… Say job of managing hospitals has nothing to do with patient care

By Chioma Obinna

Pharmacists under the auspices of the Pharmaceutical Society of Nigeria, PSN, on Friday dismissed the call by the Medical and Dental Consultant Association of Nigeria, MDCAN, to throw out the Amendment Bill for University Teaching Hospitals, insisting that the job of administering or managing a hospital has nothing to do with surgical skills.

The Pharmacists also posited that they see no reason why they should not be accorded their rightful treatment as the spirit of the amendment bill to the University Teaching Act was grounded in the belief that pharmacists, nurses, medical laboratory scientists and other health professionals are more versatile in their areas of patient care than physicians.

According to them, “You do not bring in your wealth of experience as a Specialist Physician with a stethoscope to run the hospital system. It is the same with other Specialist Health professionals whether Pharmacists, Laboratory Scientists or the other experts in the team.”

Responding to the call in a press statement entitled: “Re: Bill for an Act to Amend the University Teaching Hospitals (Reconstitution of Boards etc) Act Cap U15 LFN 2004 Open all Frontiers of Restriction in Healthcare now”, the President of PSN, Prof. Cyril Usifoh argued that all that will be needed to succeed would be the depth of administrative skills or deep managerial acumen.

The controversial bill entitled: “Bill for an Act to amend the University Teaching Hospitals (Reconstitution of Boards etc.) Act Cap U15 LFN 2004” and sponsored by Hon. Bamidele Salam representing Ede North/Ede South/Egbedore/Ejigbo Federal Constituency of Osun State is seeking among other things, to change the nomenclature of the Head of Tertiary Health Institutions in Nigeria from Chief Medical Director, redefine the qualification of the Head of Tertiary Hospitals, and provide a definite tenure of office for the Heads of Tertiary Hospitals.

The Bill also seeks to include students of Health Sciences in the training programmes of Tertiary Hospitals, include hospitals established post-enactment of the extant legal framework in the schedule and for other related matters and restructure the composition of the Governing Boards of the Federal Government Tertiary Hospitals.

Continuing, Usifoh further faulted the medical doctors’ position, citing that MDCAN in what it described as a ‘very provocative statement’ canvassed better funding and improved infrastructure but failed to justify and account for whatever “little” Government makes available to its exclusive club members who live like oil sheikhs and merchants in our various cities and capitals.

“While MDCAN and NMA still live in the stone age that they own patients and are lords of the Manor in Healthcare, their global body the World Medical Association incidentally led by one of them, Dr. Osahon Enabulele posits that the “Physician has an obligation to cooperate in the coordination of medically indicated care with other Healthcare providers treating the patients”.

Noting why physicians have failed as heads of the hospitals in Nigeria, he said if physicians were good managers it would have impacted their private hospitals which oftentimes fail under their business management.

“The incumbent DG of the WHO is a Scientist with a bias in Microbiology. This 1986 graduate of an Ethiopian University has no background in care provisioning, but he continues to succeed in his job at WHO because of his managerial expertise.

“The gregarious socialisation of the respective components of the health sector which should be a confederacy of brotherhood has been annihilated by the likes of MDCAN and its acolytes.”

He further accused the MDCAN, NMA and others to have completely mutilated the configuration of their cultural historicity as regards a team concept as known globally.

“The commonality of our brotherhood remains jeopardised beyond repairs every time we evaluate our current realities because of the unfortunate posturing of Physicians.

“In the circumstance, the conundrum which the FHIs has become needs to be rescued with the proposed amendment bill which must succeed,” he added.

Continuing, the press statement reads: “After a critical appraisal of all issues raised by the MDCAN, the PSN finds it imperative to inform that the UCH, Ibadan was the foremost set-up in terms of a formal structure for the Federal Hospitals, FHIs in Nigeria.

The UCH, Ibadan was established in 1952 with an independent Board of Management. An autonomous CEO who was designated House Governor was placed in charge of the systems. The House Governor/CEO was non-physicians and they led UCH, Ibadan to commanding heights and positive reference points.

“It is noteworthy that the UCH, Ibadan grew to become one of the top five facilities in the commonwealth. This encouraged the Saudi Royal family to access Health at UCH, Ibadan.

“While it was success stories with non-Physician CEOs at the helm in our Health institutions, same cannot be said with the 37 years of the holocaust that Physicians have dominated the headship of the hospitals based on the reigning obnoxious decree 10 of 1985 which was invented by late Olikoye Ransome-Kuti to legalise discrimination, unfair practices and slavery on non-Physician health workers by almighty Physicians in Nigeria since 1985.”

They accused the headship of Physicians in hospitals in Nigeria of being discriminatory, distorted and stifling the career prospects of all non-physician health workers in Nigeria among others.

“Today, without a fundamental change in curriculum in Medical Practice, the Physicians have explored the leadership role placed on them at the FMOH and FHIs to create a new order where Physicians start the internship on the equivalent of GL 10 and proceed to GL 13 after Youth Service, Pharmacists who hitherto were on the same entry grade level as Physicians now start the internship on GL 09 and move to GL 10 after Youth Service.

“The other Health workers who are not Health professionals still start on GL 08 and it takes over 12 years for any of them who enjoy regular promotion to attain the entry point of a Physician. This is why in less than 15 years average Physicians who attain Consultant status is already on the equivalent of GL 17 as Director.”

“A quick check of the numbers of Physicians who are Permanent Secretaries in the Federal Civil Service will confirm this analysis and the monumental injustice done to non-physician health workers in our country.

“The Call-Duty allowance and other benefits of a House Officer who just entered the civil service is much higher than that of the most senior Director in the non-Physician cadre, such that the total emolument of any Physician is over 150% of that of his equivalent in any of the non-Physician professional cadres.

“In 2009 when the current salary structure of Physicians on CONMESS and non-Physicians on CONHESS was structured, it was agreed that any adjustment on one scale would be reflected on the other one. For eight and a half years, Health workers under the aegis of JOHESU/AHPA have met a brick wall in their quest for the amendment of CONHESS because of the leadership of the FMOH and FHIs have collaborated effectively to truncate their agitation for an amendment of CONHESS.”

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