FULL INTERVIEW: Hazard Allowance Not Enough, Nasarawa Government Must Do More For Doctors, Other Health Workers – Nasarawa NMA Chairman
The Chairman of the Nasarawa State Chapter of the Nigerian Medical Association (NMA), Dr. Peter Attah has said that the Nasarawa State Government has to do more than paying hazard allowance to doctors and other health workers in the State in order to meet their demands.
He stated this in an exclusive interview with Eggonnews in reaction to the news that health workers in the employ of the Nasarawa State Government had received hazard allowance while receiving their salaries for the month of April 2024.
In the interview which held over the phone on Monday (April 29, 2024), Dr. Peter Attah said while they appreciate the State Government for paying hazard allowance, it still fell short of what was required in order to motivate the health workers to continue doing their jobs.
Below is a full transcript of the interview:
Please can you state your name and the position you occupy for the record.
My name is Dr. Peter Attah. I am the Chairman of the Nigeria Medical Association, Nasarawa State Chapter.
Earlier today we got news that the Nasarawa State Government had fulfilled its promise to health workers concerning the hazard allowance. Can you confirm and shed more light on that issue?
Yes, it is actually very true that they fulfilled their promise. Last month, we met with the Nasarawa State Government led by the Deputy Governor, His Excellency, Dr. Emmanuel Akabe. He chaired the meeting where the health workers’ union leaders including myself the NMA Chairman and my Secretary were also in attendance. The Nasarawa State Government at the time were worried because at that time, I am sure you must have heard one news – though it didn’t come from us – that said about 67 or 59 doctors left the State employment. I think that was one of the reasons why the meeting was called and we had the meeting with them.
And the Deputy Governor told us in that meeting that His Excellency the Governor had given approval for the payment of hazard allowance with effect from the April salary. Most of our members started receiving their salaries today and all of them that received the salary told us they actually got the hazard allowance as the government agreed to implement. And even with some other healthcare workers, they also confirmed the same thing. So it has been confirmed that the Nasarawa State Government kept her promise that it will implement the hazard allowance from this month of April 2024.
Sincerely we must use this opportunity to that the Nasarawa State Government under the leadership of His Excellency, Engr. Abdullahi Sule for fulfilling this promise that they made to us early last month.
Does this solve the problem of health workers in Nasarawa State?
Well, I have commended the Nasarawa State Government for following this path to implement the hazard allowance. For my members the doctors in the State, they got an increment between N27,000 to N35,000 depending on the grade level. But when you are considering the entire health workers in the State, the increment that they got in their salaries is between N10,000 to N35,000 also depending on the level because when we talk about healthcare workers, it is not only the technical staff that provide the services. Even the attendants that clean the hazardous wastes in the hospital, they are also healthcare workers and they are also exposed to hazards so they were also paid.
However, like Oliver Twist – and we have already made this clear to the government – while they have taken this measure to ensure that the healthcare workers get this welfare package, we also mentioned to them that last time that there are other welfare issues that demand their attention. Our greatest challenge as NMA is the brain drain and the japa syndrome.
For the brain drain, we have the internal brain drain where you have some of our colleagues that work with the State Government and then some that work with the Federal Government within the same State; the gap in their salary is also pushing a lot of our members to leave the Nasarawa State Government to pick up appointment with the Federal Government, providing the same services that they would have provided in the State health facilities.
As I stated in the meeting we had with the State Government, the gaps in the salaries could be close to N300,000 per month. And so some times, even when some of our members want to stay, but with the current economic reality – we have all seen the high cost of living with food stuff and so many basic necessities out of reach – our members are actually tempted. If you see this gap as huge as N300,000 per month, our members actually tempted to move from the State Government. For example, Dalhatu Araf Specialist Hospital and FMC Keffi are on the same level of healthcare service delivery. They are all tertiary institutions but you will see a situation whereby doctors leave Lafia after putting in some reasonable years, and because they feel the gap in salary is there and they still have the bills of their dependents on them, they leave for FMC Keffi. So we actually made a case to the State Government for them to also implement other welfare packages.
The circular for this hazard allowance came with the implementing period from December 2021. But as at last year before the Buhari government left, they also released a circular revising the CONMESS. What they were taking into cognizance was the inflation from the salary structure that was being implemented for the healthcare workers. This was from June last year. They got that circular out before that administration left. It was after they left that fuel subsidy was removed and we had to grapple with the high cost of living so much that even the doctors cannot even afford basic necessities of life.
Now there is a new circular that was brought out and there was a minimal increment, reviewing the salary to take into account – this was even by their own volition. It was not a negotiation between the government and the union that produced it. Now the Federal Government has implemented that circular and even paid arrears and a couple of other States within the federation have also implemented it.
Now, if you have implemented this hazard allowance that came into effect from December 2021, and you didn’t implement the one that came into effect from June 2023, the gap still exists.
And also the consequential minimum wage that the Nasarawa State Government failed to actually adjust. All these cumulatively bring a salary differential of close to N300,000. And I can tell you for free that that differential is so enticing that nobody would want to miss out on that one.
Basically, while we sincerely commend the government for implementing it, we also want to appeal to the Governor to use his good office to approve the implementation of that new circular that has been reversed. So that this internal brain drain will come to an end and doctors will be eager to pick up an appointment with the Nasarawa State Government and the citizens will be confident to visit any facility because they are going to see doctors and other healthcare workers that can provide the services to them.
For me, I want to appeal that the government approves the implementation of the revised CONMESS circular approved by Buhari government last year before they left and then the consequential minimum wage adjustment of 2019 that was implemented but it was not adjusted for healthcare workers.
Another issue that I want to inform you about is the issue of promotion. A lot of healthcare workers are grumbling because the promotions stopped at 2017. As at 2017, there were people that picked up their appointment two years before 2017 so they were not due for promotion as at 2017. And also for some of our senior doctors that also picked up appointment as at 2017, they needed a minimum of four years before they can get the next promotion. So if you add this up, you will see that there are some of our members that have been working with the Nasarawa State Government for nine years and they have not enjoyed any form of promotion. So we are also appealing to the government to actually implement the promotion so that it can encourage the healthcare workers in the State to re-dedicate themselves to providing quality healthcare services in the State.
And like I have said earlier, because of the disparity, a lot of healthcare workers, especially the doctors have left. So we believe if they can do what we have requested for, and also employ more hands so that most of our facilities can be properly covered. As it is not, there are a lot of our members that are breaking down as a result of burnout. You will go to some of the facilities and see that they are the only ones managing to be on call at such periods with a large volume of patients. They will work to the point that some of them are breaking down.
Also, the limited number of doctors we have has led to an increase in the cases of assault against healthcare workers especially the doctors. Patients are now impatient because they come with critical conditions and meet only one doctor on ground. Since the doctor cannot attend to all of them at the same time, sometimes if there is any untoward outcome, the relations of such patients could attack our healthcare workers. These are all as a result of the limited number of healthcare workers we have. And we want the Nasarawa State Government to look into this and employ more doctors and other healthcare workers.
Apart from the salaries I have mentioned, there are other incentives that they can provide. We are not insisting that once the Federal Government implements something, the State Government must start implementing it immediately. There are some other incentives that the government can give to the healthcare workers especially the doctors. One of such incentives could be the housing package that is being distributed. Unfortunately, our members are not being given this opportunity.
You mentioned the issue of salaries and other emoluments as well as the issue of employing more doctors. Apart from these two, are there any more challenges that the health sector in Nasarawa State is facing?
Yes, I mentioned those ones because they are direct but there are other things such as equipping the health facilities and infrastructural upgrade. We know that they are trying in that aspect but there are a lot of modern equipment that we need in these facilities. They are actually doing it, especially facility upgrade with the renovations going on but we are also appealing that they should bring some state-of-the-art equipment to the facilities because the same specialized manpower that we have working with the Nasarawa State Government are also working elsewhere. That will also increase the quality of care the doctors and other healthcare workers are providing.
Is there any other thing you want to say that I have not asked you?
We are grateful that after two years that the Nasarawa State Government entered into an agreement with us and they told us specifically that they were going to pay the hazard allowance, we are now appeal the them. That still falls short of reversing the brain drain of keeping the doctor.
Another thing I want to mention is the issue of our colleagues working FMC Keffi and the high tax burden on them. You could see me quoting figures. We have realized that despite the fact that they put in their best, we have consistently appealed the State Government to also look into the issue of the high tax burden. I gave you a salary differential but you will be shocked that if you go to Keffi, some of our colleagues pay as high as over N200,000 as tax. The tax is being paid on an allowance that we feel concentration should not be given to such an allowance. Take for example, our greatest exposure to any hazard happens during the call. And now the little call duty that we are being paid, government still tax it again. When we met the governor earlier, we brought it up and the government appealed that he is going to look into the issue. But when we followed up, we realized that nothing has been done about it.
I want to use this opportunity to appeal to the State Government to look into the tax especially for the doctors because of the high volume of patients we see in the facilities. Unfortunately, what we are being paid as call duty allowance is actually heavily taxed. That has also discouraged some of our members. If somebody is collecting N700,000 and he is paying over N200,000 as tax, it is only on paper that he will see such amount. We are appealing to the Governor to fulfil the promise paper that he made on the 17th of January 2023.
We are not saying we don’t want to pay tax. We are just saying that a special consideration should be given to the call duty because that is where we are being exposed maximally.
