The Minister of Labour and Employment, Sen. Chris Ngige has challenged the Nigerian Medical Association (NMA) to take the battle for the upliftment of the national healthcare system to the thirty-six states of the Federation where Governors have completely abdicated their responsibilities, likening the Federal Government to a willing horse that must not be ridden to death.     

“The State Governments have abdicated their responsibilities and nobody is talking to them, nobody is doing anything. Everything is now Federal. Federal Government will provide tertiary healthcare, secondary and even primary healthcare as well as provide a place for residency programme. How can we? How? The Federal Government is in fact a willing horse but if a horse is willing, you don’t ride it to death”, Ngige said while receiving the leadership of the Nigerian Medical Association(NMA) in Abuja.  

“Health is on the concurrent list and nothing stops the state governments from doing the primary, secondary and tertiary healthcare. In fact, when as a young doctor I did my housemanship, we had a hybrid of secondary and tertiary. That is why I left the teaching hospital and did mine at the Onitsha General Hospital while some of my colleagues had theirs at Enugu-Ukwu General Hospital and Parklane Hospital in Enugu. But today, the State Governments have run away from even primary healthcare. The secondary – most of their general hospitals are glorified residents for rodents and reptiles.”

Hence, the Minister called on the NMA to mobilize and sensitize its state chapters to take up the issue of the unfortunate abandonment of the responsibilities in healthcare delivery by the State Governments.

He further charged them, “Your state branches should live up to expectation. Their job is not just to come to the general assembly to vote for strike and go back to their people and report. They should fight to protect the state health system. It is an incongruous situation that you go to a teaching hospital and see people on out-patient care for malaria, gastroenteritis etc. It mounts pressure on those teaching hospitals, making them unable to deliver on the major jobs they are supposed to do.”

Sen. Ngige further advised the NMA to put on their thinking caps as it was becoming impossible for the Federal Government to fund the health system, in line with the Abuja declaration, as a result of dwindling resources, saying the effective use of resources was now mandatory. 

 “Let us use whatever we have effectively and efficiently. Let’s plug leakages and wastes. There is a lot of waste in the system. Some doctors don’t take call duties but are paid call duty allowance. Why do you take call duty allowance when you are not on call? Some doctors also are not exposed to hazards but take hazard allowances. Why? 

Providing insight on the just concluded Consequential Adjustment of the National Minimum Wage, he regretted that a heavy chunk of the Federal Government budget was being used to fund the current expenditure, thus limiting dangerously, the capacity of government to deliver on physical infrastructures. The need to think out of the box, he said, was overriding. 

“How do we reconcile the fact that we are doing a budget of N10.3 trillion in 2020 and out of that, personnel cost alone is N3.88 trillion, amounting to one third of the total? And when you add the running cost to it, it comes to N4 trillion. How do you explain that? It means we have no money left to even fund health, education and other infrastructures. We are abandoning all to pay just salaries. It is frightening and worrisome. That’s why we have to put on our thinking caps.”

He however commended the NMA for being appreciative of government’s commitment to the welfare of workers, saying that the Consolidated Medical Salary Scale was in the category B of the Public Service remuneration grade already well protected and remunerated before the Consequential Adjustment.  The Minister also said  Nigeria had done very well in  remuneration and investment in the health sector, citing the one percent of the Consolidated Revenue of the Federation which  accrues  to the sector on account of the Health Act. “ That one percent in the 2019 budget for instance amounted to N49 billion and N56.7billion in 2020 budget.This is  apart from the statutory budget to the sector in the Federal Ministry of Health Annual Budget ,” he asserted .

The Minister similarly explained that the NMA was not involved in the negotiation for the Consequential Adjustment of the Minimum Wage contrary to its request because the association was not a registered trade union to qualify for the membership of the Joint Public Service Negotiating Council.  He therefore seized the opportunity to request the NMA and the National Association of Resident Doctors(NARD) to come together and register as a union since the Trade Union Act has made it difficult to register them as two separate unions which they aspire to, knowing that they perform the same job.

He further charged doctors in the private practice to pool resources together and form combines to enable them beat the challenges of inadequate funding and increase their capacity to access international aides.

Earlier, in his address, the President of the NMA, Dr. Francis Adedayo Faduyile, urged the Federal Government to declare emergency on the health sector and set up national healthcare fund, in the same manner government intervened in the entertainment industry.  

He also asked for the re-negotiation of the Collective Bargaining Agreement (CBA) entered into with the Federal Government in 2009 which ought to be renewed every three years, arguing that some of its terms such as the N5,000 hazard allowance was out of place in today’s realities.  

He congratulated the Minister for the swift and patriotic resolution of the Minimum Wage impasse, and further invited him to the National Health Summit, taking place in Abuja next week.