Poor job evaluation & paymentInternal migration is just as big a problem. To prevent or minimise it, the Post Graduate Medical College once pushed for what was described as “rural posting allowance”, but the proposal was messed up by the time it was approved.
“The Salaries and Wages made nonsense of what we proposed. The amount given to motivate people to practise in rural areas must be reasonable and attractive enough to encourage people to opt for rural areas. If you say because it is rural area you are just given him N5, 000 extra, that will not motivate anybody to move there. There is need for incentive for doctors.”
Atoyebi urges that to prevent external and internal migration, there should be good facilities and good pay. Reward and sanction system must be in place and also the admission process should be controlled.
“It is saddening that here in Nigeria we don’t use our data very well. For example if you go to Ministry of Health, probably they might not be able to tell you how many radiologists they think we need in the country. Nobody is working on that. If we determine such, we give incentive; those who want to move to areas where we are experiencing shortage will get special dispensation.
“It is gloomy that in this country we don’t do job evaluation and payment; in America, doctors don’t earn the same, what we are concerned about in Nigeria is the level. Payment should be based on evaluation. It is what you do for the system that ought to determine what you get. For instance, neurosurgeons that operate on the brain ought to get more money than someone who works on the breast.
“We should also be able to control the admission process, if we know that we have enough surgeons and fewer gynaecologists in teaching hospitals, when they want to take in people, they should correct that. But the leg work has to be done first. Evaluate what the needs in those areas are and make sure you admit more people.
Need for incentive
“Second, give incentive. You must create attraction to some areas, but people may be looking for some area of specialties that they may not need to wake up at night or do so much if they know that at the end of the day they are paying the same thing.
“I will advise that as a nation, we should take the issue of health serious. We should not take it with word of mouth saying health is wealth. We need to put it into action, get correct database and plan very well and make sure we have not only adequate number of doctors produced but make sure we know the area of need more and work towards that. There are many areas that never had a doctor within five kilometres radius in this country. That should not be. We should be able to create incentive, produce enough, distribute them well and encourage them.”
No resident doctor has been recruited in Lagos in 3 years
— Dr. Tope Ojo, Chairman, NMA, Lagos State branch
Looking at issue of shortage of health worker I do like to put it in political perspective, I have two reasons I always advance in respect to this which is inability to be fulfilled individually and professionally.
You are in a country where a health worker cannot boast of a living wage, you cannot boast of very good condition of service and this is not alien to Nigeria. Shortly after independence around 70’s people were enjoying a robust package which were not only applicable to doctors. These included a car loan, house loan among others. But this is not applicable again, we are now experience a state of dead infrastructure. We have not been able to get continuous power supply in this country over the years, bad roads and even access to health facilities even as a health provider, this are personal things that when you are growing up in life you want to graduate and leave like normal human being but this is not guarantee at all.
Second, our people are unable to practice their profession to the fullest. There are a lot of things in terms of revolution that have occurred in medicine, and this is not available in our country. For instance when you are looking at surgical specialities, it has gone beyond opening people up a times, there are now facilities that can conduct the proper examination without tiring people. Many years back Lagos State can boast of 20 Magnetic Resonance Imaging, MRI machines, but now in the whole of Lagos I don’t think we can boast of five. And when you are comparing this number with the population of Lagos State we all know what it means. Even practising the profession you cannot help your patient maximally.
So how do will now juxtapose this with what I call a political decadence? It is the failure of leadership that is responsible for all of this, and the only people to be held responsible are our political leaders that have deceived Nigerians over the years. When you look at it government still spend a lot of money to train our graduate but at the end you don’t have them staying back and this can be attributed to poor governance over the years.
This is a very serious problem and until we start to see it from political perspective, and be a vanguard of change and join the train of people that will say enough is enough, regardless of your political party, the situation will continue to get worse.
In the past three years in Lagos State, the government has refused to recruit resident doctors because of their rancour with doctors employed in the State and their Association.