondents in Abakaliki, on Friday.
Osuagwu said, “We have not been paid our August salary. I don’t know whether it has to do with the no-work-no-pay directive by the Minister of Health.
“But many health workers, apart from doctors, have joined the strike. It’s a national thing and we are following directives from the national secretariat and whatever they ask us to do, we will do.”
The Commissioner for Health in Ebonyi State, Dr Daniel Umezuruike, however, said the striking doctors were hired by the Federal Government.
According to him, “We don’t have these striking doctors on our payroll, because they are all federal government staff working in various teaching hospitals and other federal health facilities across the state.
“We have health workers on our payroll, but those on strike are not the one working for us. And so, there is nothing like no-work-no-pay with us, in the state.”
Lagos must withdraw contentious circular, release fund for training – LASUTH ARD
Also, the President, Association of Resident Doctors, Lagos University Teaching Hospital, Ikeja, Dr Azeez Ojekunle, said the strike will continue until the state government meets the demands of the association.
Ojekunle, at a briefing on Friday, said the LASUTH ARD did not join the nationwide strike in solidarity with its national body, but noted that the branch had its own demands which the state government had not met.
He said, “There is a misinformation that Lagos State joined the nationwide NARD strike action in solidarity with our national body; we hereby set the record straight that there are several local issues affecting the Lagos State chapter of NARD and the health care system.
“It is disappointing that we have exhausted available diplomatic approaches through advocacy, dialogue and lobbying long before and during the strike action; yet concrete responses are yet to be implemented by the state government to resolve lingering issues. The government has shown us that our preferred option of dialogue is not theirs but to down tool.
“Should Lagos State not make expected prompt response to resolve our prayers, the LASUTH-ARD congress may not be able to guarantee continued service delivery even at the end on the ongoing nationwide strike action.”
He appealed to the state government to withdraw the circular which had removed House officers and NYSC doctors from the scheme of service.
“We also seek the immediate release of the Medical Residency Training Fund the governor has earlier approved. We demand a template for regular recruitment of resident doctors and medical officers to consolidate existing exit replacement. We also demand commencement of the residential quarter’s project in LASUTH,” Ojekunle added.
The LASUTH ARD President said the state government had not stopped the salaries of the striking doctors in the state.
Saturday PUNCH reports that the industrial action by NARD which commenced on August 2, 2021, entered its 33rd day on Saturday (today).
Ex-Health Minister, others call for funding, decentralisation of health sector
In the meantime, a former Minister of Health, Prof. Isaac Adewole, has called for increase allocation to the nation’s health sector, urging medical doctors to be more involved in politics.
The News Agency of Nigeria quoted Adewole as making the call at the opening ceremony of the 12th Biennial Delegate Meeting of the 2021 Medical and Dental Consultants Association of Nigeria at the University College Hospital, Ibadan, Oyo State.
He said, “Health policymakers have been under enormous pressure in recent years over concerns about financial sustainability and cost-containment.
“The resources available to any society are finite; still, emerging evidence is recasting health systems not as a drain on those resources, but as an opportunity to fast-track development by investing in the population’s health.
“The economic position of countries today owes much to the extent to which they could achieve better health, historically. The evidence is clear; a healthy population, including healthy older people, can substantially contribute to the economy.”
Adewole, also said that there was need for involvement of more medical doctors in the nation’s politics, to ensure more representation, because they understand health issues.
“If there are doctors in National Assembly, they will understand why they must vote more money into the sector.”
Also, the Provost, College of Medicine, University of Ibadan, Prof. Olayinka Omigbodun, said there was a need to decentralise the health sector.
Omigbodun said that the three tiers of the health sector could be served by health personnel without being confined to the federal, state or local government levels.
She said that health sector should be taken at the periphery for the people and by the people as being done in developed countries.
“Our healthcare delivery system needs a total overhauling, for example the teaching hospitals are under the Federal Government, the General Hospitals are under the state government and then, the primary healthcare, which is grass roots, are under the local government.
“At those three tiers, the healthcare delivery is being supervised by these three tiers and that is not going to work.
“Because, you need to plan for the health of the people looking at each state or community within that confined area as a whole. So, there must be a health planning team for each state or community that looks at the health of that geographical entity.
“It should be in such a way that when needs assessment of the place is done, they will be able to identify the type of health facilities needed, as well as the kind of health personnel,” she said.