I naturally dislike arrogance. It is cancerous. Anyone who develops little pieces of arrogance in himself should be on the watch out! Otherwise those “cancerous arrogant cells” will mutate and overcome the “moral health system” of the person.
I perceived such “arrogant taste” in an article written by Dr Paul John titled “Another ultimatum from JOHESU?” I was deeply sad within me. It is really shameful that Dr Paul John, who is a medical doctor, belonged to this noble profession by descending so low to “swim in the ocean of arrogance” which negates the true principles of the medical profession.
I am an administrative officer in one of the federal medical centers in Nigeria. I never really understood this “infighting” that characterized the health sector. I have to admit this by humility. However, when I was given the privilege to become recruited into the federal civil service system few years ago, I came to witness, on a ‘first-hand’ basis what is truly happening in the Nigerian health sector, regarding the battle between NMA and JOHESU. In fact permit me to state that from what I saw and from the available literature I came across, “my eyes were opened”.
Often times, we have heard the saying, “what is good for the goose should be equally good for the gander”; some have rephrased this to be “what is good for the goose and the gander is good cheese”. One of the fictional characters in George Orwell’s “Animal Farm”, held that “all animals are equal but some are more equal than the others”, after stating initially that “all animals are equal”. We also have heard that “Napoleon is always right”. This in a nutshell captures the battle of working relationship, harmony, remuneration between NMA and JOHESU. We have a situation in Nigerian health sector that “though all animals are equal”, “some animals” (the doctors) are more equal that the “other animals” (physiotherapists, nurses, pharmacists and other health workers, clinical and non-clinical). What is good for the “goose” (the doctors) is no longer good for the “gander” (non-doctors). The “goose”, having taking its own salacious full of the cheese, “with resounding cries of yummy-yummy”, have declared that the cheese is not good for the health of the “gander”!
There is an Igbo proverb, “agbara rawa nsi, efosia ya ihe ejiri mara ya. Arusi rawa nsi, agwa ya osisi ejiri pia ya”. Dr Paul made some assertions in that article of his, which at best ought to be ignored. However, I felt I had a burden to issue this reply to him and to whatever “school of thought” which he represents.
There was an interesting assertion that Dr Paul made. I would quote him thus, “If you want to become something in life, you must follow the due process. The current director general of World Health Organisation, Dr Margaret Chan, wanted to be in her current post and when she realized that the post was and is still an exclusive preserve of medical doctors, she simply applied to study medicine despite the fact that she had had a degree in Home Economics and for the fact that she was already practising as a Home Economics teacher . In my class we had many people that were studying medicine either as second or third degrees. The most annoying aspect of the whole stuff is that these medical insurgents will quote international best practices which I am sure they don't really understand the meaning”. I would like to remind Dr Paul that Jim Yong Kim the present head of the World Bank is a medical doctor, not even an economist.
When the post was vacant couple of years ago, our own Okonjo-Iweala (whose pedigree has never been questioned in the field of economics and finance management, tested and trusted as a world class economist) indicated her interest alongside Jose Antonio Ocampo (another reputable economist from Brazil). Of all the candidates, Okonjo-Iweala possessed the most formidable credential to head the World Bank. However, the medical doctor was chosen. He has been heading the World Bank and no one has ever come out to attack or criticize his administration. And he has been performing well. Someone would wonder, what is a medical doctor doing as the head of World Bank? But he has been delivering. That’s’ the truth. So Dr. Paul should not be selective in his instances that he easily brandished in his arrogant article.
Is it a criminal offence if a nurse, or a physiotherapist or a pharmacist becomes the chief medical director of a hospital? If it is a criminal offence, then the world bank executives would not have appointed a medical doctor to head that pristine financial institution, a medical doctor who is not a professional economist”! They would have put Okonjo-Iweala there. But the World Bank has not collapsed. Most of our revered Nollywood actors and actresses never read Theatre Arts. Most of our revered musicians did not study music as a profession. But they are doing very well, making Nigerian movies and music cross the shores of Nigeria and Africa.
In fact, is it not a sign of contradiction, that these Nigerian doctors clamoring that they are the only ones worthy to head a health institution, has no form of knowledge in hospital administration. In the United States, doctors have no business in hospital administration. Of course there are professional health administrators. I know of one Institute of health administration somewhere in Cross Rivers. Why would the doctors not allow a career, professional health administrator to run the teaching hospitals, federal medical centers and other health institutions in Nigeria as Chief Medical Directors? I am saying all this so that an objective mind somewhere would see the point I am trying to make. In fact, what I suggest we should have in Nigeria is “Chief Administrative Director” (CAD), not “Chief Medical Director” (CMD) as we have it today.
That reminds me. I pray that the head of service will read this piece. From what I have read from the Public Service Rule, the entry point of staff in the civil service is Grade level 7-10. But from what we have seen today, the doctors have succeeded in making their entry point to be grade level 13! Let me explain further.
The normal grade level in the civil service here in Nigeria is GL 1-6 for junior staff and GL 7- 17 for senior staff. Now in the health sector, there are two salary schemes: CONMESS and CONHESS. These two salary schemes were approved around 2009 by His Excellency Alhaji Umaru Musa Yar’Adua, former Nigerian president (may he continue to rest in peace). The Medical Doctors in the Nigerian are on CONMESS, while other medical personnel (physiotherapists, nurses, pharmacist and other clinical staff) and every other person working in the Health Sector were placed under the CONHESS structure. I would want my reader to take a look at these schemes in the chart below:
NORMAL GRADE LEVEL CONMESS (FOR DOCTORS)
Grade Level 10 CONMESS 01 (house officer/youth corps Doctor)
Grade Level 12 CONMESS 02 (Registrar/Medical Officer)
Grade Level 13 CONMESS 03 (Senior Registrar Senior Registrar II/Senior Medical Officer Grade 2)
Grade level 14 CONMESS 04 (Senior Registrar Grade 1/Senior Medical Officer Grade 1)
Grade Level 15 CONMESS 05 (Consultant/Principal Medical officer Grade 2)
Grade Level 16 CONMESS 06 (Consultant Special Grade 2/Principal Medical Officer Grade 1)
Grade Level 17 CONMESS 07 (Consultant Special Grade 1/Chief Medical Officer)
NORMAL GRADE LEVEL CONHESS (FOR OTHER CLINICAL STAFF AND HEALTH WORKERS)
Grade Level 8 CONHESS 7 -- INTERNS / NYSC
Grade Level 9 CONHESS 8 X -Officer 1
Grade Level 10 CONHESS 9 Senior X-Officer
Grade Level 12 CONHESS 11 Principal X- Officer
Grade Level 13 CONHESS 12 Assistant Chief X-Officer
Grade Level 14 CONHESS 13 Chief X-Officer
Grade Level 15 CONHESS 14 Assistant/ Deputy Director X-Officer
Grade Level 17 CONHESS 15 Director X-Officer