Special Report

May 31, 2012

CONMESS: Whither the place of agreement?

IN September 2009, following several years of negotiations between the Nigerian Medical Association and the Federal Government, the Consolidated Medical Salary Scale, CONMESS, circular SWC/S/04/S.410/220 was released by the National Salaries, Incomes and Wages Commission. CONMESS is a uniform salary structure initiated by the Federal Government for all doctors in the country.

Medical Guild had been agitating for implementation of the CONMESS through several letters and representations to government. This culminated in the strike actions of August to November 2010, and February to March 2011.

However, in 2010, the State Government agreed to adopt CONMESS and this followed with the signing of the first ever agreement to implement the salary structure in the state. The agreement, dated November 19, 2010 with number LGS/HOS/06/Vol.VI/30 was signed by the Head of Service, Mr Adesegun Ogunlewe.

In 2011, the State government reneged on the agreement which led to a four months protracted strike in the state.  With the intervention of well meaning Nigerians, the doctors went back to work after signing another agreement on the same issue with the State Government. The second agreement was dated March 24, 2011 was signed by Asiwaju Bola Tinubu, Henry Ajomale and Dr. Jide Idris.

However, in the last one month, the state health sector has been in crisis following the alleged failure of the State government to, yet again; fulfill agreement over the same issue.  In the wake of the crisis have been series of events beginning with the sacking of 788 doctors, their eviction from official quarters, legal actions in Industrial Court and the solidarity strike by Federal doctors in the state. The two parties, (Lagos State Government and the Medical Guild) have had three separate agreements over the CONMESS implementation and at each point; negotiation has broken down because government allegedly failed to keep its own part of the bargain.

This brings to question what an agreement represents. According to a business dictionary, an agreement is “A negotiated and usually legally enforceable understanding between two or more legally competent parties.  Although, a binding contract can and often does result from an agreement, an agreement typically documents the give-and-take of a negotiated settlement and a contract specifies the minimum acceptable standard of performance”

Of what use is an agreement if it is not binding on the parties involved?  Then, can it still be described as an agreement? Can two walk together except they agree?  Going by the biblical perspective; (Amos 3: 3) “two cannot walk together except they agree.” Keeping of agreement may not be the strongest attribute in this part of the world.   Nigerians have almost become used to having broken promises through failed agreement. Today, it is a common place in Nigeria to find various labour unions embarking on strikes due to failure of the government to honour one agreement or the other for the benefit of the people.

The foregoing may explain the current situation in the Lagos State Health Sector. The effects of this break down of agreement has brought calamity on not just the parties involved but the  entire health system, the patients, innocent Lagosians and the entire nation as a whole. Everyone has had their own share of the crisis. Countless lives have been lost unnecessarily.  The health system has virtually shut down. Revenue running into billions has gone than the drain while even the future of medicine is seriously threatened. But perhaps the most shocking was the unprecedented sacking of 788 doctors at a go. Never in the nation’s history or anywhere in the world have such a huge number of doctors been sacked in a single day.

Even after suffering this crushing blow the doctors don’t appear to have earned public sympathy for the singular reason that they went on strike in the first place. Worse still, the state government continues to maintain sealed lips over the status of the various agreements. Now the doctors who are down have come out to say they have nothing more to fear and as a result they are now questioning the place of an agreement in a country like Nigeria basing their argument on recent attempts by the State Government to renege on yet another agreement would have resolved the lingering crisis in the state health sector.