Dr Philip Ekpe is the General Secretary of the Nigerian Medical Association. In this interview with DAYO OJERINDE, he speaks on the controversy surrounding the Medical and Dental Council of Nigeria bill before the Senate among other issues
What is the relationship between NMA and other health unions?
The NMA before now has been worried about inter-professional rivalry at workplace between the allied health workers and doctors. Although, they seem not to accept that name, they can check the dictionary for the definition of ‘allied.’ Maybe to respect them, we can call them other health care workers that we all work together. The fact that we call them allied health workers,doesn’t mean they are superior or inferior, it is just a name. I’d rather would think that they are not happy with us and we not happy with them.
At the beginning, they felt that the NMA seemed to fight for its members alone without carrying other health workers along. Unfortunately, it is government’s divisiveness that caused some of these problems. However, it is common sense that in a hospital setting, the leader of the team is the doctor. If the leader of the team is a doctor, it now becomes funny where the other parties who are not the leaders of the team want to head the unit. How does this work?
The truth is that the relationship is very poor. The NMA was worried and that was why between 2018 and 2020, we set up a committee on what we called inter-professional rivalry. We had several meetings with the pharmacists, nurses and reached some agreements on how we could function harmoniously. But unfortunately, after having these agreements, their action has not been in tandem with the agreement, they are doing something different and that becomes a problem.
Why do you think it is the doctor that is the leader of the health team?
Let me tell you why the doctor is the leader of the team. It is the doctor that knows what happens in the nursing profession, pharmacy profession and in the medical laboratory profession. At each point in time, he can relate with them, that makes him central and that is why he is the leader of the team. The truth is that they have to accept it, it is life. Even in pharmacy, they know that they are superior to nurses before now, just that today, nurses have upgraded themselves from diploma to degree holders. Pharmacists are now upgrading themselves from B.sc, not just to Master’s and doctoral degree holders. They want to be medical doctor, they call it D.Pharm. Is that not confusing? When patients go into the hospital, they look for a doctor; calling a nurse or a pharmacist a doctor will erode the quality care because many of them take advantage and pretend that they are medical doctors, this way, they go ahead to treat patients.
The difference is clear. I don’t know what they are arguing, even the way God made fingers, they are not equal. I’m not saying we should step on them. They should understand that it is a privilege. In a society, even at home, there is no place that everything is equal, otherwise, even the technicians will be equal to the pharmacists.
JOHESU was formed as a conspiracy to fight medical doctors. The coming together of the allied health workers is not even for their protection, their target is to fight doctors. They say we are proud. I think pride should be judged by individuals. There are some courses that make you appear as if you are proud. For instance, it is seen that an average lawyer is proud, so also Medicine. Sometimes, because of the knowledge we have and the way we talk, it appears as if we are proud, even when we are not.
The MDCN bill says if you did not study Medicine and Surgery, you should not be answering doctor to avoid confusion. You can go and obtain your PhD, no problem, if you work in a pharmaceutical company, answer doctor there.
If a patient for instance is suing a hospital, the doctor is the one that appears in the court. The fact that it is a team work does not mean that the responsibilities are not separated. The MDCN bill is saying if you work in the hospital environment and you don’t have MBBS, don’t answer ‘Doctor.’ If you have Ph.D, make it clear that you are not a medical doctor, or if you want to answer doctor put it there that you are a doctor of Pharmacy.
Why is it difficult for the unions to come under one umbrella and speak with one voice?
It will be difficult to come under one umbrella unless you want to cause a total fight. First of all, they don’t want to accept that we are the leaders of the team. Let me tell you, I wrote UTME four times before I studied Medicine, all my scores were more than the cut-off points for other courses including Pharmacy, Microbiology and the rest. You can understand why I will always want to defend Medicine; I want to take charge but not disrespecting my team.
We have to understand that in the health care industry, the leader of the team is a doctor who works with other workers.
Does it mean that the NMA doesn’t have any issue with the MDCN bill?
We don’t have any issue with the bill. We’ve looked at it and we have realised that it is going to increase the quality of health care to the patients. We have also realised that it is going to reduce inter-professional rivalry, but unfortunately, I’m surprised about the turnaround from other health workers.
JOHESU accused the Chairman of the Senate committee, Senator Ibrahim Oloriegbe of favouring doctors during the public hearing of the MDCN bill, is this true?
I knew they would come to that eventually. It is about talking about tribalism, if for instance, someone is a Yoruba man and he is judging a case between two people of different tribes, if he decides in favour of his kinsman, people will say he did that because of tribalism.
This was what happened at the sitting; JOHESU divided themselves, and instead of presenting themselves as one body, after writing as JOHESU, they wrote as different associations, copying the same thing. The Chairman of the committee read the presentations and asked why they were repeating the same thing. The same thing he did to doctors, even though ours was different, we had for the NMA, the NARD, MDCAN. He read through and said we harmonise.
We can’t have two captains in a ship, it is common sense. In all my argument, I’m not saying the other health workers should not be respected, we should have a relationship but everyone should remain on their lane. I have a lot of pharmacists as friends that I respect, including the PSN president.
What is the solution to the logjam caused by the MDCN bill?
We have done the public hearing. The Senate committee on health has listened to all the parties and they are going to come out with what they think. At the end of the day, even after writing what they think, it will be voted for on the floor of the Senate. It is not as if we have so much hope, we just hope that the Senate will remain honest. The other health workers are more than us if you put them together. If they decide to lobby, they will get more resources than us. We pray that the lobbying will not overtake sense of those bills.
The Pharmaceutical Council of Nigeria wants to prescribe and give injection. If a pharmacist gives an injection and the patient has a reaction, can he handle it alone? We should not turn the patients to guinea pigs. Everyone should be on his lane. I agree we must all respect each other.
Don’t you think the MDCN bill should be stepped down for peace to reign?
The absence of war does not necessarily mean that peace exists. The last time that law was reviewed was in 1992, there are a lot of things that should be changed in the law. If we don’t upgrade that law, there will be a lot of infiltrations. Stepping down the bill is like shying away from the problem, let’s face it. We are not saying they should not aspire to be whatever they want, but they should not encroach on our area. For instance, they approved calling pharmacists ‘consultants.’ What does that mean? Are they consultant pharmacists in the hospital?
In the medical practice, to be a consultant, you have to go for residency for not less than five to six years, sometimes, seven years. And as a resident doctor, the job is temporary, when you finish, you don’t have any job, you start applying. But pharmacists say while you are working, maybe you go for a two-week training somewhere every three months or even every year and you do that for four or five years, you get a Fellowship of the West African College. After this, they now appoint you as consultant in the same place you are working. I’m just pointing out to you, because when they go out to make all those noises, it looks like doctors are terrible.
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