It is obvious that neither the politicians nor the professionals pay attention to the sanctity of live and the dignity of man. None of the duo gives any concern to fundamental duty of care which they by law owe the citizens.

It is a shame that the current election climate does not seem to blow any wind of sensitivity in the face of those on the campaign train that are aspiring for political jobs. This goes to show that votes don’t count and election is a simple act that is played to the gallery in Nigeria.

While there is sympathy for Nigerian doctors, nurses and all healthcare professionals for the way they are treated by politicians who do not give a thought to the healthcare needs of the population apart from mere rhetoric, it would be appropriate to state unequivocally that the medical profession must take their share of the blame.

Healthcare services are run on medical model, where a typical boardroom is made up of doctors, except for the secretary, director of finance and director of administration. Fund for running public healthcare system is absolutely dependent on government budget without the respective institutions developing and applying their business strategic initiatives for income generation and self-sufficiency. The income from other sources would have helped respective employers to incorporate incentives into remuneration package for deserving doctors, nurses and other clinicians. Also, it would help choices for reinvestment and services improvement.

The political decision making is with the Commissioner of Health at the state government level and he/she is a doctor. At the federal level is the Minister of Health and he/she is also a medical doctor as usually demanded by the Nigerian Medical Association (NMA). The Chairman and Chief Executives of hospitals and healthcare institutions are medical doctors.

Medical schools and associations champion professional rivalry instead of cooperation, mutual respect and collaboration. The public and patients are left out of the core centre of healthcare management initiatives.  With the absence of corporate leadership and strategic business management, the public are left out of the equation and so are completely disempowered. In respect of that, the government and politicians at state and federal houses do not see health and the important role of clinicians as election priority which could be factored into their campaign strategies.

Life in Nigeria as seen with the eyes of the wider world is characterised by low life expectancy, malnutrition, diseases, and suffering, yet the politicians do not appear to be concerned. In America today, healthcare reform remain top of the political agenda and is considered to be a reason for the gun rampage that resulted in many deaths and the intensive care treatment of a congresswoman.
Here, doctors go on strike, politicians hold political rallies and birthday parties while the ordinary members of the population die like chicken. 

Those in leadership positions travel abroad with families and friends for medical care. Nigerian doctors work as middlemen for medical tourists to Europe, India, Arab nations and Asia, thereby making their relevance in Nigeria less remarkable than they should deserve in an ideal situation.  At the clinical environment, doctors play God and many don’t show respect to their patients/clients. Service users and their relatives are not empowered to make enquiries about the skills, experience or areas of speciality of a doctor that may be providing treatment to them.

When you come to think of it, should doctors, nurses or healthcare professionals go on strike for their personal pay interest as opposed to a proper functional system of health services delivery that focus on productive quality and good customer care? Another question that one would like to ask is; what pay package are the doctors looking for when they each owe their private hospitals/clinics and charge patients private fees while they are inpatients in public hospitals.

The deaths in both public and private hospitals arising from medical negligence are never subjected to any coroner investigations. There are several assertions among the doctors that they do not have supportive environment for undergoing proactive continuing professional development or undertake challenging research that could improve clinical practice and patients’ experience. There is undue reliance on foreign generated evidence-based practice, research and innovations in medical advancements. Basically, the practice in Nigeria is relatively out-of-date and many doctors are out of touch with new techniques, drugs and technology.

While the doctors consolidate management and leadership positions, the politicians atrociously enrich themselves with the resources that should properly fund healthcare and hospital services. There is no one between the medical profession and the politicians. They are joined up as the elite defining and controlling both national resources and the associated human lives. The strike, as far as many people are concerned is like a house at war against itself.
This strike should mark the beginning of an end to future strikes and the start of recognising the importance of running the healthcare as a business on behalf of the public, with target on quality and appropriate incentives for all the categories of healthcare professionals and employees. Nigerian doctors abroad excel, so it is not a matter of the doctors in Nigeria lacking credibility to function.

Rather, it’s about their failure to concentrate in their areas of core competence, which is in giving medical treatment, teaching and research. Furthermore, the selfish and egocentric desire to give non-clinical orders without listening to others expose them to some mediocre in political positions who appear to help them sustain their dominance in healthcare management/leadership, which are aspects where their knowledge, skills and competence are extremely limited. It is the desire for political and management positions that make it impossible to realise the real pride and dignity that are associated with medical practice all over the world. It is the same attitude that takes away the commitment to save lives.

The right to strike is constitutional, but the duty to protect human dignity and save lives underlines the oath of medical profession. Is the strike therefore about the public or about the personal interest of the doctors, or to raise awareness of the insensitivity of the politicians to their responsibility for providing essential services like healthcare to the ordinary public?

While Nigerian doctors are now on strike, doctors in America are working to save the life of a Congresswoman and others in America following gunfire attack. Should a famous person in Nigeria be involved in a minor or serious medical condition, he or she would be flown out by any available plane or hired flight to a hospital abroad. Where is national pride; where is professional and political integrity? Who has the duty of care? Your answer is as good as any other as we must agree to disagree. Let your view be heard.

David Eboh BA (Hons), PGDipHE, MBA, (LLB)
Healthcare Management Consultant and Author
United Kingdom

Watch out for the launching of an online Health Management Journal of Nigeria (HMJN) under the editorial authority of Nigerian Association of Health Service Managers and Consultants (NAHSMAC). Website: www.nahsmac.com

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