Thursday, October 24, 2013

National Industrial Court Doing Disservice To Health Sector in Nigeria

 The tensions in the Health Sector have being aggravated by the recent ruling of the National Industrial Court. A close look at the celebration mood of Medical Laboratory Scientists in Nigeria is sad:

Here is what a Medical Laboratory scientist posted on Facebook

"Dearest Colleagues, I am pleased to inform you that in an epic ruling today, the National Industrial Court, Abuja Division ruled that Medical Laboratory Scientists shall head their departments AND NOT Pathetic Pathologists. I implore all members, the moment I get a copy of the ruling, every Medical Laboratory Scientist, Intern Medical Laboratory Scientists and Medical Laboratory Science students to ensure that they get the copy of the ruling for posterity's sake. This ruling is merely a re-validation of the certification of freedom (MLSCN Act of 2003) given to Medical Laboratory Scientists 10 years ago. May God continue to bless our national officers lead by the amiable "Grand Commander" Dr. Godswill Chikwendu Okara and his national leadership team and kudos to the Federal Medical Centre, Asaba Chapter leadership for their astuteness and unwavering spirit. Shame to all the saboteurs of Medical Laboratory Scientists who have been making slides for Pathologists in FETHA Chapter believing that they are or shall be our perpetual masters in the hospital. I CRY OUT: PRAIIIIIIIIIISE OUR GOD!!!!!!!!"

Another one reads thus:

"I congratulate all Medical Laboratory Scientists in Nigeria on the recent victory in the court case involving us and the Pathologists. Glory be to God who has been with us through out the years"

For the information of the National Industrial Court, may I reproduce this international standard for running clinical laboratories:

"The staff of clinical laboratories includes:

2. Clinical Biochemist
3. Pathologists' assistant (PA)
4. Biomedical Scientist (BMS) in the UK, also known as Medical Laboratory Scientist (MT, MLS or CLS) in the US, also known as
Medical Laboratory Technologist (MLT) in Canada,
5. Medical Laboratory Technician (MLT in US),
6. Medical Laboratory Assistant (MLA),
7. Phlebotomist (PBT)"

Looking at this staffing list of a Clinical Laboratory, it is surprising therefore that a National Industrial Court whose ruling cannot be appealed in matters of Labor disputes, would bungle such a landmark case. By their ruling they have insisted that the Medical Laboratory Scientist should head the Laboratories.

According to a write up by John J O'Leary, a British Medical Laboratory scientist in Pathology 2026: The Future of Laboratory Medicine and Academic Pathology, Laboratory Scientists the world over are beginning to feel that their role in General, Specialist and Teaching Hospitals is being seen as peripheral. The upsurge in resistance to constituted authority by these Health Workers is an attempt to assert that their roles in Patient Care is Central. While I must commend the highly motivated Medical Laboratory Science staff who most times work under horrendous conditions being grossly understaffed and overworked, I make haste to state that we cannot allow the best intentions to be compromised by inappropriate methods.

This methodology of relegating Patient care to the background simply to re-position themselves as Central to clinical activities is like cutting of the nose to spite the face. If both the Medical laboratory scientists and the Pathologists dig in, the patients will pay a huge price for it.

I wish to bring it to the notice of the National Industrial Court as John o'Leary puts it, that the battle of the Medical Laboratory Scientists is really about money!

"Greater research funding opportunities are now available to all pathology disciplines, and indeed young medical and scientific staff are encouraged to undertake research and pursue higher degrees as part of their professional development".

This battle which the NIC has just aggravated is simply because the Medical laboratory scientists want money to be thrown at them by these foreign donors. So, I repeat, THIS NIGERIAN VERSION OF THE MEDICAL LABORATORY SCIENTISTS STRUGGLE IS ALL ABOUT MORE MONEY.

Their insistence on the creation of directorates of Laboratory service is a model that has been tried out in various climes without success as pointed out by various authorities on this issue. How will such directorates improve patient care? How will they achieve the aim of making MLS central and not peripheral in General, Specialist and Teaching Hospitals? How will such directorates stop a Medical Officer faced with an emergency from howling for faster analysis of specimen at the laboratories? If indeed the MLS are committed to excellence as their colleagues in UK and ireland are, they will ask for better partnerships with pathologists. Hear what John o' Leary says

"Currently, there appears to be insufficient time for strategic thinking by laboratory scientists and physicians, with the empha- sis largely on turn-around times and productivity, reflected in new contractual arrangements for medical practitioners in laboratories. Most of us complain about increasing workloads, but in the process do not pursue or indeed present the requisite analysis in order to overcome this difficulty. This problem requires fundamental analysis and correction. Most of us encounter inappropriate testing requests, duplication of requests and inappropriate use of direct laboratory testing facilities where point of care testing would adequately suffice.
Medical staffing shortages, particularly in histopathology, have highlighted problems with recruitment and maintenance of staff, which for that discipline in particular may have serious repercussions in the future.
Inadequate funding structures for laboratories are universally encountered by all of us. It is common to see pathology and radiology services in hospitals/trusts competing for ‘residual’ finance"

Seeing that the future of Medicine is in Laboratory Medicine and Academic Pathology, the National Industrial Court should be informed that they have done a great disservice to the health of Nigerians. Future generations of Nigerians will no doubt pay for this miscarriage of natural justice.

I suggest that the biotechnology sector and reagent suppliers should continue to seek the establishment of strategic research links with pathologists. Though this is often pursued in an unstructured way with no specific operational guidelines for laboratories currently, specific Research & Development initiatives with third party companies are to be welcomed, because synergy must achieved between basic science, the clinical laboratory and the Pathologist. Furthermore, access to future technology platforms, chemistry's, etc. is to be welcomed, as this provides a vital spring board for innovation in our laboratories going into the future.
The National Industrial Court must note that what is needed is

1.More time for strategic thinking between Pathologists and Medical laboratory Scientists. The NIC has framed this crisis as a win or lose situation and have given victory to the MLS. The loser in the end is the Patient!

2. Pathologists must not aim at being overlords, as the Medical Laboratory Scientists struggle in Nigeria is actually a worldwide reality. It is a struggle for self determination. It is a struggle for relevance. It is a struggle of MLS to be seen as central and not peripheral. Pathologists can and should concede that their Medical Laboratory Science colleagues have a right to all these.

3. The MLS must henceforth desist from applying lethal force and falsehood in driving home their points. Accusing Pathologists of Quackery is a joke. The best and most renowned Pathology Laboratories in the world are run by Pathologists. Asking for directorate of Laboratory science won't help the patients. Claiming that they are being oppressed by doctors is falsehood as there are clear cut job descriptions. Where a Pathologists job overlaps with a Medical Laboratory Scientists, there should be workplace more Synergy and Partnership not more court cases at an Industrial Court that knows next to nothing how the Health Sector works.

Iroko Obasi ND
A public Affairs Analyst Lives in Abuja

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