MEDICAL services in government owned health institutions in Lagos were grounded, yesterday, as the Medical Guild, umbrella body of doctors in Lagos State, made good its threat to call out its members on a three-day warning strike over irreconcilable issues with the state government. The strike is to press home demands for the Consolidated Medical Salary Scale, CONMESS, and downward review of alleged excessive taxation.
Compliance with the strike was total as several hospitals on Lagos mainland were devoid of the usual beehive of activities as the doctors stayed away from their duty posts, forcing hordes of patients, several of whom turned up as early as 5.00a.m, to seek treatment elsewhere.
A check by Vanguard revealed that in the affected health institutions, most of the outpatient clinics were shut, while available services were very scanty with no apparent back up. At the Randle General Hospital, Lagos; the General Hospitals in Surulere, Gbagada and Orile Agege, and the Lagos State University Teaching Hospital, LASUTH, Ikeja, only nurses, paramedical staff and laboratory technicians were seen attending to patients.
Police presence: Earlier on, entrances to the aforementioned health institutions, were taken over by Policemen. When Vanguard visited the Lagos State University Teaching Hospital, LASUTH, Ikeja, at about 9.00a.m., a detachment of heavily armed policemen in two mini buses and one pickup van, was stationed at the entrance.
Although the reason for the Police presence could not be immediately verified, the health institution was a shadow of itself. A very low turn out of patients was observed in all the outpatient clinics and there was very little healthcare activity in progress in the wards and other ancillary departments.
Clinics shut: A hospital source confirmed to Vanguard that a number of patients who turned up early had been asked to go back home because the clinics were not in operation. Only nurses and few of the senior consultants were seen attending to critical cases that were registered prior to the strike. The medical records was shut and no new patients were being admitted. Some of the early callers who had initially been given cards were were later turned back and advised to return next week.
At the LASUTH's eye department, only five patients were seen waiting to be attended to. They confirmed to our reporter that though they had been given numbers, their cards were later returned and they were told to go home because consultants were not around. In the wards visited, there were about 12 patients being attended to by their relatives. It was gathered that all ward rounds for the day had been canceled and as at 1.30pm, none of the patients had seen any doctor or consultant.
Patients lament: Many of the patients, who expressed shock and bitter disappointment at the development, confessed the strike took them completely unawares. A patient, Mrs Cecilia Odili, said she had left home earlier to see a doctor she had an appointment with at Surulere General Hospital and was disappointed at the development.
She noted: "I am sad that doctors are on strike again. What is the government doing to avert these recurrent strikes? I do hope this is resolved on time so that normal activities go on at the hospitals, because without the doctors, the hospitals are incomplete."
Another patient, Mrs Chioma Ozurumba, expressed the hope that the warning strike would not exceed three days to give people access to medical facilities across the state. "I cannot afford the cost of treatment at private hospitals that is why I use the general hospitals. This strike will make a lot of people suffer in terms of finance. I appeal to the government to dialogue with the doctors so that the strike does not become indefinite."
At the outpatient department as well as medical and surgical emergency wards, skeletal services were available, but priority was being given to critical cases. Only a handful of patients were encountered waiting for service. One of them, who spoke to Vanguard said he was only able to obtain a card because he was familiar with one of the staff on duty.
Settling the doctors
Another patient who identified himself as Chief S.O Legbe, recounted how he brought his mother from Sangah in Epe LGA, to LASUTH. He said: "I feel so bad to have come from the riverine area only to be told that doctors are on strike. I also feel bad spending money bringing my mother yet no doctor to attend to us. It is very painful. Please help us tell the Commissioner for Health to handle his job very well and to meet with other executives to settle the doctors, because health is the most important freedom in life so far.
Appeal to Fashola: "We appeal to the doctors to also consider the patients and return to their duty posts. Most persons come from the rural areas where there are no health facilities. Please Governor Fashola should settle the doctors because the state is capable of providing their demands."
Another patient who said he had suffered partial stroke and was at the hospital with his 80-year-old father lamented the inconvenience of the strike. According to him, they was coming to the hospital for the first time on referral and had no inclination a strike was in progress, but were waiting all the same, in the hope that they would be attended to eventually.
Several of the striking doctors were seen gathered in groups discussing the development, but none of them attended to patients.
The doctors from the General Hospitals in Surulere, Gbagada and Orile Agege told Vanguard they did not go to their places of work before converging at the LASUTH for an emergency meeting, but a mild drama ensued when the doctors who were locked out of the MRC building, venue of the meeting in question, angrily protested the development. Efforts to reach the hospital's Chief Medical Director, Prof. Wale Oke, drew a blank as he was said to be in a management meeting.
Reactions from doctors during their Congress: Rising from a three-hour congress to reaffirm their determination to go ahead with the three-day warning strike, the doctors said they did not agree to suspend the strike last year out of stupidity. They warned that the strike is on and whoever wanted to return to work could, but not their members. According to the Chairman Medical Guild, Dr Olumiyiwa Odusote said: "Doctors have reaffirmed their determination to go ahead with the strike to resume work 8.00 a.m., on Saturday morning."
Odusote who also stated that the three-day warning strike may not be the end of the action said Congress may be forced to review the strike if nothing urgent is done to implement their demands. He noted: "The reason why we called this strike was actually to amplify our voice because we have been pleading and talking to government to see reasons with us. We believe that this Government have a listening ear but we decided to embark on this warning strike to shout it e louder enough for them to fulfil their own part of the agreement."
Odusote who regretted that the struggle was not a new one noted that the struggle for the implementation of 100 per cent Consolidated Medical Salary Structure, CONMESS, which began since 2010 was still going on today. "This is the same fight that government took us to court and was later thrown out of the court. It is also the same struggle that government officials sat on down on a round table to calculate the cost implications and came out with a generous figure which was presented to the governor and he, ((Fashola SAN) agreed that the state can afford to pay".
Cost of CONMESS
On the cost of CONMESS to the wage bill of the State, Odusote who queried the sum total said the money was to increase the wage bill to about N37 million. He said: "After calculation in naira and kobo and they carried to the government and the governor said they will be able to pay and accommodate that, we were surprised that the same government is now saying they can no longer pay and that we should come back to the negotiating table to start renegotiating.
"Like I said, we have the right to resume strike without notice but we gave the government about eight days notice to allow for implementation. Since the implementation was not taking place we have to resume. All that was to allow for a dialogue and for the problem to be resolved without passing this particular root. We gave government eight days notice before embarking on this warning strike. Few days before we resumed strike, precisely, last week Wednesday, government called us to a meeting the following day. Unfortunately, instead of the government to resolve the problem, they decided to compound it by insisting we should start from beginning".
Government's attitude: Dismissing statement credited to the Special Adviser to the Governor on Public Health, Dr Yewande Adesina, he said: "The SA was not around when we had this agreement. We have document to this effect. If you have document to that effect, we have nothing to fear. There is no state in this country that is ready to negotiate no work, no anything less than 100 per cent CONMESS".
Expressing shock at the attitude of the State government, he said: "To us it is even more surprising. Although, we suspected that this is what they were going to do since last year but we pretended to follow them and actually see what they are up to.
Unfortunately, when we noticed that it was becoming more and more clear that they were not going to honour the agreement we decided to back out. The last straw was the meeting we had with the ministry of establishment, with the head of service, permanent secretary Ministry of Health, where we were told that it could not be accommodated in the 2010 budget."
No work, no pay rule: Reacting to the No work no pay rule, he said if they have resolved not to pay for the three days, we will also not work. "We will also apply no pay no work rule. If they don't pay us we will continue with the strike, that I can assure you. You can see that government locked us out of the MRC building. As civil servants, we have a right to meet in any part of this premise of building, but Lagos State government has denied us our fundamental right. As far as I am concerned this is the shame of the government.
The least doctor here is a level 10 officer and above. Some of these doctors have spent not less than 35 years in service. That is the kind of government we have". He, however, described the heavy police presence at various hospitals in Lagos as "Government response to right to associate."
Government's response to the CONMESS issue
But in swift reaction, the Lagos State government described the warning strike embarked upon by the Medical Guild as blackmail, aimed at protecting their private hospitals. Special Adviser to the Governor on Information and Strategy, Mr. Lateef Raji, who made this remark in an interview with newsmen, said the doctors'demands were unfounded pointing out that the State Government was the first in the country to implement the CONMESS which the doctors are now complaining about.
Raji said: "The doctors, from our findings, are just bent on going on strike probably to protect personal investments in their poorly equipped private hospitals, and that is what Lagosians should brace up for. When you complain that somebody who is on Grade Level 15, is not on step 04, that his entry point should be Grade Level 15 step 04, I mean Lagosians are wiser."
He added that people of Lagos would soon see the truth of the doctors' action as the real reasons for the strike would unfold as time goes on.
The special adviser said the doctors were also demanding that House Officers on grade levels 10 and 12 should be paid teaching allowances, a provision which, according to him, is not part of CONMESS. He added, however, that government told them that if they could provide the evidence that it was part of CONMESS provisions; Government would pay.
On the measures by the government to provide medical service to the residents of the state, Raji disclosed that even within the Medical Guild, there are several doctors who are not going to join in the strike because they are not happy with how the Executive of the Guild called the strike.
He also expressed joy that the Government has "willing hands who are ready to ensure that emergency services in Lagos Hospitals run and that the hospitals function," assuring that government would continue to do everything in its power to ensure that the medical facilities across the State are not shut down.
Declaring government's readiness "to meet with the doctors when they shelve their recalcitrant position," the Special Adviser urged Lagosians to rise up and put pressure on the doctors to return to work pointing out that the Lagos State Government has put everything in place, more than any other government in the country, to ensure that
the doctors stay on their jobs in terms of infrastructure and working condition.
"Lagosians should know that doctors in Lagos State earn the fattest salaries in the whole of the country; that the doctors have no reason to go on strike and therefore, Lagosians should mount pressure on them to go back to work because what they are asking for are administrative issues that government has met," Raji said, adding that government assured the doctors of its readiness to correct any unavoidable errors in the implementation of the CONMESS.
Pointing out that CONMESS is a Federal Government Agreement, Raji noted that the State Government did not shy away from implementing it in full although it was imposed and that every state government has the responsibility to pay according to its capacity.
He described the strike as blackmail adding, "These doctors are just out to blackmail Lagos residents so that they will continue to be above the rules and live outside us. Lagosians should, therefore, rise up because the doctors are being paid with taxpayers' money, and the taxpayers are really sweating. They should prevail on the doctors to go back to work."
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