British doctors, NMA strike and salary increases

 Published in THE PUNCH on 11 March 2007

Casmir Igbokwe

Nigerian government has reduced doctors to certain characters in The Beggars’ Strike. Surely, these respected physicians are not the type Aminata Sow Fall mirrored in her book. Their profession is among the most highly revered in the world.  But, on February 26, certain government policies pushed them to start another strike which almost projected their lots as pitiable as those of beggars.           

This strike confirmed the fears of a concerned Nigerian, Nkom Ebenezer. The man had (in reaction to “A day in British hospital”, published on this page on 28 January 2007), said, “Casmir, you must have heard of the salary increase in the public service. You may not believe this, medical doctors are to earn less in the new salary structure. I understand the Nigeria Medical Association is already restless. Is this what you see in Cardiff? This is our problem. The government is about to create another round of confusion in the polity. And we are supposed to have whiz kids in the inner sanctum of government. We still have more years of darkness.”

In the said story, I narrated the experience I had when I took my son to the Heath Hospital in Cardiff. The baby had received and is still receiving excellent medical service free of charge. Early February, for instance, a health visitor from the National Health Service Trust visited to discuss the child’s progress. And just last week, I got a letter from the same NHS Trust asking me to bring my child for immunization. Recently, a friend told me how he was pleasantly surprised when he went to buy some prescribed drugs for his child at a pharmacy in Cardiff. As he made to pay for the drugs, the pharmacist halted him, saying, “Go, the drugs are for the little one.”

Conversely, millions of children in Nigeria do not have this privilege. Many do not have access to good health facilities. Thus, they die from preventable diseases. And to compound their woes and those of their poor parents, doctors in public hospitals occasionally go on strike to press home certain demands.

They took the latest action because they felt the new Consolidated Tertiary Institution Salary Structure introduced by the Federal Government shortchanged them. In simple terms, the salary consolidation further reduced their take-home pay. Negotiations to reverse this perceived anomaly broke down. Hence, the strike.

In the United Kingdom, doctors’ worries are not about salaries. A report in The Independent of London in January puts the salary of an average General Practitioner (doctor) to £118,000 (about N29.5m) a year. This, it notes, is a staggering rise of 63 per cent in three years.

The report stresses, “The average family doctor now earns, including private income, more than the Lord Chancellor, ministers of state, senior civil servants and circuit judges. The soaring salary levels of doctors are worsening the NHS cash crisis. Two-thirds of NHS trusts are in deficit and have cancelled operations and extended waiting times. Primary care trusts, including those in Yorkshire, Sheffield, Norfolk and Surrey, have ordered GPs to delay referrals to save money.”

Ironically, a reduction in workload followed this increase in doctors’ income. Before the new contract was introduced in 2004, GPs were said to have taken responsibility for their patients 24 hours a day, seven days a week. Now, that work is between 8am and 6.30pm on weekdays.

Nevertheless, the cry of the British doctors is of a different hue. Media reports earlier in the month said some doctors were planning protest marches in London on March 17 against a new system which could deny many of them training posts. Competition is said to be intense for a limited number of specialist training posts for doctors who have gone through their initial stage of training. The specialist training is the stage where a doctor selects to focus on an area such as paediatrics or gynaecology. Those who do not gain the training posts, which start in August, will either take a staff-grade job or go abroad. The staff-grade job does not require any training.

Other health workers in Britain such as nurses have their own grouses. Recently, for instance, the salaries of health workers were increased by 2.5 per cent. Ironically, NHS union leaders reportedly described the pay rise as “a kick in the teeth” and “a slap in the face.” Their grouse is that the pay rise is below the rate of inflation. They are also not happy that the increase will be paid in two stages in April and November. 

Like Nigerian doctors, the NHS union leaders feel they are being shortchanged and have threatened industrial action. In fact, on March 3, some health workers held marches and rallies in such cities as London, Manchester, Bristol, and Birmingham against some of these government policies.

Last November, for want of anything to protest about, perhaps, Britons started a controversy over mixed-sex hospital wards. When the government of Tony Blair came to power in 1997, it pledged to abolish mixed-sex wards in NHS hospitals. The idea then was to maintain the privacy of patients. The BBC quoted the Health Secretary, Patricia Hewitt, as saying that the target had been met. She said most wards had started providing single-sex accommodation and single-sex bathrooms.

But patients groups said they got many calls from people who believed they had been in mixed-sex wards. One Andrew Lansley, according to the BBC report, said, “If you can be seen by patients of another sex, and they are coming and going past your bed in order to go to the toilet facilities, you may not think you have the privacy you want.”

Each time I read about British people’s criticisms against their government, I laugh. I don’t blame them because many of them have not experienced first class suffering. Granted that no human system is perfect, theirs have some institutionalized social security systems to take care of the underprivileged. At least, every one of them who is sick has a ward to go to. Their only problem is choosing between single and mixed-sex wards.

Only a few of my countrymen and women have that choice. The majority of them have three basic choices. One, to visit a local herbalist and take concoctions that may cause more havoc. Two, to visit a chemist and buy mixed malarial and typhoid drugs. Three, to visit prayer houses and seek miraculous healings.

As the saying goes, he that is down needs fear no fall. Strike or no strike, life goes on. While the super rich and the ruling class, either go to private clinics or first class hospitals abroad, the poor continue to succumb to preventable deaths. I dread calling home now because each time I do, it is either that Okeke or Mama Ngozi or Chinwe is dead. And my people have resigned to fate, passing off every death now as the will of God. May it be well with Nigeria!                        

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