Doctors’ strike not anything to grieve about, says Sanwo-Olu

All health workers’ allowances approved, paid

We are in Infectious Disease Hospital (IDH) in Yaba and you journalists have asked me question around the ongoing warning strike by doctors and health workers. One of the first things we need to understand is the responsibility of the government to cater for the welfare of all workers. I have met with health workers in this Infectious Disease Hospital and I asked about their wellbeing; they said they were doing fine. I have the overall responsibility to ensure that all the state’s workforce, be it in the public or private sector, are doing well.

I also have the responsibility to ensure lives of all residents and their property are secured. This is paramount to us. The media would agree with me that in the last 412 days we have come on board, security and welfare of the people have been part of our guiding principles. And we will keep doing that as we go along.

However, disputes are also natural in human relationship. People might see things differently from the way others do see it. Personally, I am not upset about the warning strike embarked on by the Medical Guild. The action is not anything to grieve about; it is really all around communication and understanding. You will understand things when you see knowledge, and wisdom will also come in when you seek knowledge. These are key guiding principles. The issues of disagreement are very simple; it is because of lack of adequate communication.

The first thing they said is that, we owe some workers hazard allowances. For the benefit of the public, our government is the first, in March, that started paying hazard allowance to our entire health workers, almost 20,000 of them. We increased the hazard allowance by 400 per cent and this is verifiable. Lagos is the first to do this. All the entire health workers – doctors, nurses, drivers, and hygienists – got a 400 per cent on hazard allowance as enumerated in their payment structure.

Above that, we realised we needed to give additional incentive to frontline workers specifically engaged in the fight against COVID-19 pandemic. This is called COVID-19 allowance, which is outside their regular salaries and hazard allowances. The COVID-19 allowance is for over 1,000 medical officers and other auxiliary workers in all of our isolation centres. On this additional allowance, I do not need to consult with anybody. It is something I felt it was needed.

Lagos is the first in the country to create this additional allowance and we are doing it not because we wanted to show off. We realised Lagos is the epicentre of the COVID-19 pandemic and I think we should show leadership and commitment to all our frontline staff. So, we created that allowance and paid it.

So, as we go along, we needed to review our strategy, because our strategy at that time when we created the COVID-19 allowance was to contain the pandemic before it would get to the communities. So, we paid the allowance, which, in my view and everyone’s view, was roof-top. We actually paid people allowances that were like twice of their monthly salaries. We had thought COVID-19 is a pandemic we would resolve within one or two months. So, we created the allowance as motivation for everyone on the frontline.

However, all of us have seen that this pandemic has grown from being a street run to a marathon. So, we needed to have a change in strategy. Part of the strategies is to keep all allowances to what we will feel comfortable to pay. Just last month, we paid allowances. However, we feel we need to do proper enumeration on the COVID-19 allowance.  We needed to ensure that people that will get the COVID-19 allowance are people that have worked during the period of COVID-19 and those that have worked in one or all of our isolation centres.

So, we had a two-month delay, meaning that we have paid two months, but we have not paid May and June. The only reason for this is that, we want to be sure the right people get paid this COVID-19 allowance. As I speak, most have them have gotten the allowance for two months arrears. The amount the government pays as COVID-19 allowance is at my discretion and it is even still more than what the Federal Government pays. But this is not a competition.

Disagreement on tax issues

The other concern of the health workers is taxes. Tax is a component of the law of the federation. However, I have been hearing about excess tax since I was Commissioner for Establishment. Medical workers have been complaining that they are taxed more than necessary. At that time, the Lagos Inland Revenue Service (LIRS) chairman solved those problems. The salaries of medical workers have since been improved since that time. Maybe the issue now is that they still feel their salary is small.

Taxation and salary deduction is a function of the law and there are things that are allowable and things not allowable. Even at that, we said let’s further look at the salary and asked about the amount of tax can the Government place on the salary of a medical officer. At best, maybe it is N5,000, N7,000 or N8,000 they are talking about. But we agreed that we will meet with the chairman of LIRS and sit with him to look at what we can do. I cannot take unilateral decision on tax. It is the Federal Government’s law. The review cannot be at the whims and caprices of myself or anybody; any action to be taken on that must follow the law. And the independent body called LIRS has the responsibility to look at the issue and give us what is applicable and what is not applicable.

Doctors’ Residential Quarters

With all the best intention, we have two developers we have commissioned to build accommodation for health workers. Even if we start today, the minimum period we can deliver such project is 24 months. To build an accommodation is not something you can just tell me do within a short period. In this premises we are now (IDH), there is a plan to develop Doctors’ Quarters. There is an international company that has said they want to work with us to build a hospital. I told them what we urgently need is Doctors’ Accommodation.

As I speak to you, the design of the project is coming up. Same thing is happening in Lagos State University Teaching Hospital (LASUTH); we have a private sector firm we are already talking to. We have agreed to build Doctors’ Quarters for the health workers, but it is not something that will happen in a day. Space has to be aligned, designs have to be done and funds have to be available. So, we said within 24 months, we will see what can be done.

There are other challenges, which I have to explain. What will happen if I give a quarter to someone working with the State Government and two years after, the person leaves and goes to another hospital not owned by the Government; the problem is they will not want to leave the quarter. But, this is a conversation for another day. The quarters will come; it is government’s asset and we will create the asset for them.

On shortage of medical personnel

We have a standing order on replacement on exit of any health worker. The Health Service Commission does not even need my permission to do that. It has been our standing rule only for the health workers and teachers to replace upon retirement. Because of the current pandemic, there have been, in the last six months, about 600 to 700 general health workers – doctors, nurses, hygienists – that have had to retire due to statutory retirement age. We have since given approval for replacement. COVID-19 has kept all of us at home for the past three months. Over 65 per cent of civil servants in Alausa are still at home. I have given approval to recruit 760 health workers, of which 400 are doctors alone. Even the capacity to be able to identify the 400 doctors alone is a challenge. But, the process has started; the Medical Guild is aware of this. They have been carried along in the process.

Unceremonious dismissal of workers from COVID-19 work

This allegation is rather unfortunate. Sixty-five per cent of all of our health workers are working in our General Hospitals. What we have seen after we changed our strategy in the response to COVID-19 pandemic is that, we realised people are getting tired. A lot of health workers have had to work back-to-back in this period and fatigue was setting in. We said we needed to make a change and asked the fatigued workers to go back to their primary roles maybe in General Hospitals or Primary Health Centres (PHCs). We wanted to bring fresh hands in to come and help out because we don’t know for how long the pandemic will be around.

When they started, we said initially that we just wanted to put a small team of health workers together to fight COVID-19 and put it to and end; but, the pandemic has not gone. So, we felt we needed to re-tool the medical workers and re-energise them and take the ones that have worked in the isolation centres for three to four months back to their regular roles they were employed for. We agreed we will continue to pay their hazard allowances, but we needed fresh people to also come and work. Maybe the challenge was that, we had not paid the COVID-19 allowance of those asked to return to their regular roles. We have since paid the allowance. This talks about communication gap, because we never sacked any health worker. This is a case of “go back to your work” in the General Hospital or PHCs and let fresh hands come in to continue to do the work.

Special care for frontline health workers

We have a dedicated isolation centre specifically for health workers at Agidingbi. Any health worker that falls sick or test positive for COVID-19 is to be taken to the dedicated isolation centre. It has been there for over two months. We care for them there. They quarantine themselves there; they don’t need to go their homes to infect their loved ones. Over the last four months, we have had 14 hotels in which all our health workers have been staying. These hotels are located in Lekki, Ikoyi, Ikeja, Jibowu and other places. We have been paying and feeding them in these places. This is to ensure that our health workers are comfortable and dedicated. Recently, we have also dedicated a day every week for any health worker who wants to be tested. We are doing all the testing for them free of charge.

Disparity of wage paid by Lagos and Federal Govt

How can Lagos, with its lean revenue, be comparing itself with the Federal Government? For information sake, our minimum wage is higher than what the Federal Government pays. This means, across the public service, we pay more than the Federal Government. I don’t need to go into issues around who does what. We know what they requirements are. We know this is Lagos and the cost of living is higher than a few other states.

For us, we are actually doing more for our workers. So, we asked the doctors to show us evidence of pay disparity. They pointed to salary of Level 14. They later said it is entry level. How can we be joggling figures from one level to the other? If you have issues, let us look at it entirely and solve. You cannot say that one is higher in pay in Level 9 and lower in Level 14 or Level 13. That is not the solution. I am not upset and there is absolutely nothing for me to be upset about. Everybody can testify that health workers are people I have tremendous respect for and they are doing a fantastic job.

We will always have issues around misinformation or lack of information. Or maybe the Commissioner for Health is not always available any time they (Medical Guild) want to meet with him. But the man has a difficult job to do around this pandemic. So, it is rather unfortunate that my workers who I love so dearly would take this very unexpected action to vent their grievance. Grievance is natural in any dispute but discussion must start and end on the table. It is surprising that the striking doctors want to take an opportunistic approach in time of pandemic in solving issues. It is totally condemnable. As the Chief Incident Commander, I ask the doctors to come back to work; whatever the issues are, we will sort it out. I believe I am supposed to be the father to all workers, and there is no better engagement we can have except we have it on the table. Just two days ago, I met with the striking doctors’ leadership in my house.

COVID-19 Additional Allowance for engaged health workers

We run an extremely transparent government. The allowance the striking doctors are talking about is the COVID-19 Additional Allowance which I created at my own discretion. When we started, we were paying these workers two, three times of their regular salary and we felt this is not sustainable. I gave the Permanent Secretaries in our health sector a task to do a proper assessment of who should qualify.

There are 14 pillars in the EOC and we had to go round on all of the 14 pillars. We are talking about over a thousand people in different parts of the State, who are not regular staff in the Health Ministry. We needed to be sure and part of things that we wanted to generate is the real name, the real account number and bank account. This is because the allowance is outside of their salary and some of them are not on the payroll of the Government. So we needed to get that analysis right. So, it took them time to reveal all of that.

On why the allowance was paid on the day the doctors declared strike? I gave the approval since last week but NIPS could not effect the payment before the weekend as a result of a glitch in the system. That was what happened. When the doctors came to my house, I called the Accountant General in their presence and put the phone on speaker. It was exactly what I explained to them was what the Accountant General said. So, what better transparency do they want? Lagos is the only State that has given the health workers on COVID-19 frontline an additional insurance cover outside of what they regularly have. In the event of fatality or injury, the amounts are there. I don’t need to mention the figure. We gave additional insurance certificates to each person engaged in the COVID-19 response.

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