THE MEDICAL PROFESSION IS UNDER SIEGE

On Tuesday, May 25, 2004 at a welcome reception organized by the Association of Resident Doctors (UBTH chapter) to celebrate my election as the 2nd Vice President of the Nigerian Medical Association, I had stated that the Medical Profession was under siege and that all hands needed to be on deck to rescue the profession from the frontal assaults on it. This assertion was true then, and it remains true today.

Recent events in the health sector and the nation at large have revalidated my assertion, hence my decision to put pen to paper on what I have termed: “The Medical Profession is under siege”. Aside from law, the Medical Profession is undoubtedly one of the three traditional professions known by man. Man must first exist in a healthy state before he can think of organizing a harmonious society, using legal and security apparatus.

The relevance and status of the Medical Profession can easily be appreciated from the very rigorous requirements needed to be fulfilled by any individual aspiring to become a Medical/Dental Practitioner. The entry requirements into the Profession, duration of undergraduate and postgraduate training, work load, job description, and societal expectations clearly makes the Profession to stand out. Little wonder that the Profession was grouped at pre-Independence in the Senior Service Scale A (which was the apex scale), and someone from the Profession used to act in the Governor-General's Stead. All these can no longer be said to be the case, not with the paltry wage currently being earned by members of the Profession, coupled with the moral and ethical decadence of the Nigerian nation.

The relevance and status of the Medical Profession has over the years witnessed a progressive decline attributable to factors known and unknown. However, recent events that took place in the health sector and the Nation at large, have in no small measure, dealt severe blows on the Medical Profession. Cases in point include:

1. The series of retirements/dismissals of some Medical Practitioners at the Lagos University Teaching Hospital (LUTH) and the Federal Medical Centre, Asaba, respectively.

2. Mallam Nasir El-Rufai's latest assault on Medical Doctors.

With regard to the retirements and dismissals in LUTH and FMC Asaba, without holding brief for anyone, it appears to me that there was more to these cases than what was told to Nigerians. Or how else can one explain the fact that both cases never got referred to the Medical and Dental Council of Nigeria (MDCN), the body that regulates the practice of the affected professionals; how come the MDCN was not even involved in the series of committees and panels that were formed (at least not to my knowledge)? Could it be that the Minister of Health no longer has confidence in the competence and relevance of MDCN? Why was the Nigerian Medical Association not invited to participate (being the defense Union of the affected doctors) at any stage of the sittings of the committees or panel? Were the measures taken intended to be punitive or rehabilitative? Why were the reports of some of the committees turned down at some point? These and other questions have made some critical observers question the real intention and agenda of the Health Minister, especially following previous vain attempts to portray Medical and Dental Practitioners as bad Hospital administrators, and therefore create room for the repeal of the extant law on the qualifications for the position of Chief Medical Director.

Mallam Nasir El-Rufai's recent assault on the Medical Profession calls for serious scrutiny. In a widely televised speech delivered by the Minister of the Federal Capital Territory at a Stakeholders Conference on Public Sector Pay Reform, held in Abuja on Monday, 27th November, 2006, he was quoted as saying that with effect from January 1st 2007, only House officers shall be paid Call duty allowance. This, he asserted, was based on the notion that senior doctors (including Consultants) don't take Calls.

Now, the question that immediately comes to mind here is: Why will a top Minister like Mallam Nasir El-Rufai make such a scandalous and absolutely scurrilous allegation against Doctors? Could it be an exhibition of crass ignorance of the concept of Call duty (which is simply anticipatory clinical duty directly related to human life-threatening emergencies; a duty carried out outside the mandatory official working hours)? Does he even appreciate the laws regulating the practice of Medicine and Dentistry?

Even if one overlooks his ignorance of the concept of Call duty, was that the way to handle such a sensitive issue affecting the Medical Profession? Finding answers to the foregoing posers was further complicated by recent clarifications that in contradistinction to the pronouncement of Mallam Nasir El-Rufai, the Government White Paper report that emanated from the Ernest Shonekan Panel's recommendations stipulates that all Doctors who take Calls (including Consultants) shall still be entitled to Call duty allowance (though no longer a percentage of basic salary) as stipulated in circulars 1 of 1991 and 1996 respectively.

With this clarification therefore, the question that needs to be answered is: What then was Mallam El-Rufai's mission? Tried as I could to find answers to this question, one thing that constantly stared me in the face was the indisputable fact that Mallam Nasir El-Rufai deliberately extended to the public arena his now infamous rivalry with Medical Doctors and the Medical Profession.

As if the above cases were not enough, on Sunday, October 29, 2006 the Medical community was rudely shocked with the tragic death of nine (9) distinguished Medical Doctors in the ill-fated ADC flight 053 plane crash at Tunga Madaki Village, Abuja. This incidence is surely another pointer to the fact that the Medical Profession is going through a harrowing experience which only critical thinking and an internal self reflection can address.

In this light, therefore, I believe it is time for all members of the Medical Profession to close rank and work together to rescue the Profession from her enemies. The time of being too busy in the clinic and expecting the society to give you your due is certainly over. It is now time to frontally confront these challenges staring us in the face. In this regard, we must evolve a new strategy which must incorporate our contemporary history and experience. A strategy which must seek to restore the relevance and status of the Profession.

This is not a task that should be left alone for the Nigerian Medical Association. It must involve all members of the Profession, including the respected elders of the Hippocratic calling, the Medical and Dental Council of Nigeria, Doctors in exalted political offices, Chief Medical Directors and Medical Directors, and even our colleagues in diaspora. We must all quietly review our contributions to the Medical Profession and the Nigerian Medical Association. We must now constantly ask ourselves these questions: In what way(s) have I contributed to the success or failure of NMA and the Medical Profession? In what way can I strengthen NMA and the Medical Profession? In what way can I be of service to humanity? These questions are very fundamental, because for us to build foundations of greatness we must all be prepared to make sacrifices and put NMA and the Medical Profession first on our priority list. After all, for you to have the blessing of the rain you must be prepared to bear the noise of thunder.

Let us seize this monumental opportunity to defend the Medical Profession against the likes of Mallam Nasir El-Rufai and others of his ilk, who have chosen to despise and launch unprovoked assaults on the Medical Profession, especially for reasons traceable to their hubristic nature and envy. Let us realize that to give up the task of reforming the Medical Profession is to give up our responsibility as free citizens. Let us appreciate the fact that our collective destiny, and indeed our future lies in no hands but ours. It is only by this stark realization that members of the Medical Profession can look forward to exciting times ahead.

May God strengthen us to rescue the Medical Profession from the current siege.