by Chi Ibe
In a circular dated and signed by the permanent secretary, Ministry of Health, the federal government announced the abrupt indefinite suspension of residency training in its various tertiary hospitals and subsequent sack of the over 16,000 doctors that make up the bulk of the medical work force in government hospitals across the country .
The reasons stated for such a thoughtless and irresponsible move is a comprehensive appraisal of the national residency training programme, – the première training institution and postgraduate scholarship for future specialists in all fields of medicine- one of the contentious issues highlighted in the Nigerian Medical Association’s 24-point demand to the federal government prior to commencement of its now 49 day old strike.
The NMA had asked for a total upheaval of the residency training programme which has become a shadow of its former self, made all the more ineffective by the actions of corrupt government officials who have hijacked the programme for their own selfish gains. Under this system, there have been more applicants than there have been available placements for doctors who are qualified to commence postgraduate training. The NMA is also asking that government resumes the overseas postings that used to be a pivotal part of the programme in which doctors on the verge of earning their specialization qualifications were sponsored overseas to gain some exposure to the latest cutting edge advances in their various fields of study.
But make no mistake, this move by the government has not been orchestrated with the intentions of saving the health sector from collapse, neither is it being carried out with the best interests of the populace or the doctors at heart. This is a power move, pure and simple; one that is as unnecessary as it is illogical considering the consequences inherent for the defenceless citizens. It may very well turn out to be the final nail in the coffin that will send our already battered health care system into the grave.
Perhaps the most vibrant subgroup of the NMA, the national association of resident doctors driven by raw hunger and perhaps naked ambition, have been at the forefront of the struggle for the demands of the doctors and some overenthusiastic persons who do not even access healthcare in the country, after watching government fail spectacularly at engaging the national body of doctors at all levels, recommended the piecemeal conquest of the errant doctors, starting with the most volatile, yet vulnerable group.
It is even more baffling that a responsible government, one that is alive to its duties would resort to such desperate and indiscriminate tendencies. Most worrisome is that a minister of health who is a doctor himself and a product of the same system would supervise such a tragedy. One that would immediately turn our hospitals and teaching centres to mere consulting centres and our sharp young minds into rusty second class material, denied the chance to pursue the highest levels of professional excellence. The net result of course will be a reactionary haemorrhage of man power as freshly qualified doctors will immediately seek such opportunities in countries that appreciate their skill and services.
Also affected will be the quality of doctors churned out by this ignoble system. Medical students will be at the mercy of the few overworked consultants who must impart clinical skills to the students as well as take on extra duties and procedures which they would previously have trusted their resident doctors to handle. This kind of cumbersome arrangement will eventually trickle down and affect the quality of care given to the patient.
Presently on life support system, the national health care system is a sham of bad policies, decaying infrastructure, ineffectual funding, professional distrust and burdensome mortality rates but even at its most worrisome states, it is a system that is bent yet unbroken, but the spine holding everything together was the collection of sleep-deprived, overworked and underpaid resident doctors.
This legality or otherwise of this action may yet be determined by the law courts but on any practical, humane or sensibility scale, it ranks at rock bottom.
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