Strong signs point to the possibility of a new pay parity dispute between doctors and the Joint Health Sector Union members in the healthcare industry.
The Nigerian Medical Association asserted that the request for an increase in the Consolidated Health Salary Structure, which sets salaries for health professionals such as chemists and medical laboratory scientists among others, would have a negative impact on the already vulnerable health sector. This dispute is clearly between the doctors and JOHESU.
The Medical and Health Workers Union of Nigeria, the Nigeria Union of Allied Health Professionals, the Non-Academic Staff Union of Educational and Associated Institutions, the Senior Staff Association of Universities Teaching Hospitals, Research Institutes, and Associated Institutions, as well as the Assembly of Healthcare Professionals are all under the umbrella organisation known as JOHESU.
Our source learned that 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 physicians and dentists since 2014.
However, the Federal Ministry of Health stated in a letter dated April 3, 2023, in response to JOHESU’s request, that there has been a relative wage gap between the CONMESS and CONHESS salary structures since 2014.
The letter was addressed to “Re: Report of the Technical Sub-Committee on the Inter-Ministerial Committee on Adjustment of CONHESS as was done to CONMESS in 2014” and was signed by Dr. Salma Anas, Director of Hospital Services.
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.
“N42,818,704,671.00 per year is estimated to be the financial impact of adjusting the CONHESS using option one (CONHESS 11-15). The estimated annual cost of changing the CONHESS using option two (CONHESS 01-15) is N49,722,269,547.
“In light of the aforementioned, the FMoH (Federal Ministry of Health) recommends that adjustment of the CONHESS has been postponed pending a favourable economic outlook and the extraction of the commitment of NSIWC that adjustment of the CONHESS using any of the options prepared by the committee will not erode the existing relativity between CONM and NSIWC due to the prevailing economic realities and the propensity of the proposed options to create industrial disharmony in the health sector
On June 5, 2023, the Director-General of the Federation’s Budget Office received a letter from the ministry’s new Permanent Secretary, Adebiyi Olufunso, requesting that the office take the CONHESS into consideration.
In the letter titled “Re: Adjustment of the CONHESS,” it was stated, in part, “You may wish to recall the high-level inter-ministerial committee that the Honourable Minister of Health established and inaugurated 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 make up the committee’s membership.
“The committee’s report is hereby forwarded to you for consideration with the intention of using either of the two options suggested by the committee to modify the CONHESS.
It’s important to note that the committee suggested two options for increasing CONHESS. Option one: The committee applied the adjustment for doctors for CONHESS from CONHESS 11 to CONHESS 15, which is equivalent to CONMESS 2 to CONMESS 7. The government’s annual cost implications were N42,818,704,671.00. Option two: The annual amount of the CONHESS adjustment, which applies to all grade levels from CONHESS 01 to CONHESS 15, is N49,722,269,547.00.
The NMA, however, objected to the permanent secretary’s action and warned that changing CONHESS could trigger a serious crisis in the healthcare industry.
The NMA claimed that the health sector would suffer as a result of the CONHESS adjustment in a letter sent to the permanent secretary on June 7, 2023.
“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,” the NMA argued in a letter titled “Adjustment of CONHESS: Matters Arises,” signed by its President, Dr. Uche Ojinmah, and Secretary General, Dr. Jide Onyekwelu.
“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 forfeit 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 when the Medical Salary Scale and Medical Super Salary Scale were unilaterally combined with other salary structures was also restored, just to make up for the wrong that was done to us, but still no arrears were paid.
The NMA has a policy that states, in part: “NMA shall not sit idly by and allow 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 the report, a 2014 memorandum of understanding between the Federal Government and the NMA stated that it would maintain relativity between CONMESS and CONHESS.
On May 25, JOHESU began an indefinite strike to enforce its demands. The government’s immediate approval and implementation of the technical committee report on CONHESS adjustment was one of its demands during the strike, which was suspended on June 5, 2023.
