Health care workers want equal pay with doctors

There are strong signs that a new dispute over salary parity between doctors and the members of the Joint Health Sector Union may be developing in the healthcare industry.

The Nigerian Medical Association claimed that the demand for an increase in the Consolidated Health Salary Structure—the pay scale for health professionals like chemists and medical laboratory scientists, among others—would have a negative impact on the already vulnerable health sector. This is clearly an instance of doctors and JOHESU competing for influence.

The Non-Academic Staff Union of Educational and Associated Institutions, the Senior Staff Association of Universities Teaching Hospitals, Research Institutes and Associated Institutions, the Assembly of Healthcare Professionals, and the Medical and Health Workers Union of Nigeria all fall under the umbrella organisation known as JOHESU.

According to information provided by our correspondent, JOHESU had asked for the CONHESS to be adjusted in a similar manner to the Consolidated Medical Salary Structure, which has been the pay scale for medical and dental professionals since 2014.

But in response to JOHESU’s request, the Federal Ministry of Health stated in a letter dated April 3, 2023, that there had been a relative wage disparity between CONMESS and CONHESS since 2014.

Re: Report of the Technical Sub-Committee on the Inter-Ministerial Committee on Adjusting CONHESS as was Done to CONMESS in 2014 was the subject of a letter signed by the Director of Hospital Services, Dr. Salma Anas.

The letter, which our correspondent was able to obtain, stated, in part, that “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 structures and will unquestionably cause more industrial disharmony in the health sector.

The estimated annual cost of changing the CONHESS using option one (CONHESS 11-15) is N42,818,704,671.00. The cost of modifying the CONHESS using option two (CONHESS 01-15) is estimated at N49,722,269,547.00) annually.

“In light of the aforementioned, the FMoH (Federal Ministry of Health) recommends that, due to the current economic realities and the potential for the suggested options to cause industrial unrest in the health sector, adjusting the CONHESS has been postponed pending a favourable economic outlook and the extraction of the commitment from NSIWC that adjusting the CONHESS using any of the options prepared by the committee will not erode the existing relativity between CONM and CONHESS.

In the meantime, on June 5, 2023, Adebiyi Olufunso, the new permanent secretary at the ministry, asked the office to take the CONHESS into consideration in a letter to the Director-General of the Budget Office of the Federation.

In the letter titled “Re: Adjustment of the CONHESS,” it was stated that “You may wish to recall the high-level inter-ministerial committee that was established and inaugurated by the Honourable Minister of Health in September 2021 to oversee the adjustment of the CONHESS as was done to CONMESS since 2024.” The NSIWC (Chairman), FMoH, BOF, FML&E, OSGF, OAGF, and JOHESU are the other members of the committee.

“The report of the committee is hereby transmitted to you for consideration with a view to using either of the two options suggested by the committee in adjusting the CONHESS.

It is important to note that the committee suggested two options for the CONHESS adjustment upward. Option one: Where the adjustment was made for doctors, the committee applied the CONHESS adjustment from CONHESS 11 to CONHESS 15, which is equivalent to CONMESS 2 to CONMESS 7. The annual cost implications for the government were N42,818,704,671. Option two: N49,722,269,547.00 is the annual amount of the CONHESS adjustment that applies to all grade levels from CONHESS 01 to CONHESS 15.

However, the NMA opposed the permanent secretary of the ministry’s action, stating that changing CONHESS might trigger a serious crisis in the health sector.

The NMA stated that the health sector would suffer as a result of the CONHESS adjustment in a letter dated June 7, 2023, addressed to the permanent secretary.

In the letter titled “Adjustment of CONHESS: Matters Arise,” which was signed by its President, Dr. Uche Ojinmah, and Secretary General, Dr. Jide Onyekwelu, the NMA argued, “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.

“Even though we wrote a petition claiming that we had been shortchanged right away, the CONMESS circular was published, it took the government five years to implement the corrections, and we were forced to forego the arrears because the government claimed they lacked the funds to pay with a ‘plea’ for our patriotic understanding.

“At the same time, the salary relativity that we lost as a result of the Medical Salary Scale and Medical Super Salary Scale’s unilateral merger with other salary structures was also restored in an effort to make amends for the wrong that had been done to us, though there was still no payment of arrears.

The NMA has a policy of “never sitting idly by and allowing 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.”

According to Sunday PUNCH, the Federal Government and the NMA signed a memorandum of understanding in 2014 stipulating that it would maintain relativity between CONMESS and CONHESS.

To enforce its demands, JOHESU had gone on an indefinite strike on May 25. One of its demands during the strike, which was put on hold on June 5, 2023, was for the government to immediately approve and implement the technical committee’s report on CONHESS adjustment.