sponsored an obnoxious bill called A bill to establish a Nigerian council of Radiology aimed at Regulating Radiographers/Imaging scientist that is a full fledged profession with a separate ACT.
MEDICAL IMAGING SOCIETY OF NIGERIA
CAC/IT/30250
C/o Radiology Department, Maitama District Hospital Abuja.
8th October, 2013.
The Chairman,
Presidential Committee of Experts
On Inter Professional Relationship in Public Health Sector
C/o Director
Human Resources Management,
Office of the Secretary to the Federal Government of the Federation
Abuja.
MEMORANDUM
TO: PRESIDENTIAL COMMITTEE OF EXPERTS ON INTER-
PROFESSIONAL
RELATIONSHIPS IN THE PUBLIC HEALTH SECTOR
FROM: MEDICAL IMAGING SOCIETY OF NIGERIA (MISON)
SUBJECT: HARMONIOUS RELATIONSHIP AMONG PUBLIC HEALTH
WORKER:
ORIGINED CAPIES COLLECTED BY ME
ASS, SEC. NKA C.O. (NUS) 9/10/2013
MEMORANDUM
TO: PRESIDENTIAL COMMITTEE OF EXPERTS ON INTER- PROFESSIONAL
RELATIONSHIPS IN THE PUBLIC HEALTH SECTOR
FROM: MEDICAL IMAGING SOCIETY OF NIGERIA (MISON)
SUBJECT: HARMONIOUS RELATIONSHIP AMONG PUBLIC HEALTH
WORKERS:
A ROAD MAP
DATE: 7TH, OCTOBER 2013
In the 2013 National budget, the health sector received the third largest allocation (after security and education) underlying its significance in the transformation agenda. A sum of 279.23 billion naira was budgeted for the health sector.
All government healthcare goals are to be realized, using primarily health workers, health professionals in the public sector. Unfortunately, professional disharmony greatly undermines the achievement of this health targets.
This memorandum will focus on areas of conflict between Medical Imaging Scientists (Radiographers) and other health professionals with global best practices and extant laws as the background. It will suggest several ways and means of minimising conflicts, increasing harmony and producing better health outcomes.
AREAS OF CONFLICTS
Radiography/Medical Imaging Science is a branch of medical practices that encompasses
7.Electrocardiograph (ECG)
In section 28, of the Radiography Registration Act (see Attachment), A Radiographer is defined as “… a person who is trained, qualified and registered to practice any or all the various aspects of the radiography profession…”.
is described by same session of the act as “… the art and science of the application of various forms of radiant energies on human in order to promote health, treat diseases and produce various diagnostic images including:
When medically indicated”
Unfortunately, many Radiographers’/Medical Imaging Scientists are not allowed to practice their profession in most of the nation’s tertiary hospitals. A case in point is the National Hospital Abuja and majority of the teaching hospitals. This is done in arrant breach of the extant law. The culprits are the usual suspects in the public health sector-Medical Doctors. In a bid to expand roles and income opportunities for their colleagues, Hospital Heads (Doctors) and Department Heads (Doctors), make illegal policies that are enforced to the detriment of the profession that is supposed to perform medical imaging and radiography services in the hospitals.
Many Radiographers/ Medical Imaging Scientist have left the public service
and indeed the country, for this singular reason.
This is an unacceptable practices and major area of conflict.
Healthcare delivery is a highly knowledge intensive sector. Every nation that has achieved enviable health indices, invested significantly in the
knowledge-base of its health workers
It is the need for comprehensive training that informed the inauguration of
the Residency programme in Nigeria, in 1979.The Residency programme is designed to train Doctors in several specialties.
In a typical Resident (training) programme, doctors are trained in government hospitals (mainly tertiary hospitals), by consultants paid by governments, utilising government equipment and resources. Yet they constantly embark on the industrial actions, in a most whimsical manner. This is bow medical consultants are produced.
Unfortunately, no specialisation training programme, with career path, was designed for other health professionals, including radiographers (medical imaging scientists, pharmacists, nurses, medical lab scientist, physiotherapists etc). These professions acquire their specializations individually and privately. This effectively limits the number of specialist they produce.
Unfortunately when these professionals specialise, the public health system refuses to officially recognise their specialization, because the public health sector, headed by doctors, do not desire specialization by other professionals. This is an anti-human practice and patently evil and evidently dangerous. The desire for achievement and distinction is a natural impulse in humans and must be encourage and rewarded, especially in the health sector where it impacts directly on outcome.
In developed countries, there are so many areas of specialization in the health care professions, more than in medicine. (See attachment). This is another area of tong standing strife.
It must be made clear that every profession has its innate professional esteem, ethics and cadre. Therefore the practice of ANY profession to and actually heading another profession, as obtains in most tertiary hospitals, is grossly insulting. This promotes unnecessary friction. Imagine a scenario where an army officer, no matter his rank, heads the Nigerian police as IS of police or commissioner of police or a divisional police officer. This scenario is a living experience for Radiographers (Medical Imaging Scientist) where Radiologist are arrogated the leadership of Medical Imaging or Radio diagnostic Department in tertiary hospitals. These two professions are collaborative and not master- slave relationship as it is currently structured. The Radiologists are to report the MRI, CT, X-Ray images in the department. The Radiographers are (by law and training) to receive patients, examine the patients using the appropriate or requested imaging modalities and acquire the images. They also carry out the ultrasound scan and write report. This is the practice globally. Their relationship is therefore mutual. But The policies that are made and implemented by doctors in the public health sector, makes this relationship a lord-slave one, further souring inter professional harmony . It is a standard policy currently, that radiologist will head Radio-diagnostic! Medical Imaging departments in public sector hospitals.
There are 53 federal tertiary hospitals in Nigeria and they are all administratively headed by doctors. There are much more public sector hospitals in the state and local levels. All of them are headed by doctors.
These are several departments in the Federal Ministry of Health, including:
family health— headed by doctor
Public health— headed by doctor
Food and drug services — headed by doctors
Hospital— headed by doctor
Agencies like National Council on Health, National Agency for Food & Drug Administration and Control (NAFOAC), are all headed by doctors.
This is in a sector that is founded and built on inter-professional collaboration. We encourage this committee to call for the list of all chief medical directors of public hospitals, directors in Federal Ministry of Health, heads of Agencies & Parastatals under Federal Ministry of Health and make their independent conclusion.
It is known that in the developed world, hospitals are led by Chief Executive Officers (CEO), who are independent and report to a fairly constituted board of directors. Doctors know that this is the global best practice (see attachment), but because of professional impunity, they fight its implementation in Nigeria.
This arrogance of medicine is the major reason why our health indices have been in decline since 1960. It is the fulcrum of the doctor-centric policies that have alienated all health —care professions in the public health sector.
The disparity in salary and allowances of doctors and other health professor is simply provocative.
This discrepancy is not founded on any empirical basis. Radiographers/ Medical Imaging Scientists require the same WAEC/ NECO qualification as medicine students. They write same UME or JAMB and do same courses in the 1st year and most of 2nd. year. Radiographers spend 5 years and doctors spend 5 and 34 years. They both do a year internship and a year youth service.
But after that, if they are both employed in the public sector, the doctor starts at GL 12, while Radiographer/ Medical Imaging Scientist start at GL 09. The salary reflects even wider discrimination.
Post NYSC doctor — N2,844,937 Million P.A. (excluding call duty allowance) Post NYSC Radiographer — Nl.792,684 million P.A.( excluding call duty allowance)
On call duty the doctor receives N1,877/unit call, while the radiographer/ Imaging Scientist receives N728/unit call, about 40% of the doctor, This disparity is even more ramified at higher grade levels.
This disparity is neither supported by experience, length of training, complexity of job or any measurable criteria. It is another product of professional impunity by doctors in policy making level.
On the issue regarding extant laws governing health professionals, it is our opinion that the impetus for reviewing Radiographers’ Registration Act, should only come from the Radiographer Registration Board of Nigeria (RRBN) and the relevant association in radiography and medical Imaging including association of radiographers of Nigeria. (ARN), Medical Imaging Society of Nigeria (MISON), MRI- Practitioners Association (MPA) and Mammography Practitioners Association (MaPA). These are all registered and recognised by Law in Nigeria, represents the interest of people practicing different aspects of Radiography and Medical Imaging.
MEASURES THAT WILL HELP PROMOTE HARMONY.
obtained by doctors. Recognize the existing post graduate specializations in Medical Imaging Science and Radiography, with proper placement in the civil service cadre, taking into cognizance the length of training. Residency programme, with specialization in all health professions is the only way our dismal health indices can be tackled.
Inspiration can be drawn from the NHS, were the pay scale developed. We are not calling for equality in pay but justice in year medical officer does not earn more money than a seven year radiographer/maging Scientist anywhere in the world.
The committee is probably the most important committee to be set up in the health sector since 1999. If harmony can be the public, the impact on our health indices will be significant.
We appreciate the difficulty of your task and do wish you well.
Thanks you for this opportunity.
The Chairman,
Presidential Committee of Experts
On Inter Professional Relationship in Public Health Sector
C/c Director
Human Resources Management,
Office of the Secretary to the Federal Government of the Federation
Abuja.
MEMORANDUM
TO: PRESIDENTIAL COMMIHEE OF EXPERTS ON INTER-
PROFESSIONAL
RELATIONSHIPS IN THE PUBLIC HEALTH SECTOR
FROM: MEDICAL IMAGING SOCIETY OF NIGERIA (MISON)
SUBJECT: HARMONIOUS RELATIONSHIP AMONG PUBLIC HEALTH
WORKERS:
Federal Ministry of Health (Nigeria)
From Wikipedia, the free encyclopedia
The Federal Ministry of Health is a Nigerian ministry whose mission is to develop and implement policies and programs and undertake other actions to deliver effective, efficient, quality and affordable health services. It is headed by a Minister appointed by the President, assisted by a Permanent Secretary, who is a career civil servant, The current Minister of Health is Prof. C.O Onyebuchi Chuki. [1]
Departments
The Ministry has several departments specializing in different aspects of health care. The Family Health department is concerned with creating awareness on Reproductive, Maternal Neonatal and Child Health,
ensuring sound nutrition including infant and young child feeding, and care of the elderly and adolescents.
The department of Public Health coordinates formulation, implementation and evaluation of public health
[2]
policies and guideless. It undertakes health promotion, surveillance, prevention and control of diseases.
Functions of the department of Plaint Research And Statistics include developing plans and budgets and monitoring their implementation, serving as Secretariat to the National Council on Health, conducting research in collaboration with other departments and 3gencies, institutions and parastatals, conducting operational research and data collection, and performing various coordination frnctions.121
The department of Hospital Services supervises 53 Federal Tertian Hospitals —Nigeria’s Teaching hospitals, Federal Medical Centres and National Eye Centers. The department processes appointment of Chief Medical Directors and Medical Directors, supervises oral health research, develops policies on nursing, coordinates training programmes for nurses and monitors the midwifery service scheme in collaboration with NPHCDA.[2]
The department of Food and Drugs Services formulates national policies, guidelines and strategies on food and drugs, and ensure & Elcal deliv7fphrmaceutical services nationwide. The department sponsors the National Institute pharmaceutical Research and Development and the National agency for Food a4ioAdistrion and Control, and acts as regulator through the Pharmacist Council of Nigeria. the Institute of Chartered Chemist of Nigeria and the Institute of Public Analyst of Nigeria. [2]
See also
References
Retrieved from “(http://en.wikipedia.org7w/index.php?title=Federal Ministry of Health (‘Nigeria) &
10/6/2013 11:09AM
The Medical Imaging Society of Nigeria and in the diaspora ( MISON ), wishes to congratulate ( our colleagues and fellow professionals in the practice of Medical/Health Services; the Medical Laboratory Science Council of Nigeria ( MLSCN ), all Medical Laboratory Scientists, her affiliates, proponents proper and patient-based international best practices of Medicine, the Joint Health Sector Union – JOHESU, and other related Medical/Health/Diagnostic/Imaging Practitioners ), over the National Industrial Court ( NIC ) judgement/ruling in Abuja on Friday, 17th February, 2017.
The judgement/ruling ordered the autonomous establishment of the Department of Medical Laboratory Science Services in all Government Hospitals/Clinics when ruling on the case between Medical Laboratory Scientists and the Minister of Health and 13 others.
The judgement/ruling now paves the way for the Department of Medical Laboratory Services to be headed by Medical Laboratory Scientists and not by ANY OTHER MEDICAL/HEALTH PROFESSIONAL.
MISON, an umbrella body of Medical Imaging Scientists (Radiography; X-Ray/Computerized Tomography/Mammography, Sonography, Radiotherapy, Nuclear Magnetic Resonance Imaging, Electrocardiography, and Allied Professionals ), felicitate especially with the Ag. Registrar / CEO MLSCN, Mr TosanErhaboh, GodswillOkara, Chairman West African Post Graduate College of MLS, and all those directly/indirectly involved in the achievement of this landmark judgement.
MISON hopes that this epic achievement will reverberate in all sectors/departments of Medical/Clinical practice that require autonomy, hence ensuring the practice of Medicine in Nigeria, in line with international best practices.
RE: Press Release by the Nigeria Medical Association (NMA) on the harassment of Radiologists by the Registrar of the Radiographers Registration Board of Nigeria (RRBN)
The attention of Radiographers under the auspices of the Magnetic Resonance Imaging (MRI) Practitioners Association has been drawn to the Guardian Newspaper publication on the above subject matter of Thursday 17th November 2016, page 46. We the members of the above association had the option to ignore such frivolous and incoherent pronouncement of the NMA born out of parochial interest and punishable under Section 12 of the Radiographers (Inspection and Monitoring Regulations 2005) however disguised under public interest but as a responsive association, we have decided to react to the misleading publication of the NMA against the lawful monitoring activities of the RRBN and her dynamic Registrar and Chief Executive.
We categorically throw our unflinching support to the monitoring and enforcement activities of the RRBN to flush out all forms of quackery in Radiography practice in Nigeria by unequivocally stating that the RRBN is a statutory regulatory body set up twenty-nine (29) years ago by Decree 42 of 1987 now Act of Parliament cited as Radiographers (Registration etc) Act Cap R1 LFN 2004 to regulate the Radiography profession in Nigeria and does not regulate Radiology practice or Radiologists as claimed by the NMA (See the case of Prism Clinics & Diagnostic centre Ltd & 1 ors V RRBN delivered by the Federal High Court of Nigeria on the 21st day of October 2014). Having followed the ongoing monitoring activities of the RRBN over time, we are aware that no doctor was harassed to register his/her practice with the RRBN, instead, they were requested to comply with the relevant sections of the Radiographers regulations 2005 as well as the Radiographers (Registration etc) Act R1 LFN 2004 as required by law. With specific reference to Section 23 of the Radiographers training institutions/premises regulations 2005 which unequivocally states that “anybody who operates a Radiography Unit/practice (X-ray Imaging, MRI Imaging, CT Imaging, Radio-nuclide Imaging, Ultrasonic Imaging etc, Section 28 of the RRBN Act refers) in a centre or premises without registration with the RRBN commits an offence and on conviction shall be liable to fine or imprisonment or both fine and imprisonment” as may be determined by courts of competent jurisdiction. The use of the word “anybody” in the opening paragraph of Section 23 of the above regulation by extension refers to any person whether a doctor or otherwise who operates a Radiography Unit (either in a hospital etc) should cause that Radiography Unit to be registered with the RRBN in accordance with the law (See Section 15 of the Registration of Radiographers training institutions/premises regulations 2005).The latter further requests amongst other things that such Radiography units or premises shall have in its employment at least a registered Radiographer. Therefore any Doctor/Radiologist who despite been registered to practice medicine in Nigeria pursuant to Sections 9, 12, 11, 8 and 18 of the Medical and Dental Practitioners Act but wishes to include Radiography practice (which is distinct from Radiology practice as acknowledge by NMA in her publication under reference) must therefore comply with the above RRBN Acts and RRBN Regulations 2005 as stated above.
The NMA in its publication under reference acknowledged that Radiography and Radiology are distinct; thus, why should a Radiologist including consultant Radiologist practice the profession of Radiography contrary to the stand of NMA and in fragrant contravention of the provisions of Sections 13, 14 of the RRBN Act as well as the provisions of the RRBN regulations 2005. This is nothing but corruption which the present administration is currently waging war against and must be condemned. What the NMA has just done through the said publication is what happens when corruption is fighting back legitimate authority.
The NMA publication also gave a distorted definition of Radiography and failed to list the various aspects of the Radiography profession as expressly stated in the RRBN Act. However for the purposes of clarity, Section 28 of the RRBN Act stated inter alia that Radiography means the art and science of the application of various forms of radiant energies on human beings in order to promote health, treat diseases and produce various diagnostic images including (a) X-ray Imaging (b) radio-nuclide imaging (c) ultrasonic imaging (d) thermographic imaging (e) magnetic resonance imaging – when medically indicated. The RRBN Act went further to explain that A Radiographer means a person who is trained, qualified and registered to practice any or all the various aspects of the Radiography profession (as listed a – e above).
Radiographers are the technical/scientific experts in medical imaging whose training is domiciled in full fledged departments of Radiography in our universities or in approved training institutions as it is done all over the world. They are trained to use sophisticated technology imagines equipment that produce various diagnostic images as identified in the Act.
The health care delivery environment is a complex industry with many professionals working as a team to care for the patient. It is for this purpose that we have radiographers, doctors, pharmacists, nurses, physiotherapists, laboratory scientists, dental technologists etc, contributing their expertise to the success of restoring health. It is crude, unprofessional and selfish for any group in the team to claim mastery of all the professions in the health sector including the profession of Radiography to the detriment of the patients and the healthcare delivery system as a whole. This is akin to being a jack of all trade, master of none as stated by Hon. Justice B. A. Adejumo in suit no: NICN/ABJ/284/2014 between Nigerian Union of Phamacists, Medical Technology and Professionals Allied to Medicine & Anor v. Obafemi Awolowo University Teaching Hospital Complex Management Board & 6 ors
The relevant section of the RRBN Regulation 2005 makes provisions for policemen to assist the Board in the discharge of her statutory mandates of regulating radiography practice in Nigeria as well as charging prescribed fees. From the foregoing, neither the RRBN Registrar nor the board have embarked on illegal or criminal activity and has not breached any law in Nigeria. The members of MRI Practitioners Association and well meaning Nigerians are solidly behind the RRBN Registrar and his team in their resolve to rid the country of unwholesome and unethical practices in the field of Radiography. Just like corruption is fighting back the present administration of his Excellency, President Mohammad Buhari, quackery is fighting back the Registrar and the RRBN for the good work they are doing in the Nigerian health sector.
It is obvious that NMA acted ignorantly having been deficient of the laws of the Federal Republic of Nigeria and the avalanche of judicial precedence in the public domain.
We therefore advise the general public to disregard the NMA publication of Thursday 17th November 2016, page 46 and to continue to assist the team of inspectors of RRBN in their ongoing inspection and monitoring nationwide to get rid of quackery and unauthorised use of radiation by unqualified and unlicensed persons which predisposes Nigerians to avoidable radiation hazards including cancer.