Unitary labour and the rest of us: doctors and the poor in Lagos State

If stories about a possible nation-wide strike by medical doctors due to a deadlock in dialogue between medical doctors and the Lagos State government are true, then we need to be warned of a growing unitary labour that works more against the poor and helpless. We have condemned time and again parallel unitary federalism, which has flourished on promptings of increasing importance of oil to ethnic federal politicians. Already, institutions such as the Nigerian Police, Military, Customs, and Defence and so on have had bad and good shares of impact on the structure of so-called federalism in Nigeria. Major policy decisions in these centralised institutions are taken in Abuja even when urgent actions are required to address key pressing needs at state or local levels. For example, in matters of security, while governors are constitutionally recognised as chief security officers of their states, security decisions are not areas in which they call the shots outside the cooperation of state commissioners of police. This practice, which signal what can be described as governmental-unitary federalism now seem to be having a parallel in labour administration and politics—unitary labour (call it a unitary confederacy if you like).

This may be a worse form of a unitary-labour system within supposed Nigerian federal state, at the realm of civil society since members are mainly self-centred. They are mindless about what happens to the poor in so far as their private clinics can be opened for those who can afford their bills.

It would appear that the proposed strike is a noble attempt to show solidarity or resolve the conflict in Lagos State. But the approach signals some form of unitary imposition on the rest of us. It is important to think of the Nigerian Medical Association as a legitimate statutory body. Within the terrain of theoretical federalism is a need to consider the state as a sphere of authority in which civil society can engage. If at all, it should be for an enterprise that has broader benefit for the poor people of Lagos State who are already troubled by several weeks of strike by the doctors. Strikes can only be a last option when all avenues have been explored; especially in these matters that place self at the centre. The national executive will need to be tutored on the rudiments of federalism and values of the noble medical profession to which they belong. Naturally, medical doctors belong to a profession that is more or less charity in orientation, in the sense that they are pro-life, pro-health, pro-public interest and humanistic. The struggle for improved welfare can therefore be expected to wear a human face, such that the lives already lost from weeks of strike by the doctors in Lagos and those that will be lost when the nation-wide strike begins will be taken into account. In any case, leaving the Lagos doctors to fight alone will amount to being callous. So, while energies need to be saved for tackling general issues pertaining to public service delivery and governance that cut across segments of society, the national executives need to tread carefully so as to avoid sending an impression of a group of professionals who lack men with skill to engage the government high-level politics of labour-government relations.

Conflict is inevitable in life, let alone between exploiters and the exploited. What the national executive body of the doctors need to know is a need to constructively explore all available options for resolving the conflict in Lagos State. They need to think through objectively and place before them the interest of the poor, against what is usually seen as selfish demands for increased pay and improved working conditions by labour. At this time, when the poor in Nigeria have been so devastated by corrupt leaders, only strategic engagements with the state officials in matters that transcend selfish desires will suffice. They should consider the legitimacy of their actions with regards to whether such actions help or hinder wider societal struggles for change in Nigeria. It will be shameful to find the people who should be in the streets demanding change in Nigeria all dead from sickness after a possible nation-wide strike by the doctors. Usually, people die, even from minor ailments, during such strikes because they cannot afford private medical bills.

Avoid being used by national and state political elites. Strikes are a means to an end and not the end. Knowing when to apply is part of the wisdom of labour leadership. Public hospitals have not heard good stories to tell. Some of the doctors are callous to patients, whom they often want to hurriedly dismiss in order to attend to their private clinics. Those who do not own one yet, hope to do so shortly, while serving in private practice. Given the fact that this is one profession in need of manpower, only a crop of medical experts-conscious and fighting for their rights with a sense of compassion for the sick- can attract divine and material blessings. Ask anyone in the 36 states of the federation who has been severely sick without money to visit private clinics during the doctors’ strike. And he/she will tell you how horrible it looks.

This plea to the doctors underlies my attention to the government. Politics is not about threats of sack when labour confronts government officials with demands. The rot in governance, oil sector and so on in Nigeria is sufficient to trigger all forms of reaction from the civil society. Conversion of public funds to private funds has turned public hospitals into mortuaries. Most of the hospitals are empty of drugs other than aspirin and homemade malaria tablets that often resist malaria attack. Even the so-called free medical services by some of the state governments, have only a semblance of it. In the case of Rivers State, where the doctors are equally well paid, some of the health centres are manned by doctors who are hostile to patients. Hospitals should be opened 24 hours to the public because of the sick; yet this seems to be a fact yet to be learned by the doctors. The government is simply not providing necessary monitoring and supervision that can keep the doctors at work. Instead, a culture of impunity has matured. This results in decay of the hospitals. Attitudinal issues have risen several times, discrediting Nigerian doctors at home. Ironically, the same doctors who leave the shores of the country to Europe, North America and South Africa have done exceedingly well as they must adjust their behaviours to soothe relevant laws and professional requirements in those settings.

Nigerian politicians have notoriously considered local hospitals death traps by frequently running to foreign hospitals for treatments and check-ups. The same way these politicians have seen local universities as no-go areas for their children, whom they send to Ghana, South Africa, USA, Canada, UK, Russia, Malaysia and so on. At the moment, not up to 2 percent of Nigerian public universities have neither foreign nor prospective foreign students. The original dream of those who conceived the idea of a university, which included a centre of learning and production of knowledge across cultures, is being defeated in Nigeria.

Generally, hospitals in Nigeria deserve better attention from government at all levels of government. The macho –like approach of announcing dismissal of the doctors in Lagos State’s over extended strike, clearly shows the tattered comportment of the state government in handling industrial disputes. The political approach of courting sympathy from a devastated public by demonising the doctors only shows the lack of political wisdom and conflict resolution capacity of the government.

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* Fidelis Allen, Ph.D, is currently at the School of Built Environment and Development Studies Centre for Civil Society, University of KwaZulu-Natal, Howard College Campus, Durban, South Africa.

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