PRESS
RELEASE BY THE ASSOCIATION OF RESIDENT DOCTORS OF UNIVERSITY OF NIGERIA
TEACHING HOSPITAL ITUKU OZALLA, ENUGU STATE (ARD UNTH) ON THE REASONS BEHIND
THE PRESENT INDUSTRIAL DISPUTE IN UNTH.
Preamble
The
Association of Resident Doctors, University of Nigeria teaching Hospital, Ituku
Ozalla, Enugu State recommenced total and indefinite strike action on Friday,
16th October, 2015 to press home our various demands which
border on the inability of the Chief Medical Director (CMD) of UNTH, Dr
Christopher C. Amah to maintain an acceptable level of sincerity and
uprightness in the management of affairs of the hospital.
The current
CMD has destroyed what is left of UNTH through corruption and gross
insensitivity to the plights of the patients and staff of the
hospital. His incompetence, corrupt practices and high handedness has
reached the level that can no longer be condoned by doctors in UNTH.
The CMD’s
continued boast/brag that he can neither be sacked nor queried by the President
of the Federal Republic of Nigeria irrespective of how long any group remains
on strike has become an issue for the listening ear of President Muhammadu
Buhari and the general public.
Current
Issues
1) Gross
and unimaginable degeneration of hospital facilities and quality of services
It is not
exactly out of place to classify UNTH as a death trap, because it barely has
what it takes to qualify for a primary healthcare facility, say for manpower.
As it is now, a UNTH that is on strike is more beneficial to the masses than a
UNTH that is not, this is because a working UNTH exposes both patients to
untold and unimaginable risks and health hazards.
A situation
where common medical diagnostic equipment, as simple as sample bottles for
blood and urine collection, syringes and needles are unavailable, is most
appalling to say the least. Dying patients are forced to travel a distance of
over 20kilometres to private facilities to access these basic investigations.
The laboratories in UNTH lack appropriate reagents and equipment to conduct
basic and near complex laboratory investigations despite having very well trained
laboratory physicians and scientists ready to offer these services.
A hospital
as big and supposedly prestigious as UNTH cannot offer continuous x-ray
services for 3 consecutive days in week, forcing patients to leave the hospital
for an investigation as basic as this. More sophisticated equipment are
acquired through dubious means and sabotaged thereafter, such that equipment
like CT Scan Machines and Radiotherapy machines are available in the hospital
but in a non-functional state for months now. These patients who obviously have
no choice are forced to either move to Enugu urban, over several kilometers
away, to access CT-Scan and MRI or even travel as far as UCH Ibadan, LUTH
Lagos, and National Hospital Abuja to get radiotherapy services for the treatment
of cancers.
Most
patients who come in with mild to moderate injuries/ailments, become victims of
UNTH by the time they are tussled and ruffled down to Enugu urban, over 40
kilometers, to access these basic and almost mandatory investigations which has
epileptic and unstable availability in UNTH. Many of these patients either die
in transit or have their injuries/ailments further complicated and worsened,
while the health workers look on helplessly, most of them afraid of speaking up
for fear of victimization. The hopelessness of the situation has created job
dissatisfaction for health workers, with some of them being inpatient to retire
and ago, feeling in part responsible for these demises.
Even sheets
for taking clinical notes, forms for drug prescriptions and laboratory requests
are most times nowhere to be found in UNTH. In some cases especially for
laboratory forms, patients are given that one remaining copy to photocopy
compulsorily before submitting samples to the labs.
Poor and
dilapidated state of the consulting rooms and hospital wards are better
imagined than experienced. Bed bugs, rodents and even reptiles thrive in these
areas. Torn insect proofing on windows have not been changed for a long period
of time, ensuring adequate spread of insect borne diseases across board. As we
write, there are no bathrooms in the wards in UNTH, patients and their
relatives are forced to take their baths in the open bush surrounding the
hospital complex. Males and females, old and young are all subjected to this
most dehumanizing condition. Patient relatives who come in healthy most times
go home with malaria and other contagious diseases.
With a heavy
heart, we inform Nigerians that as at today, there is no available running
water in the major areas of the hospital. For example, the general and private
wards, clinics and laboratories, despite the much ado by the hospital
management that they have sunk ultra-modern boreholes in the hospital, do not
have available running water. Even theatres do not have access to running
waters, as such scrubbing before surgeries are improvised in a hospital
supposedly as prestigious as UNTH.
Most
disheartening, patients in UNTH are forced to draw water from a relatively
shallow well as old as the name UNTH itself for their basic needs. The
implication of this on the health of the patients and their relatives who use
it should be better imagined. Even primary health care centres have moved
beyond in line with the Millennium Development Goals.
So far, we
are happy to inform Nigerians that following our cry out and in a desperate
attempt to cover his numerous ills and acts, Dr C. C. Amah brought in borehole
drillers on Tuesday, 20th October, 2015 to continue the
abandoned borehole project. It pains us that Dr C. C. Amah would wait till
services are withdrawn before doing the needful. In this, we are happy that our
cry out to and for the masses has already started yielding results.
Basic and
emergency drugs are not always available at the pharmacies as patients travel these
same distances to assess drugs prescribed for them from private pharmacy
outlets in Enugu town. Many patients die due to unavailability of emergency
drugs in the emergency rooms. Most times, doctors and other health workers have
to contend with unavailability of hand gloves and even methylated spirit for
months, without explanation, with resultant stress being transferred to
patients and their relatives. Several reports by Heads of Departments and their
representatives on these pressing issues to the Dr C. C. Amah led hospital
administration have been to no appreciable or palpable avail. The risks which
medical and health workers in UNTH are subjected to, the travails they pass
through in a bid to provide healthcare services in UNTH is quite enormous, and
has now been pushed beyond limit.
This has
greatly affected negatively, the outcome of patients being treated in the
hospital when compared to those treated in private hospitals in Enugu. This has
also most negatively affected the training and psyche of resident doctors and
medical students, and has led to the loss of accreditation of the Medical and
Dental Council and the National and West African Postgraduate medical colleges
in different departments, particularly Paediatrics and Dentistry.
The fact
that UNTH has become grazing grounds for cattle is no longer news. UNTH has
become an abode for animals, both wild and domestic, due of the gross
irresponsibility of the UNTH management to sustain the proper level of grasses
around the main hospital complex and staff quarters. While patients and UNTH
staff are exposed to all forms of infections being transmitted by these
animals, others are exposed to the deadly attacks of wild animals especially
snakes and scorpions.
2) Illegality
and disregard for due process in employments
Job racketeering
in UNTH is a fact that cannot be swept under the carpet. The fact that people
pay to get jobs in UNTH is an open secret that cannot be overemphasized.
It is only
in UNTH that employment letters are most times backdated and people are made to
also backdate their acceptance letters and dates of resumption, a dirty way of
siphoning funds from federal government coffers. Some of these staff at the
point of employment even received pay slips of the money they never received,
and these were for months they did not work but were covered by the backdated
appointment letters they so received. The employments have even become so petty
that appointment letters are now issued in hotel rooms. This is better
imagined.
In UNTH,
people even start work without due process of filing and mandatory medical
examination and arbitrary grade levels are assigned to them without due
consideration and reference to the extant laws as enshrined in the public
service handbook. Many staff in UNTH as we speak are even yet to do the
mandatory pre-employment medical examination. Others did so after having worked
for many months. These people, of course, were not reprimanded by the Dr C. C.
Amah led hospital management, lending credence to the fact that they may have
paid heavily for the jobs and are as such untouchables lest they expose their
route of entry.
3) Over
bloated Service charges and Corrupt financial practices in UNTH
Patients are
made to pay through their noses to assess the substandard healthcare services
offered in UNTH. They pay such exorbitant fees for little or nothing offered
them in return.
For
example, every patient entering the ward or theatre is forced
to pay an enormous amount of N7, 500 for oxygen whether they need it or not.
Fees are fixed with so much impunity and without regard to the poor helpless
Nigerian masses that depend on UNTH for their healthcare needs.
The Hospital
theatre is run by a cartel that collects monies for disposables and lab tests
without issuing hospital receipts for them. Even after collecting these monies
from patients, surgeries end up being cancelled because of unavailability of
the same disposables patients had paid exorbitantly for. When surgeries are
re-booked, patients go through the same process of paying fresh bills for them.
Details of
the fraud on-going in the open heart surgery charade in UNTH will be a story
for another day.
4) Unlawful
withholding and misappropriation of Staff Salaries
In a display
of gallantry in the field of corruption, the management of UNTH led by Dr C. C.
Amah has mastered the act of diverting salaries of staff of
UNTH. There is an age long practice in UNTH where by newly employed
residents and houseofficers will be denied their call duty allowance for their
first month in the hospital. When the going was good in UNTH, once the staff
finishes his/her program and exists the system, the staff is paid this withheld
money immediately with the last salary or at most by the successive month.
Now, this
money once deducted will automatically become the property of the UNTH
management to misappropriate. To cover their ills, they will subject people who
have left the system with all forms of letter, begging from one office to the
other for their legitimate salaries.
As we write
over 100 house officers that finished their one year housemanship are still
being told stories and denied their legitimate salaries up to 8months now. Many
of the resident doctors who have exited the system are also begging for their
unpaid salaries years after they left the system.
This is just
a tip of the iceberg of the magnitude of misappropriation of funds ongoing in
UNTH. Fraudulent award of contracts to close relatives of the CMD and his
cronies as a safe haven for diverting funds from UNTH will be exposed in time.
5) RENUMERATION
OF DOCTORS
A) Proper
placement of Doctors
The Federal
Government of Nigeria, through the Head of Civil Service of the Federation
(HCSF), in Circulars referenced HCSF/EPO/EIR/63755/11/192, dated 4th November
2013 and reference No: HCSF/EPO/EIR/63755/T1/195, 19th of December, 2013, and
the Director of Hospital Services, Federal Ministry of Health (FMOH) through a
letter with reference no: C.3884/Vol. 1 dated 19th of December, 2013,
explicitly and clearly approved the skipping of salary grade level for Medical
and Dental Officers in Federal Civil Service. It was clearly directed that the
equivalent of CONHESS 10 should be skipped for the CONMESS structure following
a National Industrial Court judgment which directed that CONHESS 10 and its
equivalents should be skipped for federal health workers.
Since this
Judgment and subsequent directives were given, most Chief Medical Directors
(CMDs) and Medical Directors (MDs) of federal tertiary health institutions
commenced immediate implementation for other health workers since 2013 but not
for medical doctors. The NMA and NARD made various attempts to correct this
anomaly, when in 2014, the CMDs and MDS were yet to start the implementation.
This was one of the cardinal reasons NMA embarked on a 2months nationwide
strike in July and August 2014. The strike was called off based on the promise
by the Federal Government that the financial implication of skipping of CONMESS
will be captured in the 2015 personnel cost budget as the main reason then was
that CMDs/MDs did not capture it in the budgets of their respective MDAs.
In UNTH, we
were initially informed by several high ranking members of UNTH Management team
including the Chief Medical Director Dr C. C. Amah, the Deputy Director of
Finance Mr C. C. Onuchukwu and the officer in charge of budget in the accounts
department of UNTH, that Doctors in UNTH were properly placed/captured in the
2015 personnel cost budget.
At first,
UNTH Management, after initially feigning ignorance of properly capturing
doctors in the 2015 personnel cost budget, claimed that the reason why they
can't implement the budget which has been approved is because of the global
short fall in release of funds to MDAs, this was debunked by the fact that
personnel cost budget can only be tampered with if it will be replaced by the
supplementary budget, otherwise you leave civil servants without salaries. More
so, having captured Doctors correctly, we expressed concern why only Doctors
should bear the brunt of a shortfall, if FG cannot sustain the salaries of
civil servants, you either pay everyone a percentage of their salaries or pay
full salaries up till where the funds released can cover.
When our
superior argument on the excuse of shortfall prevailed, the UNTH management
craftily moved to non-availability of template for implementation of skipping
for Doctors as their handicap for paying skipping. Again we referred them to
the Federal Government Circulars which made exclusive and clear reference to
the equivalence of CONHESS 10 as the level to be skipped for CONMESS. It took
the Permanent Secretary of the Federal Ministry of Health another circular
released on 29th July, 2015 with reference C.2262/T/111 to
explain simply English Language to our hospital management, clearly stating
that CONMESS 2 is the equivalent of CONHESS 10 and expressly directing them to
commence payment and guide their future budget articulation.
With this
again put to rest, our CMD has now come up with another gimmick, that the
Chairman, National Salaries Incomes and Wages Commission (NSIWC) gave a verbal
directive against skipping as such he will not pay us our proper emoluments
lest he be prosecuted; we want to draw the attention of Mr. President on the
following points as regards this fraudulent claim:
i) The
circular for skipping of Doctors emanated from the highest level of civil
service hierarchy, the Head of Civil Service of the Federation (HSCF) and it
followed an industrial court judgment. We believe NSIWC should be under the
HCSF and as such will not issue directives contrary to the directives HCSF.
More so, since the circular from the HCSF followed a NIC judgment, making such
statements as Dr C.C.Amah claimed is making an attempt to challenge the Court.
This simply explains why The Chairman NSIWC could not have said that talk more
of committing it in writing least he will be held in contempt of Court.
ii) As
at now, more than 24 Federal Tertiary Health institutions in Nigeria are paying
doctors their appropriate salaries based the court ruling and appropriate FG
circulars. To limit the examples to the south east region of Nigeria where UNTH
is situated, all federal tertiary hospitals have started implementing the FG
directive either in full or in part. While the managements of National
Orthopaedic Hospital Enugu and Federal Teaching Hospital Abakaliki have
continued to comply fully with directives of Federal Government as per the
proper placement of Doctors, those of Nnamdi Azikiwe University Teaching Hospital
and Federal Medical Centre Owerri have done so in part. This is another
clear show of shame on the part of Dr C. C. Amah.
We as
Resident Doctors of the University of Nigeria Teaching Hospital (UNTH), Ituku
Ozalla, Enugu have after following due process for dialogue, spent over 45 days
after our first notice of strike making every attempt to prevent service
disruption in the hospital, was forced to embark on an indefinite strike
following the Hospital Management's inconsistent position on proper placement of
Doctors, reneging on their several promises to pay our due entitlements as
covered by relevant laws of the land.
B) 2014
Teaching allowance arrears
Early last
year, the Federal Government issued a directive stopping teaching allowance for
house officers and junior residents, this was firmly opposed with valid reasons
from the NMA and NARD leading to the Federal Government immediately reversing
her directive. The federal government thereafter gave a clear directive that
resident doctors should be paid teaching allowance.
Almost every
institution in Nigeria followed this directive and started paying their doctors
teaching allowance as directed by the federal government. Our CMD, Dr C. C.
Amah remained adamant and refused to pay doctors the teaching allowance as
directed. Following repeatedly failed negotiations, ARD UNTH embarked on strike
in March last year to demonstrate their dissatisfaction with their rights being
trampled upon by the tyrant CMD, Dr C. C. Amah. It took the intervention of well-meaning
Nigerians and the Medical and Dental Consultants Association of Nigeria (MDCAN)
UNTH Chapter, to convince us to resume duties, since this was a legal issue
concerning our emoluments, that they will prevail on the CMD to pay us our due
allowances, for us to suspend the two weeks old strike.
Despite
these interventions, the CMD as we write, did not pay the teaching allowance
throughout last year, and has also not paid the arrears till date. Little
wonder, those who prevailed on us during the last industrial action over
18months, had no moral justification to approach us this time.
The CMD
claimed the hospital had no resources to pay teaching allowance in 2014, yet
after paying normal December 2014 salaries, the hospital had over four hundred
million naira (N400, 000, 000.00) left in her personnel cost envelope in the
GIFMIS account which was taken back into the federal government coffers,
meanwhile the whole teaching allowance owed all deserving members in UNTH would
have cost just about twenty four million naira (N24, 000, 000.00).
As we write
you Sir, UNTH is the ONLY federal health institution in Nigeria where residents
were not paid Teaching allowance in 2014 and are still being owed the arrears.
C) Advancement
of Residents/Promotion Arrears
The
unnecessary bureaucratic bottlenecks experienced by resident doctors in their
advancement and that experienced by other healthworkers in their promotion have
become enormous and unbearable. A situation where a registrar will pass the
prescribed exams and apply for advancement and it takes the hospital management
over 9months to process same has called for a public outcry.
To make
matters worse sir, when the advancement/promotion are processed and dated back
to the effective date the doctor became qualified for the promotion, the
accounts department will still refuse to pay the accrued arrears.
In a recent
and daring show of shame, the CMD and his cohorts, after misappropriating
personnel cost funds of UNTH, ventured into unlawful demotion of some recently
promoted members of staff in UNTH including Residents. Though they claim this
was as a result of high wage bill as against available funds, they have refused
to make available the nominal roll used to disburse personnel funds to
ascertain the true financial state of the hospital as claimed.
Their
continued refusal to expose this document to ascertain the claim further gives
credence to the massive corrupt practices ongoing in UNTH. Full details on this
will follow this press release.
D) Two
months relativity arrears
Last year,
there was an adjustment in the CONMESS salary structure to reflect relativity,
which was supposed to be effective from January 2014. The Federal Government in
the last quarter of 2014, released two months arrears for such payments, but
UNTH management only paid some doctors and left a good number of deserving
doctors either under paid or not paid at all. These people were properly and
duly captured in the budget submitted for the arrears and funds released in
full, but in their usual act of impunity, they only paid some people and left
the funds for the remaining people yet unaccounted for
6) Lack
of Due Process in the re-appointment of Dr C.C Amah as CMD
We have
noted with great dismay, the gross irregularities in the re-appointment of Dr
C.C Amah. There was a wide shift from the routine advertorial for the office,
followed by an interview process that will select three people, for the
honorable Minister for Health to present to the President from which he would
make an informed selection. The appointment however remains the prerogative of
the President of the Federal Republic of Nigeria.
We have
reasons to believe that the appointment of Dr C.C Amah was not unrelated to the
over four hundred million Naira (N400, 000, 000. 00) the hospital intentionally
left in their accounts till December 31st, 2014 which got sucked
back into the FG coffers. We believe this was a premeditated action, an
indirect way of paying for his second tenure. They caused the return of these
monies despite enormous and legitimate arrears being owed to all cadres of
staff in UNTH as at December 2014.
Truth be
told, there is no CMD in UNTH. The tenure of Dr C.C Amah ended on
16th may, 2015. He is in that office on the erroneous authority
of a fraudulent document which we believe he bribed his way to get through the
then Minister of State for health, Dr Khaliru Alhassan who signed the document.
This document dated 4th December, 2014 is reappointing Dr C.C
Amah almost 6months in advance, an anomaly of the greatest order! To lend
credence to this fraud, the Hospital PRO, Mr Keleze communicated the staff and
general public of Dr C. C. Amah’s reappointment 6 months after the letter was
signed and delivered, painting a picture that Dr C. C. Amah was just
reappointed.
The
fraudulent manner in which Dr C. C. Amah went about his charade re-appointment
and succeeded may have given him the courage to continue with his impunity with
reckless abandon. Little wonder, Dr Amah has boasted in several quarters that
he is untouchable and can neither be queried by the Federal Ministry of Health
nor the President of the Federal Republic of Nigeria, no matter how much any
person or group of persons in UNTH cry out. There is the saying that ‘every day
is for the thief but one day is for the owner of the house’, the real owners of
UNTH are the Nigeria and we do not in all honesty believe that the President,
who has maintained a track record of zero tolerance to corruption, will look
the other way especially now that the several ills in the Dr C. C. Amah led
UNTH has been brought to fore.
Our
Prayers
Our demands
are simple, logical and straightforward;
1) ARD
UNTH calls for the immediate sack of the Chief Medical Director, Dr Christopher
C. Amah over allegations of high wired corruption, seizure of staff salaries,
high level of extortion of patients, purported sale of appointments, high
handedness and reckless looting of hospital funds resulting in gross lack of
facilities and poor working conditions in UNTH Enugu.
2) We
are calling for an overall probe of the administration of Dr C. C. Amah with an
aim to giving justice to the numerous patients who have died or suffered undue
morbidity in UNTH because of the poor working/service condition imposed on them
by the incompetent CMD.
3) That while we demand for a total
overhaul/rebooting of UNTH with an aim to delivering appropriate tertiary
healthcare services for Nigerians, doctors in UNTH should be brought at par
with their counterparts in other tertiary health institutions by properly
placing and paying them as directed by the Federal Government.
Signed:
Dr Ugwuoke
Aloy
Ifedinso
President
ARD UNTH
Dr Ndiokwelu
Chibuzo
Secretary
General
ARD UNTH
Dr Chukwuma C. Oraegbunam
Public Relations Officer
ARD UNTH
ARD UNTH
Dr Chukwuma C. Oraegbunam
Public Relations Officer
ARD UNTH
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