There are strong indications that a fresh crisis might be looming in the health sector between doctors and the Joint Health Sector Union members over salary parity.
In what is evidently a rivalry between the doctors and JOHESU, the Nigerian Medical Association said the demand for the upward review of the Consolidated Health Salary Structure, which is the salary structure for health workers including pharmacy, medical laboratory science, among others, would lead to negative consequences on the already fragile health sector.
JOHESU is the umbrella body of health workers’ unions and associations, including the Medical and Health Workers Union of Nigeria, the Nigeria Union of Allied Health Professionals, the Non-Academic Staff Union of Educational and Associated Institutions, the Senior Staff Association of Universities Teaching Hospitals, Research Institutes and Associated Institutions, and the Assembly of Healthcare Professionals.
Our correspondent gathered that JOHESU had requested the adjustment of the CONHESS as was done to Consolidated Medical Salary Structure, which is the salary structure for medical and dental doctors since 2014.
However, in response to JOHESU’s request, the Federal Ministry of Health in a letter dated April 3, 2023, said there was an existing relativity between the CONMESS and CONHESS salary structure since 2014.
The letter signed by the Director of Hospital Services, Dr Salma Anas, was titled, ‘Re: Report of the technical sub-committee on the inter-ministerial committee on adjustment of CONHESS as was done to CONMESS in 2014’.
The letter, which was obtained by our correspondent, read in part, “There is an existing relativity between the CONMESS and CONHESS since 2014, therefore adjusting the CONHESS using either of the two options proposed by the committee will erode the already established/existing relativity and restore pay parity between both salary structure and will definitely lead to more industrial disharmony in the health sector.
“The financial implication of adjusting the CONHESS using option one (CONHESS 11-15) is put at N42,818,704,671.00 per annum. The financial implication of adjusting the CONHESS using option two (CONHESS 01-15) is put at N49,722,269,547.00) per annum.
“In view of the foregoing, the FMoH (Federal Ministry of Health) recommends that due to the prevailing economic realities and the propensity of the proposed options to create industrial disharmony in the health sector, adjusting the CONHESS has been put on hold pending a favourable economic outlook and the extraction of the commitment of NSIWC that adjusting the CONHESS using any of the options prepared by the committee will not erode the existing relativity between CONMESS and CONHESS.”
Meanwhile, the new Permanent Secretary at the ministry, Adebiyi Olufunso, in a letter addressed to the Director-General of the Budget Office of the Federation on June 5, 2023, asked the office to consider adjusting the CONHESS.
The letter titled ‘Re: Adjustment of the CONHESS’, read in part, “You may wish to recall the high-level inter-ministerial committee constituted and inaugurated by the Honourable Minister of Health in September 2021 to see to the adjustment of the CONHESS as was done to CONMESS since 2024. The membership of the committee comprises the NSIWC (Chairman), FMoH, BOF, FML&E, OSGF, OAGF, and JOHESU.
“The report of the committee is hereby forwarded to you for consideration with a view to using any of the two options recommended by the committee in adjusting the CONHESS.
“It is pertinent to note that the committee recommended two options for the upward adjustment of CONHESS. Option one: The committee applied CONHESS adjustment from CONHESS 11 to CONHESS 15 which is equivalent to CONMESS 2 to CONMESS 7 where the adjustment was done for doctors. The cost implications for the government was N42,818,704,671.00 per annum. Option two: The CONHESS adjustment that affects all grade levels from CONHESS 01 to CONHESS 15 amounts to N49,722,269,547.00 per annum.”
The NMA, however, opposed the move by the permanent secretary of the ministry, warning that adjusting CONHESS might lead to a serious crisis in the health sector.
The NMA in its letter dated June 7, 2023, addressed to the permanent secretary said the adjustment of CONHESS would have negative consequences on the health sector.
The NMA argued in the letter titled, ‘Adjustment of CONHESS: Matters arising,’ signed by its President, Dr Uche Ojinmah, and Secretary General, Dr Jide Onyekwelu, “We wish to clearly state that CONMESS was not reviewed upward, rather error in translation of the Collective Bargaining Agreement that gave rise to CONMESS in 2009 was corrected.
“Despite writing the petition that we were shortchanged immediately, the CONMESS circular was released, it took the government five years to effect the corrections and we had to forfeit the arrears as the government said that they didn’t have the money to pay with a ‘plea’ for our patriotic understanding.
“At the same time, the salary relativity that we lost with the unilateral merging of the Medical Salary Scale and Medical Super Salary Scale with other salary structures was also restored just to right the wrong that was done to us but still without any payment of arrears.
“NMA shall not sit idly by and allow anyone to degrade our salary by tampering with relativity, as this shall worsen medical brain drain with attendant negative consequences on our fragile health sector.”
Sunday PUNCH reports that the Federal Government had in 2014 signed a memorandum of understanding with the NMA that it would sustain relativity between CONMESS and CONHESS.
JOHESU had embarked on an indefinite strike on May 25 to press home its demands. One of its demands during the strike, which was suspended on June 5, 2023 was the immediate approval and implementation of the technical committee report on CONHESS adjustment by the government.