The Nigerian Medical Association (NMA) on
July 1 embarked on a nationwide strike
, thus doctors working in government-
owned hospitals have boycotted work,
leaving majority of sick Nigerians stranded.
In an open letter titled “Facing the
Challenges in the Health Sector” to the
Secretary to the Government of the
Federation, Pius Anyim, on June 11, the
association of all medical doctors in Nigeria
listed a 24 ‘minimum point’ demand. This list
is expected to be field by government
before NMA members would return to work.
However on Thursday, President Goodluck
Jonathan ordered the sack of all resident
doctors in Nigeria.
Mr. Jonathan directed the suspension of all
Residency Training Programme and the
hiring of part-time medical officers to
replace the doctors.
The inadequate funding of the Residency
Training Programme is one of the reasons
the NMA is aggrieved. Below is a list of the
challenges faced by the NMA:
A demand that seven Deputy Chairman
Medical Advisory Committee (DCMAC), four
for Teaching Hospitals and three for
Federal Medical Centers be appointed to
assist the Chairman Medical Advisory
Committee (CMAC). The association noted
that the CMAC is presently saddled with
statutory responsibilities that are too
heavy for an individual to handle. The
DCMACs is expected to have the same
qualifications as the CMACs. The NMA also
argued that directors in other government
establishments are supported by deputies
and sees no reason while that of the
CMACs should be different.
The association opposed the appointment
of directors in hospitals. The position, it
said, distorts the chain of command and
induces anarchy while exposing patients
to conflicting treatment and management
directives with mostly negative
A demand that grade level 12 (CONMESS 2)
in the health sector be skipped for medical
and dental practitioners.
The association also demand that the title
‘Consultant’ should not be assigned to
non-doctor personnel. Arguing that
consultant describes the relationship
between a specialist medical doctor and
his patients, the association said that
giving the title to a non-doctor personnel
will only lead to anarchy and chaos in the
The immediate implementation of a
January 3, 2014 circular and immediate
payment of the arrears for 22 years
during which members were short-
changed. It also demand an adjustment of
doctor’s salary to maintain the relativity as
The acceleration of the passage of the
National Health Bill and extension of the
Universal Health Coverage to cover 100
per cent of Nigerians rather than 30 per
cent as currently prescribed by the
National Health Insurance Scheme (NHIS).
Appointment of a Surgeon General of the
Federation with immediate effect.
A correction of entry point of a health
officer to CONMESS 1 Step 4 as originally
contained in MSS/ MSSS while the
Registrar/ Medical officer is moved to
CONMESS 3 Step 3.
Call duty allowance for Honorary
Consultants should be increased by 90 per
An adjustment in the specialist allowance
as contained in the 2009 collective
bargaining agreement. Also all doctors on
CONMESS 3 and above must be paid
specialist allowance or its equivalent, not
less than 50 per cent higher than what is
paid to other health workers.
Hazard allowance for medical doctors
must be at least N100, 000 per month. The
hazard allowance for medical doctors is
said to be at N5, 000 per month presently.
Immediate release of the circular on rural
posting, teaching and other allowances
which must include house officers.
An immediate withdrawal of a circular by
the Central Bank of Nigeria (CBN)
authorizing Medical Laboratory Science
Council of Nigeria (MLSCN) to approve
licenses for importation of In-Vitro
Immediate release of the circular for the
retirement age for medical doctors as
agreed with the Federal Government.
The FG through the health ministry should
formalize and implement the report of the
interagency committee on residency
training. The FG is expected to release the
uniform template on the appointment of
resident doctors in line with earlier
agreements. Also a concrete funding
framework for residency training must be
established while the overseas clinical
attachment must be fully restored and
properly funded in the interest of the
That in the interest of harmony in the
Federal Medical Centre, Owerri, the
government should pay the salaries of our
members in the center as agreed on
October 21, 2013.
Immediate concrete steps must be put in
place for the reintegration of our
members back into the IPPIS platform.
All attempts to coerce house officers not
to join NARD must stop.
The orchestrated intimidation, harassment
and physical assault of our members in
the departments of pathology (Laboratory
medicine) by laboratory scientists and
tolerated by the Federal Ministry of Health
The endless circle of incomplete salary
payment of our members in many
hospitals in the name of shortfalls in
personnel cost must stop.
Universal applicability of all establishment
circulars on the renumeration and
conditions of service for doctors at all
levels of government must be granted.
Government should as a matter of urgency
set up a health trust fund that will
enhance the upgrading of hospitals in
The position of the Chief Medical Director/
Medical Director must continue to be
occupied by a medical doctor as contained
in the Act establishing the tertiary
hospitals. This position remains
sacrosanct and untouchable.
The NMA henceforth shall not accept the
continued violation of any of any of the
terms of the 2009 Collective Bargaining
Agreement. This is exemplified by the
payment of the Medical Physicist and
Optometrist with OD (who are on
CONHESS) call duty allowance using
CONMESS circular. Similarly, the phrase,
“Ministries, Departments and Agencies”,
MDAs in the said agreement should
replace “Federal Ministry of Health and
other Federal Health Institutions” as
contained in the 2009 CONMESS circular.
The Nigerian Medical Association (NMA) on