University of Nigeria Research Publications

AGU, Leslie A. U

Aut

hor

PG/MPA/93/24638

Title

Industrial Relations and Government Funding in Teaching Hospitals: A Case Study of University of Nigeria Teaching Hospital

(U. N. T. H), Enugu

Facu

lty

Social Sciences

Dep

artm

ent

Public Administration and Local Government

Dat

e

March, 1999

Sign

atur

e

I N D U S T R I A L R E L A T I O N S A m GOVERNMENT FIJNDINC, I N T E A C H I N G HO93PITALS: A

CASE STUTIY 0)' U V I V K 9 P f W O F NIG R W A TEACYINO H09PITN;

(U.N.T.H), ENUGU.

A D I SSERTATION S!JRMITTED T O THE DEPARTMENT O F P U R L I C ADMINT Z?RATION I N P A R T I A L

WLFILMRNT OF T?X RmJJ IREM ENTS FOR THE D,%REE OF MASTER OF P U B L I C

A D M I N I S T R A T I O N (M.P .A)

U N I V E R S I T Y O F N I G E R I A , NSUXXA.

Thi s Disse r t a t ion E n t i t l e d I n d u s t r i a l Relat ions

and Goverhment Funding i n Teaching Hospi ta ls : A c a s e

s tudy of Universi t y of Nigeria Teaching Hospi tal

(u.N.T.H) Enugu i s w r i t t e n by L e s l i e A.U. Agu with

R e g i s t r a t ion Number PG/M'.P .A/97/24638, A B o n d i d s

s tudent o f the Department i n P a r t i a l Fulfilment of

t h e Requirements f o r t h e Masters Degree i n Publ ic

Administrat ion, Univerai t y of Nig er'ia Nsukka (UNN) , during the Academic yea r ?gg7/cj8,

~ . * ' . h

.-

Publ ic Admihintra t i o n (u.N.N). /

External Examiner

This study i s d e d i c a t e d t o my Mum,

Mrs. M.I. Agu, s l ~ d my Dad Engr. T.A. Agu.

The aphorism "heal th is wealthw is u n i v e r s a l l y

acknowledged. To' both t h e inr?i v idual and country,

h e a l t h i s of' utmost import'ancte i f any meaningful

progress i s t o be achieved.

Implementation o f h e a l t h programmes t o f o s t e r t h e

o b j e c t i v e i s a funct ion of the execut ive arm of

government, a l t h o u ~ h a u t h o r i t y f o r same comes from the

Teaching h o s p i t a l s a r e t e r t i a r y h e a l t h i n s t i t u t i o n s

s i t u a t e d a t t h e p innacle of t h e h ierarchy of the h e a l t h '

s t r u c t u r e s , These prime i n s t i tu t ions have r e c e n t l y been

bedevi l led by i n d u s t r i a l c r i s i s t h a t . is t ry ing t o l eave

them i n ruina,

This research work has, the re f o re , examined indus t r i a 1

r e l a t i o n s and government funding. The aim is t o f i n d out

how funding m i l i t a t e s o r enhances the at ta inment of good

h e a l t h f o r a l l Nigerians through i n d u s t r i a l peace.

It is a very thorough work, f ind ings of which w i l l

no doubt, i f implemented, stem i n d u s t r i a l c r i s i s and g i v e

t h e teaching h o s p i t a l s , e s p e c i a l l y the Univers i ty of

Nigeria Teaching ~ o s p l t a l , E n u ~ u a new l e a s e of peaceful

i n d u s t r i a l re la t ions s t a t u s and a t t endan t progress ,

LESLIE AGU*

I w i s h t o acknowledge with g r a t i t u d e t h e g r a c e

of and mercies of t h e Almighty God who sus ta ined my

e f f o r t s throughout t h i s programme.

Nly supervisor , D r . .Fab. Onah i s a very ha dworking

Academic, and he displayed t h i s a t t r i b u t e t o i e

utmost i n - h i s advice and .guidance t o me i n t h i s

research work.

. . Also, m y colleagueq were a bunch of amiable

i n d i viduals . Our exchange . of 1 deas and i n t er-ac ti on8

cannot be fo rgo t t e n eas i ly .

. TABLE O F C O N T ! T ?

CHAPTEli ONE,: INTRODUCT ION :

.......... 1 - 1 Statement of Problem.. 3

Object ives of the Study.. ....... 5

Signi f icance of t h e Study.. ..... 5

Scope and Limi ta t ions of t h e study..............^..^.^...^^^. 6

............. 1.5 L i t e r a t u r e Review.. 8

........... 1 .6 Research Hy~,~othes i s.. 52

....... . 1.7 Methsd of Data Col lec t ion 52

1 - 8 ~ h e o r e i c a l Poundotion o r ...................... frame work 52

. 1 - 9 C l a r i S i c e t i o n of key concepts.. 55

..................... Reference:. 59

vii

CHAPTER TWO: -- BACKGROUND INFORMATION ON THE CASR STUDY:............oo.ooooooo 63

2. A O r g ~ n i z a t i onril u t r u cture. . . . . . . . . 65

2.B. Teaching Hosp i t a l s a n Organiza t ions : 70

CHAPTER TITREE:

3.1 Data Presentat ion. . . . . . . . . . . . . . . . . . . 95

3.2.1 Budgetary A l l o c a t i o n Below W.H.0 .P re sc r ip t ion : . . . . . . . . . . . . . . . . . . . . . . 105

3.2.2 Lack of Modern F n c i l i t i e s and Poor maintenance ........................ 106

3.2.3 Annual Rudget Regarded as R i t u a l :. . 106

3 . 2 ( b ) S t a f f Motivat ion and I n d u s t r i a l Re la t ion ........................... 107

3.2.1 Teaching Hospi ta la a r e Hazardous . Institutioll~:...................... 107

3.2.2 I r r e g u l a r S a l a r i es.. . . . . . . . . . . . . . . . 1 0 7 - - 3.2.3 Allowances p a i d i n Ins ta lments . . . .. 107

'3.2.4 UoNoTeH s t a f f a r e f r u s t r a t e d . . . . . . . 1 0 8

3.2.5 S k i l l Drain.. .,.. . . . . . . . . . . . . . . . . . . . 108

3.2.6 Lack o f o p p o r t u n i t i e s t o Iny . complaints t o executives.. . . . . . . . . . 1 0 8

3.2(c) C i r c u l a r s , I n t e r p r e t a t i o n and Implementation.. . . . . . . . . . . . . . . . . . . . 109

3.2.3 Undue P u b l i c i t y t o Fringe Benef i t s . 109

3.2.2 , Dorn4.nation of UoNoToH by Doctors t o the Detriment of others...'. .. . . 110

n

v i i i

Page

2 . S t a f f welfare undermined by top Administrat ive s t a f f .

3. Z(D) Mismanagement of funds and monitor- ing of performance.. ................

'a .......... 3.2.1 Misappropria t i o n of fhnd..

3.2.2 '" Lack of e f f e c t i v e monitoring scheme:

3.2.3 Lack of e f f e c t i v e consu l t a t ion by ............ t h e . minis t ry of Health..

......... 3.2.4 Management Incapaci ta t ion. .

I l l

I I I

11 1

..... 3 . 2 ( ~ ) Findings from t e s t Rypothesis.. 11 2

3.2.1 Relat ionship Between Government fundinp and i n d u s t r i a l Relations.. .. 11 2 .

3.3 Irnplicnti on of f i n i i i n g s ' f o r Admini st rh t i v e E!.'f'i c iency and ........................ e f fec t iveness 113

CHAPTER Fax:

............ 4.1 Summary and Conclusi on.. 11 5

................... 4. 2 Recomrnenda tions.. 116'

.................. APPENDIX I MID 2,. 1 28

Thie work e t u d i e a i n d u s t r i a l R e l a t i o n s And Government

Funaing I n T e ~ a h i n e ; BaspitaJ.a, A aase s tndy of U n i v e r e i t y

ef N i g e r i a Teaoning U o s p i t a l UNTH, Enugu. The o b j e c t i v e of

t h i s s t u d y i e t o d e t e c t t h e oau~es of t h e c o n s t ~ n t r i f t

a n l i n d u s t r i a l r e l m t i o n a r i s e s i n t e a b h i n g hompitaln. I f

t h i s a r i e i e i s a l lowed t o p e r s i s t , t h e h e a l t h o f our people

already dwind l ina w i l l none - d i r e .

The c e n t r a l q u e n t i o n waa whether inadequa te f i n a n c i a 1

r e s o u r c e s t o t e a e h i n g h a ~ p i t u l n , hns Ireen t h o a n u m of

incessant e t r i k e a o t i o n i n t c a e h i n g hospi taI . s , Also, 5.8 t'hi.rr

i n a d e q u a t e f i n a n c i a l rtsaaurcea r s e p a n e i b l e for ]-OW motivat 5.clr1,

and t h e maea exoduu of s t a f f o f t h e t e a c h i n g h o o p l t a l n .

Hypotheses were formulated . Qnestionne.iren were

adminfrstertd t o a nample of 200 menbere of t h e honpi . ta l

s t a f f . Many key o f f i o e r a o f t h e h o s p i t a l were in terviewed.

R e l a t e d h o a p i t a l and o t h e r r e o a r d e were utud.iet3 and analyaed..

Quee t ionna i rea w i t h open and c losed, q u a e t i o a s combined was

a l s o used f o r t h e ancalyeee of problem under in i renl igat : ion ,

We a l s o used e imple percenthge t a b l e a t o p reeen t and analyse

eome of t h e d a t a c b l l e c t e d .

The a t u d y r e v e a l e l t h a t inadequa te funding of our

t e a a h i n g h o e p i t a l e i e r o a p o n e i b l e f o r our t e a c h i n g h o s p i t a l s

inabSl . i ty t o provide malern f a c i L i t i e ~ f o r t r e a t m e n t o f

aat i en te , research, diagnoeia and teaahing, pay s t a f f

~ a l a r i e s and allowanaes on time, e tc . Also, low funding he13

been revealed as the major aauee of industrial. c r i ~ e s i n our

teaching hosp i ta l s . The workers currently working i n the

teaahtng hosuita : ? hulra very 3,aw morn7.a '5sc3va?t of $ n m d e q ? ~ ~ t r

f in~lncee.

Baaed on the above f indings , reoommendatione ware mm3e

which w i l l nci cnly a t a l l e t r i k a e but improve rclnt ionehfp

between s t a f f , management and government.

CwAPTER ONR

INTRODIE TIOI r

Baohlround-and Need of the ~ S t u d x 9

Men a r e r a t i o n a l beings endowed with i n t e l l i g e n c e

t o produbs and i nven t t h i n g s t o r o s t e r t h e i r l ive l ihaob .

No man ia an i s l a n d un to himself. Man is e s s e n t i a l l y

grsgarioue and this inherent q u a l i t y brings about

fnter-aot ion, in t e r -aa t lon produaes harmony and 6ometimes

a o n r l i o t ,

I n an organisa t ion , people of various cha rac te re

an& views work t oge the r , everyone wlth his own i n t e r e s t ,

I n such s e t t i n g , mode o f , d i s t r i b u t i n g t h e b e n e f i t s i e

epec i f i ed e i t h e r t o avoid c o n f l i c t or t o e e t t l e i t ,

Government l a s t % 11 t h e major f o r c e i m p o l i c y

f o ~ m u l a t i o n , It provides t h e envi ronnent and set^ t h e

b a l l of development r o l l i n g , It a l a o r e g u l a t e s the

ayatex- and a p p l i e s sanct ions , Among the f a c t o m

d i r e c t l y i n p i w i n g on development i s heal th . Bea l th

i a a major iaeue i n developmant. It is an eaknowledged

development indica tor . This means t h a t a eeuntry

t i l l e d with 8ick paople is not develope8. It equal ly

means t h a t gover~lment ahould give s e r i o u s a t t e n t i o n

t o hea l th ao t h a t t h e c i t i s ene w i 11 be f i t and

knowledgeable t o pursue development objeat ives and

accomplieh them,

The p o l i t y 18 a eysten and when the e r a of o i l

boom elapsed, t h e economy of Nigeria became depressed

The depreseion ane. aagill-over e f fec t8 i n t he hea l th

sect@? which e t a r t e d t o witness increasing eubvention

i n t r i c k l e s and a t a r a t e very much l e a s than the

I M h t i o n a r y rate, The t c ~ c h l n g hospi t a l e fortune8

a t a r t e d dwindling, Our expert medical mm-pomr which

were even having r e f e r r a l case8 from London, e8peclal lg

in t he Univereity of Nigerici Teachin& Hospital (u,w,T,H),

mugu eoon saw the a k i l l e d personnel and the p r ide of

the natf on'eeexing greener pastures outside t h e aountry.

M8sa t i s f ac t ion among t h e s t a f f b e c a ~ s t h e vogue

aince t h e management coulc? not meet t h e i r ob l iga t ion

t o the s t a f f , I ndus t r i a l a c t i on became r i f e within

the teaching hoepi tals. The doc tore , nuraes, para-

medical and non-medical 8 t a f f a t one time o s t h e other

had gone 'on s t r i k e , The e f f ec t is suffering , f r u s t r a t i o n and death f o r the c i t izene, Inadequate

1

funding meant t h a t teaching h o s p i t a l s had t o revlew

t h e i r charges almoet beyond the reach of the

v u l n e r a b l e common man. The s i t u e t i o n e s c a l a t e d t o a

c r e s c e n e ~ where t h e U.N.T.H f o r example was abandoned

t o r a t s , ca ta and 3nakes. Snakes even took over t h e

opera t ing t iha t reso

Effort8 by government t o cushion and e f f e c t s of

the hardship by review o r s a l a r i e s and allowance8 of

staff eeem t o compound t h e problem of induutr i ta l

a c t i o n e i n c e t h e government usua l ly reneged i n pmvid ing

s :u? l i c i en t f inds t o pay t h e approved new ratee.

It i s , t h e r e f o r e , t o find o l l t how government

mndinpr ha8 inf luenced i n d u s t r i a l a c t i o n i n teaching

hoapi t a l s with p a r t i c u l a r r e fe rence to the U.N.T.R. , 8

FJnugu t .mdt has spurred t N a study,

1.1 Staternant of P r o b J s .

Balogun M o J o (1 986 :23l) I n reviewing the.problems

of f inance i n Pub l i c i n s t l t u t i o n a observed t h a t "The

i rony of the e i t : i a t i o n l i e s i n t h e flsct t h a t while some

organiea t lona have enpugh resources t o misa l loaa te ,

othem opera te on ahoe striw builsf~t. The Unive r s i t i e s ,

the Teaching Hoapit a's a r e amow orpanis a t lons t h a t

could do wl th increased c a p i t a l a l l o c a t i one and

add1 t i o n a l sources o f opera Sinir; revenuew.

We, the re fo re , ask t h e ques t ion whether t h i s '

inadequate f lnanc i a 1 resoarcee t o teaching h o s p i t a l s ,

regarded as soof a1 s e r v i c e s i n a t i t u t i o n s with the

capac i ty t o renfler f r e e s e r v i c e has been t h e cause of

incessan t s t r i k e mction i n teachi.ng hoep i t a l s i n t h e

l a s t t e n years ,

Also, i s t h i a inadequate f i n a n c i a l reaourcea

r e s p o n ~ i b l e f a r t h e low motivat ion of workers i n t h e - +

teaching h w p i t a h .

I n add i t ion , i s t h l e - inadequacy o f f i n a n c i a l

resources r e8pons ib le . fo r the mass exodua o f s t a f f o f

t h e teaching hospi t a l a . This is genera l ly known a s b r a i n

The problem is t h a t t o serve the c i t i z e n s wel l

the teaching h o s p i t a l s need f u n 6 . They need h ighlp .

motivated s t a l l f o r t h i s purpose. A s i t ia t ion where

t h e s t a f f of teaching hoep i t a l s go on s t r i k e f r equen t ly

10 determen-i.al t o t h e . h e a l t h of t h e c i t i z e n s , It even

d r a i n s government f i n d s e ince enforcement of "no work

no payn has not r e a l l y worked i n Nigeria. This l a due

t o the f i c t , t h a t t h e go'vernment r eac t ion t o t h r e a t s of

i n d u 8 t r i a l a c t i o n l a more o r l e s s i n d i f f e r e n t . The

c i t i z e m s u f f e r , t h e e t a f f suffer, i n t h e and,

gdrernment ends up paying t h e s t a f f i o r wi

a o r k not done,

Thoae who die as a r e s u l t of i n d u s t r i a l a c t i o n can

nevm come back t o l i r e and their con t r ibu t ion t o

development 1 6 l a a t ,

1.2 O ~ t i v e s of t h e S t u w .

The ob3ect ives o f t h e etudy i s t o e a t a b l i e h

whether government funding has any e f f e c t s on

i n d u e t r i a l r e l a t i o n 9 i n teaching hospi t a l e . If s o ,

we shall tl-y t o e s t e b l ? nh ivh++h-?, t h e e f f e c t s a r e

p o e i t i v e on negative.

I n o t h e r wFd8, in what way o r my8 has t h e

govarment funding helped o r worgen the i n d u s t r i a l

r e l a t i o n e between t h e mmagernent nnd labour i n o u r

teaching h o ~ p i t a l s , 13 add i t ion , t h e o b j e c t i v e o f t h i e

research is t o so lve problems and c o n t r i b u t e t o knowledge

g a n e r ~ l l y . Also i t is t o de tec t t h e c a u s e s of the constant

rift and i n d u s t r i d r c l h t i o n c r l s i .;: i n teaching hospi tc le .

. >

1.3 Si~:nLficance of t h e Study,

One o f t h e acknowl.ea&ed importance of r e sea rch

as a scientific inqu i ry ~ i m e d a t so lv ing an i d e n t i f i e d

problem through i n t e g r ~ t t ed d a t s -toll cc t ion and data

a m l y ~ i s methoCs i a t h a t i t col:tributes t o knowledge.

Our hypothesis conjectuPea t h a t government fbnding

inf luences indu s t r i a l r e l a t i o n s i n teaching hospi t ala.

T h i s s tudy w i l l prove o r Cinprove it. The etudy w i l l

then show the kind of e f f e c t f b n d l q ha8 on i n d u s t ~ l n 1 .

r e l a t i o n s so tha t recommendptions made from thle

proven 81 t u a t i o n w i l l he lp emerli o r a t e the s i t u a t i o n

and u l t i m a t e l y p o s t e r i n d u e t r i a l peace end s t a b i l i t y

within teaching hoepl tal8. It w i l l a l s o he lp o t h e r

c o u n t r i e s having some pwblems p r e v d e n t i n the

Nigerian teacMng hospitals t o borrow a leaf fmm our

f ind ings a M prevent t h e p i t f a l l a we have a l r eady f a l l e n

i n t o t o +be c . h g r i n of our system anc! citizens.

Eseen t i a l ly , t h e study w i l l help r e sea rcher s

researching on t h e same o r re la ter ! c a s e study. The 8tuUy

w i l l a180 he lp t o e x p ~ n d o r increaae l i t e r a t u r e .

1.4 S c o ~ e a n d . m f t a t i o n s of t h e 3 ' .

While one w u i d l i k e t o do c e r t a i n thinga, one

always f i n d g w unant icipo t e d end a n t i c i p a t e d problem8

coming between one and one '8 objec t ives .

The ~ J t e r of' Publ ic AdmirAstrcition (M.P ,A)

progremme is f i l l e d with a c t i v i t i e s , One, t he re fo re ,

f i n e s cneself f ~ c i n p pauc i ty of t ime t o grapple wi th

Both t h e academic, seminar and r e sea rch works. Apsrt

from one t r a d e union i n U.N.T.K, other8 have e c a n t r

records. The .forst i s t h a t %spite conetant s t r i k e s

the unions do not keep recorda. The e f f e c t t o facan

through t h e i r records and ex t r ec t w h a t one can find

was ardoua, Most t r a d e union ofiYbciale were angry

when I approached them for interview, To reach Fomcr

management ~ t o f f wa.8 not easy e i t h e r , They were major

mctors and t h e i r c o n t 3 but ions would have been of

immense enlightment. . -

As expected, s t a f f already f e e l i n g exceedingly

f r u p t r e t e d not ready t o complete ques t ionna i re

on research i n indus txha l re lat . ions. They want t o 8 4

leave t h e s e r v i c e if they,can fl nd something else- t o

do'o '. 1 ,

The teaching h o s p i t a l s hove no co-ordlnating

o f f i c e J where a r t i c u l a t e d data could be reached. This

and the o t h e r hand1 capo and conetrrainl; s enumerated

p laced g r e a t obsteclee on the r e sea rch study.

a

1.5 L i t e r a h m e Review.

(A.)-L, Innnztance of Human Resourcen i n O r g a n i ~ a t i o n c -

A n~fion ha8 no m*~nlng without people. S o c i e t i e s

and na t ions a r e g i v e n i d e n t i t y by t h e humah beings

i n h a b i t i n g them. The world i t s e l f had meaning only

when God. es tab l i shed s t r u c t u r # e s and f i n a l l y c r e a t e d

human beinps t o occupy, tend and p roc rea te and u t i l i z e

t h e s t r u c t u r e s t o f u r t h e r c rea t ion . This is confirmed

by Bollin/Fontano i n t h e ,Good news Bible (1 98685).

nThen God aaid and now we w i l l make human

beinga; they wi 11. be l i k e ua and resemble u s . . .. . . . Ood looked a t e v e ~ y t h i n g he had m d a , and He was very

pleaeedw.

S o c i e t i e s and mt Aons are p o l i t i c a l e n t i t i e s

e s t a b l i s h e d t o perform c e r t a i n f unctlona a d f u l f i l

c e r t a i n o b l i g a t i o ~ \ - . S x h f ~ l n c l t i o n s inc lude i n t e r n a l

s e c u r i t y and o r d e r l i n e s s , enforcement of d i s c i p l i n e d

behaviou~*i.,and development of the e n t i t y .

The funct ions cannot be accomplished without

people manifesting a n d a c t u a l i z i n g t h e i r s k i l l s and

mental power. Human beihgs a re , the re fo re , the cream,

hub and engine of soc ie ty , They can make o r wr i t a

progress , Perhaps, t h a t was the reason why Ohiwerei

F e l i x (1996:i 8) aff i rmed i n t h e Burrday Vanguard t h a t :

"Our e x c e l l e n t results would not have been poss ib le of course without t h e d i l igence , hurdwork and l o y a l t y of t h e

' company's employees. Conscious of' t h i s t h e management sought t o improve wages and s a l a r i e s which took f u l l account of i n f l a t i o n . ,Conditi on8 of s e r v i c e were a l s o improved a3 necessary cont inous t r a i n i n g continued t o be emphasized and i n the y e a r under review, over 700 employees a t tended courses while a. f u r t h e r 1 2 were placed i n Advanced Training coureeaN,

The a e s e r t i o n o f M r . Ohiwerei f o r t h e Nigerian

Breweries' PLC was re-echoed by t h e Chiorrnan of Nest le

Foods ( ~ i g ) PIX: - Dor e - Edwin George (1 996 r .18) :

T h i ~ company cont inues t o r e l y on our s t a f f who a r e s a t i s f a c t o r i l y adapting t o technologica l changes and lmprovi ng t h e l r s k i l l s , The company cont inues t o i n v e s t i n manpower Training and

' development, Management employee r e l a t i o n s remain c o r d i a l ,

While the importance df rnnnpower expressed

above may b e Been prom a micro and p r i v a t e s e c t o r

p o i n t . of view; from a wider persy e c t i v e Babangida

(1991 :xix) noted i n h i s Budget speech tha t : - .

*We reco&nize t h a t a c r u c i a l pre-requie i t e f o r a success fu l recovery proflramme is , the existence of a motivated, product ive and e:.'fic i e n t woric force . Our work force c o n s t i t u t e s the human c a p i t a l oi' t h e nation. As a c t i v e ingred ien t s of a l l t he factors of' product ion human c a p i t a l playa R moPe irnportunt r o l e than phys ica l c a p i t a l w .

Al ln these p o i n t t o the f a c t t h a t no organ i sa t ion

can do without it '8 human resources. Modern Personnel

and Human Resources Malagement evolved a s a d i s c i p l i n e

t o manage and co-ordinate . the a c t i v i t i e s of human

beings within an o rgan i s t ion to make e f f k t i v e t h e

b l ind and conglomerate of mul t ip le s k i l l s ava i lab le .

Balogun M. J. ' (1 9 8 3 : ~ 68) a l s o e s s e r ted:

*An important and perhaps the most s t ~ a t e g i c and independ-ent v a r i ~ b l e i n any organis a t i on in manpoaer resource. The c a l i b r e , morale and motivat ion of t h e work f o r c e I n an o rgan i sa t ion t o a l a r g e extent determines how successfuJ. t h e o ~ g a n i s a t i o n w i l l b e i n achieving i t ' s ob3ectives. The c r u c i a l r o l e of r-mpowar explains t h e emphasis f r equen t ly p l eued on personnel management ana- Indua t r i a l ' Rela t ions process i n n ~ g a n i a a t i o v n.

Peter Drucker (1 988: 5lc) joined thoo e already quoted

a u t h o r i t i e s i n emphasizing t h a t :

8 ".. .. . t h a t a business e n t e r p r i a e is c r e a t e d and managed dy people orld not forces-economic f o r c e s s e t l i m i t s t o v ? b t management c a n do, They c r e a t e oyportuni t lee f o r management 's ac t ion , B u t they "do not by themselves determine w h u t a bus irless is o s w b t i t d&ew. . ..

To a l a r g e extent , one can R R Y without f e a r of

contradiction t h a t Nigeria and o t h e r t h i r d World

coun t r i e s l a g behind because t h e i r h m n c a p i t a l lack8

what Olewe B.N. (? 995: 31 2) c a l l e d nadminis t ra t ive

c a p b i l i t y " which t h e a b i l i t y t o achieve the ob jec t ives

of development through organis a t i on. Nigeria lack3 thb t

s k i l l e d maniower in/they a r e c i t h e r not empowered

through p rov i s ion of i a c i l i ti es f o r yerformanc e o r

they aFe i n s t r a t e d and f o r c e d t o emigrate t o o t h e r

f e r t i l e environments where t h e i r con t r ibu t ions are

b e t t e r appreciated,

One may ~ s k why Nigerio n h o u l d be planning t o

import Cuban doctors i f the conducive environment is

c rea ted f o r h e r OHn nat ionaln 1 x 1 t h u t profession. We

do not laok doctor8 and medical personnel. The

a r t i f i c i a l s c a r c i t y is t h e r e a u l t of s k i l l d.rain,

Saudi Arabia snd o t h e r ' Middle East Countries a re not

b e t t e r endowed t h n Nigeritr, Our problem has been

Hal-edmini~ t r ~ t i on and extreme Rrec !d ines~ on t h e s i d e

- .

of' those.,t t h e helm of !a f fa i r s .

Some recognis ed a u thor i ti e s have def ined

manqement w i t h n atrong human content. For i n s t ance ,

Roljemary Stewort (1962) adw i t as "deciding what

should. be done and g e t t i n p o t h e r p e o p l e t o do it. I n

same vein, Dr. E.A. Iwu (1 990) emphasized t h e need

f o r managers t o blenc! ~ n d synchroriise t h e i r b e l l e f a

with thoee of t h e i r subordintlte if they must achieve

orgnni Ra>ional. ~ o e l s.

The Japanese envoy M r Shihoto who W B 8 apeaklng I n

Sunday Champion of J u l y , 1 0 t h 1996 asae r t ed t h a t ~ a ~ o n e s e

ci t l z e n s i n Niperia have reduced from about 300 t o

66; i n the last f i v e years because , the re was l i t t l e

o r nothing f o r them t o do. He s t a t e d t h a t the HonCa

A~aelnbly Plant I n Ota, Ogun S t a t e has dwindled from

a product ion o f 300 motor cyc les t o j u s t 90 p e r month,

Addi t ional ly , t h e r e i s no mnrket fop the l i t t l e

produced, S ince these 'men w i l l be mope product ive a t

home.they were dthdrewn. T h i s i s t h e a c t of' a

courltry uhich vslues it'^ manpower and what they can

achieve f o r t h e i r corxntry.

The importrnce o f manpovier could be seen on l t ' e

expor ta t ion which earn t h e ehport ing countr l es f o r e i g n

'3 ,

exchange and a l s o enhrc.l;es i t s esteem i n t h e community

of na t ions , Nigeria i s doinc. tNs under i ts f o r e i g n

p o l i c y t o w ~ r d s Africa on the i n i t i a t i v e of exepreeldent

Ibrrahim Babanpida, Nigerian Pmfeas iona l s are

dlapatched t o n e e Q Afr ican coun t r i e s f o r research ,

t e a c h i w and o t h e r works, They improve t h e i r sk!.ll,

ea rn fo re ign exchawe and advtinc e t h e i r country ' 8

B, Mwjor&tprs i n t h e I n d u s t r i a l Relotions System and their R o l e alKi d.i;lbkiLt:S.

There a r e t h r e e recopniaed a c t o r s i n t h e i n d u s t r i a l

r e l a t i o n s syatem, Ubeku A.K. (1 975:96) exglained t h a t

"the t h r e e a c t o r s tope the r c r e a t e t h e ~ e b of ru les

~ o v c r m t h e work p l a c e end work communityw.

Theae t h r e e a c t o r s srp t h e workers fine t h e i r

unions, the government and Its agencies and t h e

employers and t h e i r aseoc1srt.l one,

Labour i s recopnised a s tl f ~ c t o r o f production,

Its presence Is , ' t he re fo re , i n e v i t a b l e i n any work

131~ce , Labour, t i i t h mental a n d phys ica l and products

o f huam bxertion, I n t h e some vein, entreprenuership

has cone t o be acrorded the Same s t c t u s a8 labour ,

It i s a factor o f production, Whether we view e n t e r p r i s e

from t h e p o i n t of view of risk bearinp, investment,

c a l c u l a t e d riak-tnkirg o r i n the opinion of echeumpeter

' . 14

as "c rea t ive des t ruc t iontc , i. e. in t roduc t ion of

innovat ion hinped on new ideas , new technology e t c ,

o r J.9. says p o i n t of vie^ i . e mobi l iza t ion of

resources from l e s s t o nore proc!uctive a reas , t h e

f a c t remaim t h t i t i s a l s o a p r o d r t of human

exert ion. So wonkera are f o r c e s t o be reckoned

wf. t h i n t h e i n d u s t r i a l r e l a t i o n s system. They provide

the i ~ b o u r needed t o provide goods and se rv ices which

s o c i e t i e s r e q u i ~ e f o r exis tence.

. -/ 6. Workers and Trade Unioq

A s orpranised group, labour is un i t ed and given

c o l l e c t i v e s t r e n g t h by t r u d e unions. According t o

t h e Trade Union Decree (1 973 :31) , a t r a d e union is

any combination of workers o r employers whether

temporary or permanent, t h e p u r p o s e of which t o

r e g u l a t e the t e n m nnd corlditions of employment of

workers.. . . tv

Formation of t r a d e union i s l e ~ i t i r n a t e a s i t is

both provided f o r i n t h e c o n s t i t u t i o n of t h e Fedral

-- Republic of Nigeria, 1979, p a r t i v uml e r freedom of /,

a s s o c i a t i o n thus:

"Every person shrll l be e n t i t l e d to assemble f r e e l y axd a s s o c i a t e , ; i th o t h e r persona, and i n p a r t i c u l a r he may form o r belong t o a p o l i t i c ~ l p a r t y , t r ade union o r any o the r aSs0ciat lon f o r t h e p r o t e c t i o n of h i 8 i n t e r e s t o

AS a con tinuout3 a s s o c i a t i o n of workera, wage/

s l a r y earners f o? the puri)ose of maintaining o r

inproving t h e c o n d l t i s n s (jr their workiw l i f e , a

t r a d e union protect^ t h e i n t e r e n t of workers, .; / -

D o Functions and Qelc of Trade Union?

(a) P a t e r m l. p r e t e c t i on t o workera.

( 5 ) Frame-work for c o l l e c t i v c bargaining.

( c ) Education of t h e workers a8 t o the i r r i g h t e ,

( 8 ) They l i a i s e with mana~?eaent f o r p r o d u c t i v i t y

improveaent , a m i t y and o rde r l inese i n t h e

wark plmcc.

( e ) They run b u s i n m a l i k e grocery shops where

members buy th ings as nubsidized ra t e s .

(i) They run o t h e r b u o i n e s s to e n r i c h t h e i r purse.

The Nigerian Labour Conuress owns t h e labour.

Transport Ltdo The Senlo? Sta f f Associa tion

of U.N,T,H, runs a mass t r a n s i t o u t f i t ,

( g ) They provide scholarsh in to the c h i l d r e n of

their membera,

(h) They pay mmbers d l r ing prolonged s t r i k e s ,

Item (h) i n p a r t i c u l a r i s a short-coming i n the

Nigerian t r a d e union Bystern i n c o n t r a s t t o those at'

developed world, T h i s a b i l i t y t o pay worker8 makes

government of t h e s e coun t r i e s and the emgloyers t o

t a k e t h r e a t o r notice of s t r i k e s s e r i o u s l y because

t h e workers r e a l l y have nothing t o lose, I n t h e

cu r ren t Academic S t ~ f €' Union or Univerui t ies imbroglio

i t t r i e d t o pey i t b menkeru h i 1 . e the e t r i k e l a s t e d i n

some Universl ties, i , c , Universi ty of Joe.

Trade Uniono as a c t o r s in the sys t e n help In

f ! y + t i n g injustice and inequity i n soc ie ty , For

ins t ance , the Natl onal Union of Petrolerim Engineers

(?lllPENG) &d petroleum and Gan Workers Asnociation of

Nigeria (PF~GASSON) strike of 1994 was p o l i t i c a l l y

motivated, I t wanted t o dse c o l l e c t i v e power and i t s

occupation of t h e core of? the economy ( o i l ) t o bend

t h e government t o address She June A2, 1993

Trade unions a r e s o ~ ~ t i m e s allowed t o form . 9

p o l i t i c a l ps l r i t ies . There i s t h e Labour Pa r ty of

Br1tmll.n PE a n example, This i s dependent on the

ideology governiw a p a r t i c u l a r p o l i t i c a l system.

In the communist and populer soc ia l i sm blocks no

a p c e i a l r o l e is a ~ s i g n e d t o t m d e unione.

I n Nlgerla, at tempts to form p o l i t lctll p a r t i e s

by l sbour has alwaya been f r u s t r a t e d by t h e power

c o n t r o l l i n g t h e po l i ty . I n 1963, the Labour Movement

formed t h e Socialist Workers and Farmers Par ty (SWAPP),

It wars not r e ~ i s t e r e d eventur:lly, The Nigeria Lr~bour

Pa r ty forrnt.8 by lobour under the Babawide adminletra-

t i o n ale0 was not r e g i s t e r d , Under t h e on-going

t r e n s l t ion proprbmme, Lo bour has taken t h e inl t i a t i v e

again by Pascal Raf'yau.

Labour ant? p o l i t i c s hnve always gone hand f n hand,

I n a r e c e n t intc,~.view, t h e doyen o f labour i n Nigeria

Pa Michael Imuodu confirmed IR Sunday times of October

12, 1990 t h a t he WRS workinp hnne i n hmd with l a t e

Right Honourable, Dr . Nnamdi Azfkiwe when he, Imuodu l e d

t h e 19155 general s + r i k e f o r which he wes eventual ly

impresone8, Sos a p a r t *om t h e apparent pay r i s e f o r

workers, l abour was d i r e c t l y f igh t ing f o r Nigeria ' e

indep endenc e.

Trade uniona a luo enp;npe i n i n t e - n a t i o n a l

a c t i v i t i e s o rgan ised by t h e I n t e r n a t i o n a l Labour

Organ i sa t ion ( I . L . ~ ) Organ i se t ion of Trade Unions i n

Africa (O.A.U.T.~). They form p e r t of t he t r i p a r t i t e

team and Niger ie i s a s i g n a t o r y t o t h e I.L.O.

conventions.

Trade unions p rov ide s o c i a l i n t e r a c t i o n f o r t h e i r

members i n t h e r o r ~ i , of' end of t h e year p a r t i e s . The

forum a n d o l f i c i e l r a l l i e s p rov ide t h e conducive

environment f o r sugpestionb3 f o r improving t h e syatem.

Members o f t h e Man~gernti~t ere, i n most cases ,

p r e s e n t dur ing the occasion anC m r r y t h e vital

aupec t s of the i n t e r n c t i o ~ homc f o r u t i l i z a t i o n .

#

19

E, @vernment and i t s Apencies.

According t o D r Osaro, i n present ing a seminar

i n Universi ty of Benin Stetod t h a t a government

i e made up o f those e l ec ted by t h e people t o govern

them and run t h e a f f a i r s of a p o l i t f c a l ayetem,

I n Nigeria nnd most Afr ican coun t r i e s , power I R a l s o

acquired by t h e "o r e OF the pun i n coups d e - t ~ t ,

The citizens accept such s i t a t i t i o n by co-emion o r

subtle a c q u i s c ~ n c e , Government u l t ima te ly provides the

enahling environment f o r development of the s o c i e t y

throuph r u l e s , r e ~ u l ~ t l o n s , l awg, policies, e s p e c i a l l y

d i s t r i b u t i v e type". kccord i r i t o him ( D r Osaro) - the

f'unctlone and roles of goverrlmerrt i n orpanised labour

and work environment include: -

Recopni t i o n of' t r a d e unf-ons and t h e i r l e g a l i t y ,

mode of r ep ; i s t rg t ion are tll covered i n such laws a s

t h e cons t l - tu t ion , the Trade. D i ~ p u t e 8 Decrees of 1968,

1969, 1973 and 1973.etc.

The work in en'^ Compen~etlon Decree No, 17 of 1987

which covered such i s s u e s a s s a n i t a t i o n i n t h e work

environment, indus t* ia l aaf e t y , pay end e a l a r y system8,

e x p l o i t a t l ~ n of labour, collective b a r ~ e i n i ~ , e t c . .- a r e a 11 provided a~ laws by t h e government.

E 2 Major ~ v l o y e 2 r ~ . ,

The government i n a major employer and t h e r u l e 8

a p p l i c a b l e t o government workers of t e n ee rva e e - a buaia

f o r o t h e r p r i v a t e employers t o f i x uelaries/wages and

r u l e s f o r t h e i r own w o m e r s . I n 1942, the Babangida

admin i s t r a t ion d e c e n t r a l i aed t h e co . l lec t ive bargaining

fo r wages bnd s t a t e governments were urged t o gay t h a t

they could a f f o r d bearing other needs i n mind and

through c o l l e c t i v e bargaining, Minimum wage W a 8 f i x e d %

at var ioue times by the Shagari and Babangida

adminie t r a t i o n a ,

g.3 Emer~ency Conditions, - Under emergency cond i t ions , e s p e c i a l l y those

p r e c i p i t a t e d by t r a d e unions, t h e government can enact

an t i - labour laws t o r e s t o r e normalcy. The g l a r i n g

example at' .NUPWO and PE?WASSON ha8 a l ready been c i t e d ,

21

var ious adminis t r w t i ons mi l i ta ry and c i v i l have

reformed o r reorganiaed the umbrella union, Niger ian .

Labour Coigress (N.L.~) . A. S.U .U. has been groecr ibed

a number of t imes; same app l i e s t o o t h e r powerful unions

l i k e Aseociatlon of Resident Doc to re and Nigeria Hedical

Aesoc itation, Although theae a n t i-labou r enactment e

have been o v e r t l y condenrned aa v io la t ing i n t e ~ n a t i o n a l

e i t h e r by the need t o maintain IB w end o r d e r o r as

cont ravent ion of' ex tant and s u b s t a n t i v e laws, It 18

an thia b a s i s tha t t h e National Electric Power

Authori ty e t a f f were imprisoned. It is t h e same with

Chief Frank Kokarb, Somehow, government has a way of

providing i t a e l f r i g h t h e n t h e r e i s i n t c m n t i o n a l

v i e i t a t i o n e . The I.L.O. and O A U T ~ U h v e kept q u i e t i n

the face of Kokori's continued de tent ion , While t h i s

18 on, Nigerla waa g iven ~ p e c i a l p o s i t l o n i n t h e I . L . 0

this year.

When'governrncnt i a n o t dir-ect ly involved i n labour

matters, i t s a g e n c i e ~ do 80. Sorne of t tie sgencies

h c l u d e the Federal Ministry of Labour and Product iv i ty ,

f i r ~ t , e s t a b l i u h e d i n 9938 and Lnbonr Inqrec to ra te

22

and made a Departmmt of Ubour i n l942, Apart from

entwine; t h a t lebour lawa aspeci ally t h o ~ e on n o t i c e

o f s t r i k e s , s t r i k e i t s e l f , se t t lement procedures,

labour adviaory counc i 1,s a r e observed, the Ministry

of U b o u r and Product iv i ty a l s o opera te employment

agenciee end o r g a n i ~ e s t r a d e t e s t and i a s u w c e r t i f i -

c a t e s t o a r t i s a n 8 end craftsmen i n both t h e p r i v a t e

and p u b l i c s e c t o r s of' the economy, I t , the re fo re ,

regul p tes s t a n d o r d ~ ,

The0Minia t r y alao employ labour inspec to r s ,

indu e t r i a l s a f e t y of f i c e re ; i t appoint 8 medititora and

c o n c i 2 l i a t o r s f o r settlement of d isputes . Theee

c f f i c l s l a help t o enaure e a n i l y i n t h e work place.

E 5 Le b our RoLi,ci,t:g. These a r e pcnerul.ly m d e by the government, The

Nati onal Labow Policy o f l975, f o r i m t a m e por t rayed

the government a s puzlsujmg a pol icy of nguided democracyn

i n labour mattera aimed a t ensuring t h e promotion of

labour/managemeat ca-cparatl on and c o m u l t a t l o n a t

appropr ia t e levels, Guided democracy e n t a i l s both

l a i s s e z f e i r e and same i n t e r fe rence , For ins tance ,

t h e unions 'and empl-oyers d e t e m ~ i n e thed r a f f a i r s by

mutual co-operation u n t i l the f u t i l i t y of mediatiorr,

The government v i ~ the Federal Ministry of Labour

4

in tervenes by conc i l l i o t i o n , a rb i tration, National

1ndw triAl Cour t . and spec ie 1 ptrnels of i n q u i r i e s ,

p r o s c r i p t i o n , buns arrd enbargcee , e t c ,

E.6 wLerna t i o n a l A c t i v i t i e ~ ,

To complemer~t th e t r i p . s r t I t a rele t i o m h t p i n

labour , management r e l a t l o n s , t h e government aleo

prnr t ic ipa tes i n t h e conventions of t h e 1,L.O. and

OAUTUU ao they a r i ~ e , I t is s l ~ o expected t o adopt

and enforce these 'conventions * i ch i nva r i ab ly

embrace t r a d e union education; Currently, t he re ex i s t e

i n Nigeri a, the Natlonel I n s t i t u t e f o r Labour Studiee

In pursuance of these o b j t c t i v e u ,

As providers of the environment through investment

and consequently employment, eniployers expect t o t - (a') Get a return on the c a p i t a l employed 8 u f f i c i e n t

to e'trart new end more money f o r investment t o - enable t h e venture grow.

(b) Recrui t , t r a i n and retain a labour f o r c e t h a t

can a s s i s t the f i r m achieve i t 8 mission and

objectives,

( c ) Create a conducive i n d u e t r i a l c l ima te t o foster

e t s b i l i t y i n t h e work place. This is el t h e r

done by l i s t e n i n g t o labour sugaes t ions ,

welfare p e y l n ~ ; nttequm tt? wages

f a c i l i t i e s ,

(d) Remain competitive in

Eabodr r e l a t ionehip w

end prov!.ding

the induutry.

on i n t e g r a t i v e , . d i s t r ibu t ive and a t t i t u d l n a l s t r u c t u r e . *

b a k a i n i n g , Ben j ~ m i r i Selekman ( 1 958:22? ) , A l l these

b a ~ g a i n i n g systems o r e based on ti..e f a c t t h a t t h e

i n t e r e u t of labour and rnane~emenl coalesce and cohere

a t some point o r tile o the r ,

Trade unfons which had already been def ined

in t h e con tex t of t h e 4913 Tr*ade Union Dtrcree a l a o

covers employers. So tht: Nigerian Employers'

Consu l t a t ive Associa t i o n ( N . E . c . A . ) which is t h e

umbrella ass@ociet ion of e l l employers i n t h e p r i v a t e

inc luding some government i n s t i t u t i o n s is a t r a d e

union, providing p a r a l l e l l i n k wi th t r a d e unions,

Chijiolte 0, (4996:2). The r o l e of employera is b e t t e r

seen *om ~ b z i e Xgweonu ('1980:145) a b s t r a c t from N.E.C.A

bnd-book v1z:-

To a s s i s t i n order ly development of i n d u s t r i a l

r e l a t l on6 i n Nigeria.

To ensure t h a t employers t a k e uniform act ions on

matters a f fec t ing the1 r i n t e r e s t .

To l l? i se w i t L povermenta on v i t a i l e s u e s that

might a f f e c t employera.

T r i p a r t i t e r e l a t i o n s h i p i n i n t e r n a t i o n a l labour

matt e1.8.

Ca l l ing r e c a l c i t r a n t members t o o rde r by making

them comply with e x t e n t laws.

Education ana t r e i n i w : of i t s members i n i n d u s t r i a l

r e l a t i o n s matters,

While N.R.C.A. which has e l e g a l backing has done

well, it has a l a o refused t o maintain d i r e c t r e l a t i o n -

ship vd th t h e N.L.C. It hns a l s o brxm known t o c r i t i c i z e

every i n t e n t of government to l ncrease wnges f o r

workers. Members of N.E.C.A. have been known t o v i o l a t e

I n d u s t r i e I s a f e t y rulee, deacreate the environment

through p o l l u t i o n and employ ru lea not g e n e r a l l y eanct ioned

by extant qnd substantive labour lawu. Most employera

do n o t y e t allow t h e . orpan i sa t ion hnd ex i s t ence of

t r a d e unions in t h e i r work premises. The reason 18 t o

a l low them e x p l o i t ~ R ~ O U P and paypi t tance f o r s t renoua

26

ghyeica l and mental exert ion. They g e t away w i t h t h e s e

infringements because of p reva len t unemployment, the f a c t

t h a t employaent is inf'ornial i n m t u r e and ignorance of

the law on t h e s i d e of' t h e workera. Even where they

a r e aware, they are o v e r t l y apprehensive of being

sacked with a wave of t h e hand by the employer8.

8 . ~ a p a c i & of' t h e Major Actors.

Modern labour r e l a t iona involves ths am_~loyer 'B t

and t h e worker ' a a s independent persons brought together

by t h e exchange o r purchase and s a l e of labour eerv iceae

The buyer of labour is ths employer o r entrepeneur. By

v i r t u e of ownership the enterpreneur has c o n t r o l over

job oppor tun i t i e s , g iv ing t h e worker o r r e l a t i v e l y

dependent pos i t ion . The foregoing, the re fo re , demands

t h a t t h e worker g i v e s h i s l o y a l t y and obedience t o t h e

employer t o hold on t o hie job. Wages cra reward f o r

labour which t h e worker earns is t o a l a r g e r extent

exchange f o r f i x e d wage and who is I n a subordinate

p o s i t i o n to t h e a u t h o r i t i e s o f h i s employer's t o ' do

any Job ass igned . to him i n o r d e r t o c o n t r i b u t e t o

c o ~ p o r a t e o b j e c t i v e o r well being of t h e communitye

Workers a re too many ;a a g a i n s t t-nployers who a r e

r e l a t i v e l y few, .The ~vorkers &re t h e r e f o r e i n competit iun

among themselvea t han t h e empl oyc:r:q r ; n~orlp; therno elves ,

r n l J r r l ~ s may be t h e reason f o r the constant t h r e a t t o sack

Universi ty l e c t u r e r s who go on s t r i k e under t h e

auspices of ASUlJ, t h e attempt t o r ep lace Nige'risn doctors

with Cuban, M y p t i an , o r I trreal doctors and t h e

constant tle8aul.t of a l l crtepories of workers i n the

Public S e r v i c e with retrenchment, r a t i o n a l i z a t i o n and

premature retirement .,I thout t h e e ccruinp benefits.

Eawin Baiye (1989:9) writ ing on' the 1989 Budget focus

i n t h e Guardian Newspapem r e f e r r e d t o t i m t year as t h e

one i n which publ ic ~ e r v a n t s including thoae i n Teaching

H o ~ p i t a l s were rrrcxic, " h u m l l i ~ t e d ~ ' .

On the eame isscle of humil ia t lon of.' t h e pub l i c

se rvan t s , Mr. Solomon Ona?!linon, then Secre tary of the

Associat ion of Senior C i v i l Servants ofs t h e Federat ion

accuded t h e t h e n B~hangida Adminia t r a t i o n of' dabbling

into u n f a i r . T ~ b a u r - r e l a t i o n u p r a c t i c e s s i n c e the

government proceeded t o s l a s h the en t i t l ement s of pub l i c

se rvan t s a s p a r t of t h e opium c a l l e d 8truc:tural Adjuatmtmt

P r o g r a m e without the court 'esy of consul t ing t h e Trade

Unions, Onaghinon sake :

",,, t e l l m e i n w h < t country publ ic o f f i c e r use8 h i s money t o f u e l government c a r tind use i t t o d o off i c i a l duty w i thout refundw.

The workers o f t e n do not have f i n a n c i a l reserves

t o f a l l back on when sacked, Moreover, with t h e

prevalence of unemployment i n Nigeria i n p a r t i c u l a r

and the world a t l a r g e , g e t t i n g jobs is l i k e passing

through t h e eye of a needle and workerb s u f f e r

exp lo i t a t ion , hurni l i ta t ion a nrl i n s u l t s i l e n t l y . A8

t h i e atudy is progress1 ng, workers i n t h e Local

Goverr~ments i n Enugu S t a t e embartied b c i r g owed e ight

months s a l a r y a r r e a r a , I n t h e same ve in the UNTH

workers were owed, s a l a r i e s f o r over 6 months. The

cond i t ion waa s o p a t h e t i c t h a t t h e I n s t i t u t i o n became

a a u b j e c t f o r prayers i n churchso iz the country f o r

r e t u r n of normalcy. The si t u a t i o n s t rengthened the

r e so lve of thoee who m i g r ~ t e c ' t o Saudi Arabia and o t h e r

g reener pas tu res hever t o re turn ,

The law enforcement agent8 work f o r t h e government

and they obey when d i r e c t e d t o d e a l with d i s s iden t

workers. When the labour leader8 i n U.N,T,H. h e l d the

institution under s i e g e i n expr&sion of t h e i r gr ievance

f o r being s i d e l i n e d j u s t as t h e Federal Government d id

I

na t i o n a l labour l eader s already highl ighted , th i e

t ime a t micro l e v e l , the p o l i c e end y l a i n c lo thed

a'lecuri t y men invaded the Hospi ta l a t t h e beckoning

of the aut,hori t iea . The union l e ~ d e r e were unduly

h a r r a ~ s e d i n t h e i r homes end they had t o rbeyort t o

p o l i c e on s e v e r a l occasions. In t h e end, the quthor-

i t i e s of t h e p o l i c e , on the d i r e c t i v e s of the S t a t e

GoJernor intervened; i t was t o i s s e ' s t e r n warnings and

t h r e a t 8 t o t h e labour l e a d e r s t o In t imida te them.

A l l t h e s e ai:nply a h o w t h a t e q u a l i t y of t h e t h r e e

major a c t o r s i n t h e labour r e l a t i o m is only i n theory.

In p r a c t i c e , t h e government and employere a r e much more

powerful and labour is usua l ly subjugated. While the

organlsed p r i v a t e s e c t o r is comu l t e d be: 'ort budget

p repara t ion a nd announc emnnt , labour unions a r e ignored.

Government a s f i n a n c i e r s of teaching hospi t a l e provides

them with funds needed f o r s e r v i c e s and a i c t a t e s t h e

tune by d i r e c t i n g o,n the ueeage, a p p l i c a t i o n and

u t L l i e a t i o n of such funds. During t h e 1996 May day,

t h e governnent ajrected t h a t the usual march p a s t by

workers should not hold. Retrenchment Is c u r r e n t l y

going on i n t e a c h i q h o s p i t ~ l s . The reques t of labour

t o be representea t o ensure fairness m e t with rebuff.

The retrenchment is being c i r r i e d out without due

re fe rence t o t h e manpower needs of t h e teaching

hospitals. This p r a c t i c e negates a l l known norm and

t h e concept of personnel aud i t uhich Ubeku (1 975:24(r)

n.. . is i n t o t h e p r a c t i c ea and p o l i c i ea of the o rgan i sa t ion t o s e e I. whether they accord with needs and valuea of the people : - whether they a r e i n keeping with

c u r r e n t s t a t e of bueineas development and

- whether they need chenge i n t h e light of the c ircums tanc e~ . *

Ubeku'a view is revechoed by Strause and Seylese

(1 972 8353). They argued t h a t pereonnel a u d i t f unc ti one

Serve t h r e e basic purposes :-

*They he lp enaure t h a t sound p o l i c i e s are being implemented.

They a a s i e t i n evaluat ing the c o a t eff ec t iveness of a l t e r n a t i v e personnel technique ; and

They eerve t o a l e r t top managernant when exi8 t1.w ' p o l i c i e s ehould b e changed.

It 1e c l e a r f ro% the fore*ofng t h a t personnel a u d i t

may Involve e t a f f changes and e l in lmat ion , it is not

I t 8 o r main purpose as i s tho case i n Nigeria since

Nigeria is a Cieveloping country and development

i n d i c a t o r s show i i iat, l l ~ e o t h e r c o u n t r i e s on t h e same

p e d e s t a l , the s tandards of awareness and l i v i n g of i t s

c i t i z e m a r e y e t t o a t t a i n V.H.O. and World Bank standard@,

Thia s t a t e of a f f o l r o places g r e a t e r s t raixl on t h e

t each i rg h o s p i t a l s a s they a r e compelled by circumstanc ea

of under-development t o porro m both primary, secondary

and t e r t i a r y func t ions , e t c . Low Nutr i t ion , Poor

S a n i t a t i o n , Slum l i v i n g a tc . p m v a l e n t i n countries

l i k e Nigeria b u t ~ e t j s the f'ollowing q u c ~ t i o n s posed by

Prof a s a o ~ Dudley Seere (1 969 33).

"What has been happening t o poverty?"

"What has been happening t o u n e ~ p l o y m e n t ? ~

W h a t has been happening t o i n e q u ~ l i t y ? ~

...If any o r all of these c e n t r a l problems have

been growing worue,. e a g e c l a l l y i f ' a l l three have, it

would be s t r a n g e t o c a l l the r e s u l t "development, even

t h e p e r c a p i t a income have been dec l in ing over t h e

yeare and they have 4tdverse e f f e c t s on people 'a h e a l t h

i n our aoyntry.

I n a review o f world economy i n t r e n a i t i o n f o r

twenty t h r e e yeare , 1965 - 1988, Anne Tinker (1 991 :22 )

a p t l y s a i d ,

"The chal lenges of development l i e s i n t h e broadest sense , i n improving t h e q u a l i t y of l i f a. This c a l l s f o r not only h igher incornee but a l s o g r e a t e r a c c e s s t o educat- i o n ard higher etandards of h e a l t h and n u t r i t i o n , B e t t e r h e a l t h and n u t r i t i o n br ing aubs t a n t i a l economic benef i t a , r e l e a s i n g rasou ' r cc t h a t can b e ueed f o r o t h e r development goals , Heal th and n u t r i t i o n a l s o have long run e f f e c t s on groduc t i v i t y and output , becauee they - inf luanae a c h i l d ' s a b i l i t y arm motivation t o l ea rn , Although progress i n education is important as an end i n i t s e l f , i t , too, f u e l s economic $rowthw.

This a s s e r t i o n confir~na Prof, F r i t z Beske (1994:76)

b e l i e f t h a t :

%here l a an inherent l i n k between t h e economic c a p a b i l i t y of a country and t h e a t e t e of it8 h o a l t h s e r v i c e s o r o t h e r s o c i a l s e c u r i t y meaaurea. Soci a 1 8 ecurl t y c o s t money, Wary s e r v i c e needs an economic ba si s , theref ore t h e r e i s a c l o s e connection between t h e economic s t r e n g t h of a country and the 8tandard of i t s health e e r v i c e s . . . . The recovery of economic p o t e n t i e l go h n d i n hand regardless of the changes concerning t h e f i m n c ing and s t r u c t u r e of h e a l t h ca re proviai on,, ."

Ye have a l r e a d y h i ~ h , l i g h t e d manpower a8 the hub

o f any o r ~ . : a n i ~ t c t I o n . People1es:i o r g n n i s ~ t i o n is a

euphoria . Any count ry which, t h e r e f o r e , trif l e e w i t h

the h e a l t h o f its c i t i z e n s , i u prepar ing i t se l f f o r t

even tua l d e s t r u c t lc,n. Poor h e a l t h complicat es n u t r i t i o n a l

problems, ments l r e t e r d a t i on , a b i l i t y t o l e a r n a d

c o n t r l b u t e t o the growth of t h e country. Perphas, t h i s

i s +,he r o o t of our t o t e l backwardness economically,

p o l l ti c a l l y end educa t iona l ly .

I n 1995, tk~e United Nations Development Programme

dec l a red N i g e r i u E Vitamin A d e f i c i e n t country and

embo'i'ked d i s t r l bu t lon of v i ternin 'A ' supplements t o

echo018 and h o s p i t a 18 t o e l l e v l e t e myop i~ and o t h e r

ophthalmologi c a l and o c u l a r comylicetionR on t h e country '8

f u t u r e genera t ions . Our Teaching ITospitals now have

m b a t a n t i a l ca se8 of m&nutri t , ion and k w a ~ h i o k o r

e c a t t e r e d i n i t s p a e d i e t r i c wards. These a g a i n l e d t o

t h e d e c l a r a t i o n of Niperib and o t h e r su b-SUaran and

Asian c o u n t r i e s a8 the 4 8 p e o r e s t c o u n t r i e s i n t h e

world - see T a b l e 2.1 complied by S a r a t h Ra j spa t i r ana

Without adequa te funds , i t is d i f f i c u l t t o meet

the demands of b n s i c ftmc ti onr3 ~ i n d t he e x t r a burden

in!!erent i n t h e ~ e c ' u l i a r m ture of our ecology. The

t a l e of thc,te&ching hoepi t a l a has been f u l l of woes,

hue and o m f o r f i n a n c i a l and o t h e r forms of aid. It

ha8 been a s t o r y ' o f negotia t ione and strikes, chronic

di.ruytion of se rv icea and high patea ai s p e c i a l i s t

and non-epecialis t labour turnover and s t a f f exodua.

In the Nigerian Televis ion Authority N e t Work

News of' Thursday, 1 8 t h July 1996, t h e Chief Medical

Direc tors of Teaching and S p e c i a l i s t Hospi ta ls i n a

conununigue i s sued a f t e r t h e i r meeting i n Joa , appealed B

t o the Federal ~ovemmbnt t o improve t h e f ind ing 02'

h e a l t h t o reduce t h e preaeure and burden on patients.

Although pover ty is r e l a t i v e , i t i e excrucia t ing i n our

uountxy where i n f l a t i o n a r y s p i r a l has defea ted a11 known

economic log i c e T h i s a1 tua t ion compounde the p a t h e t i c

condi t ion of Teaching Hospi ta ls which a r e l e f t t o

8 houl der t h e burden . While manpower is very e s s e n t i a l , they need t o

have t h e wherewithall t o . funct ion. Mental power i n

man does not manifest i n a vacuum,

2. S t a t e and Ef fec t s of Rant3irifi.

Worried by t h e d e t e r i o r a t i n g s t a t e of h e a l t h of

t h e average Nigerian, t h e dec l in ing l i f e expectamy,

t h e h igh r a t e of maternal and i n f a n t m o r t a l i t y ,

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dec l in ing n u t r i t i o n a l level. and the s t a t e af despa i r

and melslncholy c l e a r l y eeen on the f a c e s of t h e

ci+j ixtn8, one 18 f u r t h e r b u g ~ c d t o e s c e r t a i n the level

of funding of t,aeching hoap i t a l a . One is a l s o

i n t e r e s t e d i n f ind ing out t ;:.e empirical ef fects of the - funding system.

One 8e@mE1 t o a s k the ques t ion "what r e a l l y a r e t h e

problems of our teaching h ~ s p l t a l s ? ~ Could it be poor

finances o r m i s rnanagrment of t h e ava i l a b l e resources?

Why has t h e averaKe Nigeritlrl not been a b l e t o benef i t

a8 he/she shoilld do from t h e h o s p i t a l s ? Ha8 c o s t of

treatment f r igh tened c i t i z e n s away t o moan t h e i r f a t e ,

s i n c e most of them cannot a f f o r d the cos t of treatment

o t h e r sources exia t f o r r a i s i n g more funds t o

supplement what the government provides? \ V k t a r e the

axperiences of o t h e r developing countr ies a n d thoee of

developed ones, and what can we borrow from t h e i r

* Why i a our government not placing h e a l t h c a r e on

i t e ' p r i o r i ' t y l i a t end i n s t i t u t i o n a l agenda a8 do o t h e r

edvanced countries which have thus improved t h e l i v e 8

of t h e i r c i t i z e m and b u i l t up s k i l l e d , bubbling,

vivacious end perky manpower t h a t has been the s e c r e t

and cream of t h e i r develoynle~t un l ike coun t r i e s l i k e

ours , which have remuincd subservient t o t h e s e o the re ,

and y e t t w n i n g mund t o accuse them of imperialism,

neo-coloniel iem and e x p l o i t a t ion.

I n a recent c a s e a t t h e Universi ty of Nigeria

Teaching H o q i t a l , a man was rushed t o t h e Casualty a t

t h e p o i n t of death. The nurse8 were on s t r i k e and t h e

doctors were not avaf l ab le . T h e poor man was again

rushed t o a p r i v a t e h o s p i t a l i n town and he was asked

t o pay )sc30,000,00 f o r su,rplery. The r e l a t i o n s could not

r n i s e the maney, P r i v a t e hosp i t a l s a r e i n r e a l business

and r e a l busincsu is a l l about money making not c h a r i t y

and yhi lantropy. The man wes rushed back t o the UNTH

Casual ty and gave uk wh.ile h i s r e l a t i o m were a t i l l

confering on how t o deal with ~ L F I problem. The eurgery

could have b c-n done without a d e p o s i t a s an emergency

a t UNTH if a l l were wel l with t h e I n s t i t u t i o n , The c o s t

of t h e Bt3O,OOO,OO s e r v i c e will. not exceed M7,000.00 I n

UNTH. Th i s 1s only a t i p ot' t h e iceberg,

Development is a 11 about ab ~ l e n c e and t h e lopsided

theory of Ragner ?lurkfie ~ E I R been s e e n a8 f u l l o f loopholes.

There is no development it' tihe m a j o ~ ~ i t y ere poor and

t h e ~ i i i o r i t y a r e mf.l l ionaries. The ~ h u r e o f 609&

vulnerable p r o g o ~ t i o n of the populace an2 t h e i r access

I

t o basic s o c i a l f a c i l i t i e s , e s p e c i a l l y hea l th , matters .

We need t o as^ why t h e i n s t i t u t i o n a l and i n f r a s t r u c t u r a l

decay i n our h e a l t h i n s t i t u t i o n s , Is i t t h e r e s u l t d

poor funding and mismanagement of funds. Whichever,

a l t houph one wi l. l q u i c ~ l y agree w i t h t h e t 'or~~ier, i n view

of the Chief Medical Direc tors c n l l e a r l i e r . What t h e

Chief Medical Dfrectors say should b e t a k e n s e r i o u s l y

a s they a r e the heads of teaching hospi tn le . They wear

t h e shoes and know where it pinches most. They had

greppled. with p e r e n n i s l inc7,ustrisl a c t i o n , the most

vocal of Hhich r e s u l t e d i n t h e hideous murder of Prof .

Bandipo who u n t i l h i s u n f o r t u m t e death i n 1995, was 5

t h e Chief Medicel Direc tor of Ahrnadu Bel lo ~ k i v e r a i t ~

Teaching Haspi tal . The angry workers f e l t he had received

t h e i r a r r e a r s of allowance and ref used t o pay. them.

They h e l d him hos tage , best him merci less ly , locked him

up i n t h e m o r t ~ a r y for two hours and l a t e r pacited him i n

t h e boot of a 504 P e u ~ e o t c a s uhere he died. It was

no t long ba.:fore i t was c l e a r t o a l l and sundry t h a t t h e '

r 6 r e gem d i d n o t r ece ive t h e money. Nigeria thue l o s t

one of i t s renowned adminis t ra tors and atmosphere of

m i s t r u s t teat arose froin poor funding,

allocation^ of N i ~ e r i n m d Zimbabwe t o h e a l t h fol? nine

years (1983 - j991) and f o m d a8 p e r t a b l e 2.2 that

Niger ia had cong is t e n t l y f a l l e n behind Zirnbnbwe, a n o t h e r

t h i r d world c o u n t r y , i n the a t t e n t i o n p a i d t o hea l th .

The f i n a n c i e l ~ l l o c a t ion of' the cc)l~.nt r ies t o h e a l t h

are shown g r a p h i c a l . 1 ~ on figure 2.4.

Tab le 2.2 B u d g e t ~ r y --. A l l o c a t i o n u -------..- t o Heolth i n Niger ia Cornpar@ wi th Zimbabx.

--A-

A l l o c a t i o n t o % Zimbabwe I ---

13

" " ' I . I 1

11

1388 1

19891 30

4990 1 40 I

19yq ! - 39 I I t

Source: Wari u u s I n t e r n a l and A d m i n i s t r a t i v e I

da ta , UNTH 1994,

I"'

There i s no doubt t @ t Nigeria 's populat ion is

g r e a t e r than Zimbabwe's, Some a p p l i e s t o i ts resources,

Using t h i a as a bas is of ana lys i s , we can i n f e r t h a t

Nigeria does not show a s much i n t e r e s t i n the h e a l t h

of i t s c i t i z e n r y a8 Zirnbabwo,

While Zimbabwe's a l l o c a t i o n t o h e a l t h inc reases i n

l e a p s and bounds with every new year , t h a t of Nigeria

increased only i n t r i c k l e s , The f a c t s would be more

pronounced if we r e l a t e t h e s e a l l o c n t i o m t o t h e

popula t ions of these two ~ o : i ~ , ~ . r i e s vhich d i f f e r i n

s tagger ing p rwpor t ion~ . Our h e a l t h system is full of defectrs. Dr. Shahu

Sule (1995:h) i d e n t i f i e d the major ones as:

Inadequacy i n coverage, W J ~ t h t h e r u r a l comrnuniti e s

and t h e u r h i i poor not being we l l aerved.

Inappropr ia te o r i e n t a t i o n of the s e r v i c e a wi th a

disprogur t ionote ly high investment i n c u r a t i v e

ae rv ices t o t h e de t r iment of promotive and

prevent ion ~ s e r v i c ea,

The management of the s e r v i c e s o f t e n how mhjor

weakness r e s u l t inn i n waate and ine:f?ficiency, a8

as shown by .the f a l l u r e t o meet t a r g e t s and goals .

42

The involvement of t$e p r i v a t e s e c t o r and t h e

com~nunity has been minimal a t c l - l t i c a l p o i n t s

i n t h e d e c i s i o n m a k i r v : p r m e s s e a .

The p a u c i t y on' b a s i c heo1t;h s t a t i s t i c s and

o t h e r r e l e v a n t h e a l t h inf'orma t i o n has a major

constra int , a t a l l s t a g e s of' planning , implemen-

t a t ion, moni t a r i n ~ t , anti evvlua t i o n of h e a l t h

development.

The f i n a n c i ~ i resources a l l o c a t e d t o h e a l t h

development, p r o jects/pro~:rumme have been found

t o be i n ~ d e q ~ t e t o a l l ow f o r p o s i t i v e r e s u l t s .

The bas ic i n f r t r s t r u c t u r e and l o h i s t i c s aupyort

hnve been defective au a r e s u l t of inadequa te

maintenance of' b u i l d i w , medical f a c i l i t i e s

i nc lud ing veh ic l ea as well a s d r a s , vacc ines

and s u p p l i e s system.

Sule (1 985) op.Cit. f u r t h e r confirms t h e input/out

syateme theor. / when he s ~ i d t h t :

w..... a f t e r a l l , mont of us a t t h i s conference b v e ei th&r b e e n a t the r e c e i v i w end of the most, i f not a l l t h e major d e f e c t s t h a t . h a v e conatant , ly been i d e n t i f i e d wi th t h e count ry 'a h e a l t h endeavour3 i n t h e mnrlugement of' h e a l t h development . , , , n

Prof, Adeoye Lambo (19%:33) wri t ing i n the

Newswatch Magazi~~e a l s o a s s e r t e d t h a t :

nNigeria l i k e most o t h e r developing nat iona, speruis very lit t l e on research and development i n the her. l t h s e c t o r . . . . Today, a c q a l s i t i o n of' knowledge has come t o a h a l f , our i n s t i t u t i o m of.' h ipher learning have almost been destroyed ana those who a r e leadi rg the vigorous p u r s u i t a re i n a a t a t e of apathy."

Aris ing from t h e fore-going a n a l y s i s , t h e feedback

mechanism i n t h e s y s t e m which is the complaints from t h e

c i t i z e n s a r t i c u l a t e d above do not epur t h e changes

required f o r improvement i n the h e a l t h system,

In recent tirnce, a new probiefi hes bedevi l led our

h e a l t h sec tor , The new cankerworm is s t r a i n e d i n d u s t r i a1

r e l a t i o n s and a t t e n d a n t s t r i k e s , The t e a c h i m h o s p i t a l s

a r e a s soc ia ted t o Univers i t ies . When l e c t u r e r s go on

a t r i k e i n regearch i n s t i t u t i on6 and un ive r s i t i e a , the

impact i s , severe i n t h e h e a l t h s e c t o r a s teaching,

r e sea rch and therapy a r e a l s o h a l t e d i n the a s soc ia ted

teaching hoapi ta 1s..

I f h e a l t h is given p r i o r i t y a t t e n t i o n and funded

ndequately, the long run e f f e c t w i l l b e o v e r a l l i n d u s t r i a l

peace i n t h e s e i n a t i t u t i o n s , b e t t e r and undisrilpted s e r v i c e

t o s tuden t s and p a t i e n t s and, p e r h p s , new innovation8.

A l l t h e s e w i l l improve the

a d economic s ub-oy st e m ,

good h e a l t h of t h e p o l i t i c a l

But as long as t h e p o l i t i c a l

a u t h o r i ties cont r o l l i n g th6 external envi njrment p e r s i s t

i n ,paying l i p service t o health, b a c k w ~ r d n e e s , f r u s t r a t i o n ,

d i e e a s e and c r i m e w i l l c o n t i n u e t o b e p a r t o f us.

As a p roces suu i .byan, t z ~ e l t t z w i l l only produce

o u t p u t t h a t iu commensurate wi th t h e f a c i l i t i e a , manpower

and r e s o u r c e s a l l o c a t e d t o i t . Improved f n c i l i t i e s w i l l

r educe agony f o r t h e c i t i z e n s . I t is a p i t y that while

o u r surgeons do not. s e e s u r g i c a l b l ~ d e s For thei r* ",ark,

the a r t of aurgery i t s e l f hbls gone l a s e r technology which

i s non-invusive t . : d lea8 peiriful. . We a r e nevi t o o f a r away

t o c a t c h up wi th med ica l pract l ' c es i n most ~ d v e n c e d and

even some thi1-d w o r l d c o u n t r i e s wit, h b e t t e r economic

managers a nd p o l i t l c i ens.

J . LR bour Disput crs

Trade D i s ~ u t e s . -.--.-

S e c t i o n 37 of t h e Trade D i s p ~ i t e s Act 1476, defined

" t ~ ~ j d p d isputeat ' 8 s m y dispute between employers and

- wi th t h e ernploy~enl; and non employmel~t of the t e r m s of

employrncnt 'and physj .ce l condition of wvrk of any person.

This means t h a t a brkoch of, c o n t r a c t o r infr ipgcment

on t h e t e rms of' eml;l.oyment by employers ~I11 r e n u l t i n '

s t r i k e s o r l ockou t s o r produce some r e b c t i o n from t h e

employees s o a f f e c t e z . T e m s and condit ions of' work

convent ional ly embrace:

(a) Wages, s a l a r i e n end all.owonc es (houoiw , t r a n s p o r t )

(b) I!cnrs of w o ~ k , overtime.

( c ) Welfare rcetters l i k e canteen, medical t reatment ,

pension and g r n t u i t y , prornot ions, e t c .

( d ) Leave per iod , vacat ion ~ l l o w e n c e and bonus,

(8) Workers Safe ty and working environment genera l ly

( f ) M s c l n l i n a r y measures.

Trade disputes could. a l ~ o a r i s e between one group

of workers and o thers . A t p resen t i n the U o N o T e H e ,

t h e Non-Academic Staff' Union (N.A.s.~) which was

proscr ibed as not having j u r i s d i c t i o n i n teaching

h o s p i t a l s has gone t o cour t bused on Decree no. 4 of

1996 (~mendment of' Cup, 437 LFN) , r e s to r ing that

jur iedTct ion, a t l e a s t t o some staff cadre. The

Medical and Health Workers Union of Nigeria which wera

preparirig t o spread the i ln t e n t a c l e s has found themselves

i n 8 r7ilemma. NoAoS.Uo has a l s o c h a l l e w e d mannpment

t o r e s t o r e the abrogated o u s t e r o r face i n d u u t r i a l - 4

a c t i o n by its members,

a.2 Kinds of Disputes.

Trade d i spu te8 e r e of two k inds , v i z - i n d i v i d u a l

g r i evance and col.1-ective gr ievance . The former pris es

when a worker feels t h a t h i s r i g h t s have been t rampled

upon o r d e n h d him. H e , t h e r e f o r e , seeks avenue t o

recoup h i s l o ~ s e s 06 r ed re s s . This c o u l d be through

pet i t !oning t o t h e a u t h o r i t i e s o r wr i t i ng h.is union

t o complaln, i n which ca9e t h e union trikes up the matter*

wi th management,

The c o l l e c t i v e d i s p u t e s ueua l ly involvea a group of'

- workers who e i m i l e r l y mr3y f e e l aggr iaved ~ n c l p e t i t i o n o r

u s e , t h e i r union t o f ight; f o r r e s t i t u t i o n . The Nat iona l

Associo t i o n of Nigeria Nurses and Midwives (NANNM) used

t h a t Hpproagh when they fought f o r ~ e l n ~ t n t c m e n t of

nu r se s sacked u n i l a t e r a l l y f rorn t h e Aro Psychio t r i c

Hosp i t a l , Abeokuta. They even tua l ly won and t h e a t a f f

rega ined t h e i r jobs, This case simply shows how

i n d i v i d u a l c a s e can ~ l s o d c v e t a i l o r e s c a l a t e i n t o

co l l . e c t i ve ,grievance & l l c h i s much more compl ex.

J . 3 Soulicm of Disputes,

Otobo ,R. and Omole M. (1 987: 223) i d & t i f i e d two

eources o f t r a d e d i s p u t e s : - t h e i n t e r n a l s o u r c e s which

are mnntrgement s t y l e , m t u r e of phys i ca l environment

, of t h e worker, conociousnens of' workers a s t o t h e i r r i g h t s ,

o t h e r condi t ions of s e r v i t . ~ . , e f f i c i ency o r otherwise

of promot ion system and t h e cumbersomeness of gr ievance

and d i spu te pruceciure. The e x t e r n a l sources include

government indu,strie 1 and economic po l i cy , na tu re of

n a t i o n a l economic mismanagement and the g e n e r a l die tri-

but ion of wealth and power i n m c i ety. These source8

combine t o bring a !>out the oc cur enc e of indus t r i a 1

d i q u t e o r ,otherwise between workers and anployer'e.

The a s s e r t i o n of Otoba and Omole is a p t ~ ~ C R U R F ? t h e

c u r r e n t economic problem of Nigeria which has ddversely

a f f e c t e d t h e finarlces due t o var ious sub-sectors inc lud-

ing h e a l t h a rose f m m economic mlsmnnagement , cor rup t ion

and agreed. In t h e same vein , t h e a t t i t u d e of t h e govern-

ment t o h e a l t h is respons ib le f o r t h e low a t t e n t i o n

extended t q _it; These t w major f a c t o r s determine o t h e r

f a c t o r s t h R t con t r ibu te t o d i spu tes i n t e r n a l l y , When

When government rcfuses ' t o grant f u n d s enough f o r

budgeted f a c i l i t i e s i n h e a l t h i n s t i t u t i o n s , r e l easee

whatever it has even g iven I n t r i c ~ l e s and detennines

s t a f f es tabl ishment from outs ide , non payment of

s a l a r i e s , i 'nabil i ty t o promote s t a f f 'or cont ravent ion

of d i s c i p l i n a r y procedures become t h e order of t h e day

and mamgement looen c o n t r o l of s t a f f . How do you u

d i s c i p l i n e on the o t h e r hand, how can s e r v i c e s b e

improved without adequtr t e funds.

K. S t r i k e s I

The h e a l t h c a r e environment h a s been u n s t a b l e

i n t h e l as t t e n y e a r s d e s p i t e t h e f a c t tlla t govern-

ment c l a s s i f i s d h e a l t h i n t he Essen t i a l Se rv i ces a r e a - Trade Dispute and E s s e n t i a l Se rv i ces Decrm No. 23

of 1976, The most s e r i o u s e f f e c t of' t r a d e d i s p u t e

is s t r i k e . S t r i k e is a temporely s toppage of work

by employees i n a n o r g m i s ~ t i o n i n pursuance of a g r i v e -

anbe o r demand. It is an economic s t r a t e g y or weapon

adopted bv t rwde uni ons t o force govern~nent t o s - 4

n e t , o t i a t e wi t h i t , t o inr'luenc e ~overninent act ion,

implement c o l l e c t i v e agreements, e tc . S t r i k e i s a

s a n c t i o n and u s u a l l y ind. icates a breakdown o f c o r d i a l

r e a a t i o n s h i p between labour and management.

Archibishop Olubumi Okogie (1 996 :5) c a l l e d s t r i k e t h e

" l a a t card". The consequel~ces of s t r i k e i s fa r - reach- '

ing on the system hence the government proclaimed

p o l i c y of gu ided democracy and var ious law e s p e c i a l l y 8

on s e t t l e m e n t t o s t a l l i t s occurence, Not ice t o go

on a t r k k e must bc ,g iven , renewed and t h e consent of t h e

8 taPf involved ob a i n e d be fo re i t . c o u l d t a k e p lace .

The goveinrnent agency l i k e Minis t r y of Labour i n t e r v e n e s

through medie t i o n and cor~ci_ ' , l l a t i o n . Beyond t h e s e two

stages, government u s u a l l y qu ick ly ref e r e the i 88ue i n

d i ~ p u t e t o t h e I n d u s t r i a l ' k r b i t r o t i o n Pane l f o r

c o n s i d e r a t i o n . A t t h a t s t a g e ~ n c ! 5 : ~ v i r t u e of Trade

D i spu t e Amendment Decree No. 21 o f 1978, strikes

becoa& i l l e g a l . I F i t had beem embarked upon i t s h o u l d

be c a l l e d off'. Two 8 t r ikc : ; O C C U T . ~ ~ i n U.N.T.H. Thie!

yea r . The n u r s e s and Mcdicul Labora tory S c i e n t i s t s went

on a t r i k e because of t h e i s s u e of c a l l d u t y a l lowance

wN.ch t h e s a n e Ind i i a t r ' i a l A r b i t r a t i o n Panel ( I .A .P)

approved wi thou t r e a l l y working o u t the g u i d e l i n e s .

The m a t t e r r e v e r t e d t o a r b i t r a t i o n . S ince the two

unions mentioned ~ r o n t l n u e d t i ieir s t r ike days a f t e r

t h e o r d e r to r e v e r t t o t he s t a t u s quo a n t e , t h e "no work

no pay" law was involved and t h e n u r s e s and l a b o r a t o r y

s c i e n t i s t s have l o s t twir puy f o r t h e du r t l t i on of t h a t

i l l e g a l s t r i k e s .

Crises of l e g a l i t y - a sitilrl t i o n &ere ~ o v e r r m e n t

r e f u s e s t o obey i t s own law is a l s o i l h e r e n t i n t h e

3y stern. The r u l e r e q u i r e s t h a t government s h o u l d e n t er

i n t o negotiation t o ..art ont l abou r problems. But i t

doen n o t obey the law it has made and i n f r u s t r a t i o n ,

dhen l a b o u r uses i t s "lust card" gover~lment w i l l descend

h e a v i l y on labour . By Decree No. 9 and 10 of 1994, t h e

government iii sso!.ved t h e N i f , r e r i ~ Labour Congress , U N P E N Q

and PENGASSON as a r e s u l t of' t h e June 1 2 quagmire.

Simi lar ly , Chidinma Ibegbu i n the Vangunrd Newspaper of'

Wednesday, 1 4 t h , 1996 repor ted t h a t the Minister of

L ~ b o u r &nd produc t i v i ty , Senator Uba Ahmed u n i l a t e r a l l y

cancel led the de lega tes collrerence on the merger of t r a d e

unionn a c h e d l e d l'or 29th May, 1 936.

K . l Kinds of ;rrt,rii&+s,.

S k i k e s talte var ious forms ranging from "sit , downw,

n g ~ sloww, "wild c a t s t r i k e N , "warning s t r i k e " , "sympathy

s t r i k e w , "protected s t r i k e w and 'Qi~hteni ly l s t r i k e n . The .

main f e a t u r e s of t h e s e strikes horde; on t h e i r l e g a l i t y

o r othervdse. " \Y i i t 3 . c a t s t r i k e " occurs when workera

disobey th$ . r union leaders and embark on s t r i k e . I n

"go slow", the workers come t o work a n d d e l i b e r a t e l y

become agonisingly slow. i n t h e i r m r k allc'l t a k e t h e i r

e e a t s end refuse t o work. A wwarriing s t r i k e n cun best

b e i l l u s t r a t e d by tile r ecen t demonstbation by Local

government workers i n Enugu S t a t e i n p r o t e s t a g a i n s t

t h e e i g h t months s a l a r y owed t h e i r colle#gues i n some

Locdl govarnmenta. They expressed t h e i r readiness t o

g o on f u l l s c a l e s t r i k e i f ' t h e s i t u a t i o n was not

addressed. S imi la r ly , thk Vanguard Newspaper r epor ted

on 24th May, 1996 t h a t Gerrmny publ ic s e r v i c e woriLere

went on s t r i k e f o p f e w hours FIS R '%mrnirp" f o r eventual

f u l l 8ce le sfvrike. If t h e (hrea t i n the example of

Local Government m r k c r s is c a r r i e d out, i t becomes

sympathy s t r i k e a8 expression of s o l i d a r i t y with

t h e i r mal t rea ted colleqgues. "Protected s t r i k e " l a

one t i l a t has exhausted known l e g a l procedure while

nll;.!htening b-trikew a r i a ea from i n t e r union c r i s i a

r a t h e r than a problem between mansgment and union.

I t i e a l s o c a l l e d demarcation s t r i k e , I

K. 2 Imberman Woodrruf f,

He i s an American s o c i a l s c i e n t i s t who advised

on the need f o r rnmaganent t o g i r d i t 6 loina and scan

t h e environment of the work p l a c e t o d e t e c t e a r l y

warning s i g r p of d iscontent on t h e s t a f f And handle

i t before it e s c a l a t e s i n t o f u l l s e a l e gr ievance and

eventua l ly , s t r i k e , Imberman e t a t e d t h a t :-

wThe warning s igns of' employee d l ~ c o n t e n t a r e ev ident tcj those who take t ime t o look and I f s ten , , , , . . n

H e f u r t h e r s a i d t h a t a t t e n t i o n to labour and

management relationship before a s t r i k e is a good

investment.

One o q ~ q o t ' but ag ree with t h e research s c i e n t i s t ,

Imberman. In Nigeria end i t s h e a l t h e e c t o r , even when

t h e workers cornlain openly and make represen ta t ions ,

t h e a ~ t h o r i t i e s usua l ly no hee, herice s t r i k e s and

p r o t ~ a c t e d i n the system,

1 .B gesearch H y ~ o t h F ? R ~ 8.

Thie research mrk s h a l l b e guided by t h e

a l t e r n a t i v e and n u l l hypothesf s the t:

H l : Qovernmmt fund lng in f luences i n d u s t r i a l r e l a t i o n s / a c t i o n i n teaching hosyi ta la .

HO: ' Government fundinp does not d u e n c e f ~ d u e t r f n l r e l a t ions /ec t ion i n teachirw hospi tal8.

1.7. Method of Data Col.lect1on.

For . the data c o l l e c t i o n exerc ise , t h e interview,

method with uns t ruc tured qu a t i o n s was used f o r management

8 t a f P and Trade union of f i c i e l s , Q d e s t i o n n ~ i r e with open I

and c l o s e quest ions combined was a l s o used.

1.8 Theore t i ca l Foundation o r Frame Work.

The t h e o r e t i c a l foundation of this study l a

rooted on the ecolopy ~ p p r o ~ c h , concep t o r theory.

( a ) The FXo1op.v Approach.

The aphorism "hefilth is wealthn ia popular and Rhould .

apply t o every r a t 1 onal nation. A.W.H.O. publ ica t ion

defined ngood h e a l t h w as "a s t a t e of complete physical,

spcic51 and mental well-beinp, and not necevear i ly t h e

absence of i l l n e s s , d i s n b t l i t y or inf i rmity."

--

53 ÿ hi- mdans t h a t h e g l t h goes beyond c u r a t i v e

medicine t o every aapect of well. being l i k e _prov i s ion

of p o r t a b l e wdter supply, s s n i t a t i o n , h e a l t h educat ion

and personal hygiene, food. and n u t r i t i o n , education,

good, drainage system a s a complement t o s a n i t a i o n ,

phyaical education and p r a c t i c e and what Prof . WOW.

Ros tow r e f e r r e d t o a s " ~ n a ~ s produ &ion" which i n d i c a t e s

the a v i l a b i l i t y of a l l l i f e supporting f a c i l i t i e s a t

cheap p r i c e s , making them a f f o r d a b l e by everybody,

especia1l.y the vulnerable 6% of t h e populet i on.

The b r i e f in t roduc t ion s h a l l guide u s i n t o t h e

t h e o r e t i c a l foundat ion o f t h i s s tudy vvhich we have

a l ready noted is on ecology,

Ecology r e f e r s t o t h e t o t a l i t y of man'a phys ica l

sur roundinp;~ and it a con ten t s , l i k e space, a i r , water

and aquat ic l i f e , vegeta t ion ancl h a b i t a t , c t c , It is

t h e brain-child of Udwig Von Bert lanfy, and der ived

from t h e b i o l o g i c a l sciences. It connotes the l i v i n g

organisms i n i n t e r a c t i o n with f o r c e s of t h e i r i r l t e rna l

and ex te rna l environment d.uring which they import and

export inf luences i n symbiotic r e l a t i onship,

(b) The Sy st ems Theory

The eco log ica l theory has i t s G o t 8 i n t h e systems

approach. A system c n n be conceived 8s R whole o r

54

complex composed of parts or sub-systems wi th determin-

a b l e bonndaries, working i n correspondence t o achieve

a balance i n such a way thR t a disequi l ibrum i n one

p a r t can, if. ' not a r r e s t e d , spread the malaise t o t h e

o t h e r p a r t s and eventual ly pa ra lyse t h e whole.

Anderson J.E. (1975:9), quoting David Easton

s t a t e d t h a t :

"Public pol icy m y be vierred a s t h e response of a p o l i t i c a l system t o demands a r i s i n g from i t 8 environmentn.

The h e a l t h aec tor a s a n open sub systern i n the

l a r g e r execut ive sub-system of t h e t o t a l p o l i t i c a l 835 tem

rece ives . inputs ( f i n ~ r l c i a l a l l o c a t i o n , pol icy d i r e c t i v e s ,

e t a f f and demand f o r s e r v i c e s ) from the p o l i t i c a l ,

e o c i a l and economic environment. It yroceeses t h e s e

inpu t s and d e l i v e r s them i n t o t h e ex te rna l environment

again .as outputs , which have outcomes or coneequenciea.

The output a r e t t lngible m~nif 'estatiorls of a c t i o n of

pol icy irnplementers suc11 as number of chi l.dren immunised,

number of surg i ' ca l oper;;tiorls perl'orrned, home vi sits

and number of' r lu raes or doc t o r s r t ~ c r u i t ed or t ra ined .

The outcome be$o:nes t h e q m l i t y and r e f l e c t i o n of t h e

output on t h e ma'sses, e.g. dec l ine i n inf'ant mor ta l i ty ,

childhood d i seases , hea l thy and product ive c i t i z e n r y ,

e tc .

1 C l a r i f i c a t i o n of Key Concepte. u

Imperfect' Mobil izat ion - The g e n e r a l i t y of masses 6

belor* to var ioue formal and informal o r g ~ n i s a t 1 one making t h e cap tu re of abso lu te l o y a l i t y impoasible,

Countervai l ing Force - Creat ion of balance and compromise ~ r i s ing f from c l a s h of i n t e r e s t of groups i n a p o l i t i c a l syatarn.

NANNY

Hydraulic Thesi 8

- National Aesociat ion of , Niperisn Nurses and Miduvivea.

- Associa ti on of Resident Doctome

- The exis tence of cornposi t e d i s c i p l i n e o r prof efisions i n an orgenisat ion.

- The 0x1-stence of composite preesurea from various g r o a p n on the p o l i t i c a l nyztc::: t o s a t i s f y e demend., propounded by Socia l S c i e n t i ~ t , C c j r l Frederich.

D e m a r c a t l a $ t r i k e - A a t r i k e actl . on embarked . upon by EI u n i o ~ l i n o r d e r t o induc e Management t o recng- n i s e i t o r g i v e it some regard ,

I n s t i t u t i o n a l Agenda - - Demands and problems which government, of f i c i e l s . b e l i e v e de se rve s e r i o u s a t t e n t i o n ,

PEST

S u b s t a n t i v e Issues I

Culonial isrn i n a new form. "nee" rnenns "neww. It e q u a l l y ' means ~ ~ ~ ! l + ~ l e c o n t r o l or' developing c o u n t r i e s ' economies by f o r e i g n e r s v i a a l i e n ecolromic packaaee.

An a t t emp t t o p rov ide f o r a l l A r e a s wl t h i n a system o r er-q:age i n a l l economic a c t i v i t i e s f o r t o t a l self ' r e l i s n c e , A s o r t of c l o s e d econoqy which is a euphor ia , I t is a ti leory of development p w t u l s t e d by A lbe r t H i r c h s m m and Nosentein Rodan,

Prof . Raaner Nurkse 's develop- ~rlent t heo ry which pos t u l a t cd s p e c i a l i s a t i o n and c o n c e n t r a t i o n on a reas of' advan tage Fo r maximum economic b e n e f i t .

An acronym f o r p o l i t i c a l , Economic, Soci a 1 and Technolop i c a l f a c t o r s a s i n p u t s i n t o t h e p o l i t i c a l system.

C u r r e ~ ~ t , s u b j e c t s of c o n f l i c t o r d i s c u s s i o n , o f t e n d i s t i n - g u i s h d from p r o c e d u r a l i s s u e s ,

Open System

Warriiq S t r i k e

Input Output.

Outcome

M.P.A.

T r i p a r t i t e

S t a t u s quo a n t e

- A system t h a t rece ives inf luences from t h e ex te rna l env i ronment arid equal ly i n f luenlu 1:s the externol envi ronment by it EI output ,

- A s t r i k e which lasts f o r a few duys/hours to warn the a u t h o r i i i es of the need t o need demands or' unions, l ' a i l ing which FI t o t a l s t r i k e w i l l f'o 1.Low,

CoLLective Bargaining -

. . Pol icy

Influence:; f roln t h e ex te rna l boundaries of t h e bureaucracy vuhlch i t processes and purnys i n t o t h e ex te r :wl environment as t a n g i b l e m n i f e s t a t i o n s of a pol icy*

Consequences of t h e output and it.s long run l a s t i n g e f f e c t s .

Uni vers i ty of Nigeria Teaching Hospital ,

Three p a r t i e s

E x i s tir.q{ s t t l t e of a f f a i r s before a s t r i k e - Workers usual ly s t a r t work penuing s e t t l m e n t .

A system whereby management and workers s i t &on round t a b l e con~i'erenc e to n e g o t i a t e and decide mutually and peaceful ly matters a f f e c t i w both p a r t i e s .

- A decis ion with r ami f i ca t ions , long term conno t a t i o n and i n t e r - connected taken by a u t h o r i t i e s concerning pub l i c goa1.s and means 01' achieving them.

Sys t em

Guided democa~cy

A complex of elements with s p e c i f i c boundaries and

inter-connect i om funct ioning i n harmony.

- A combinq t i o n of f r e e i n t e r a c t i o n between A& bour and mamgement laced with in te rven t ion by povernment if se t t lement proves t!lt?my.

- Academic S t a f f Union of Univer- s l t i e s (now proscr ibed) .

D i s t r i b u t i v e , Regulatory & Redis t r i b u t i v e ' - Theodore LowI's typology of

p o l i c i e s hinging mainly on the benef ic i a r l eu 0:' the policy.

Anderson, J.E. (1975) - Public Policy Making, Thomaa Nela on 8: Sow Ltd. , London.

Adebayo A. (1979) - -- P r 1 . n c : i . e ~ cr rd Prac-t ice of Publ ic f idminis trot lon i r i X i ~ e r i f i , spec ?run; -3ooks Ltd.,

Allen U u i a (1 958) - M a n ~ , ~ m e n t and O r ~ s n i sntion McCIraw and ~ i l l s ~ ~ o r ~ d o n .

Car l Predorich (1904) The Prrxesu of Govwriiient Blooming ton, Indihrla Prhl!lc i 2 i a Preas.

Co l l ine Pontana (1 986) Oood r!es Bible, Williams Col l ins Sons Rc Co, Ltd., London.

Drucker P,F, (1 985) Mam~ement . Tasks. Resuonsi b i l i t i es, P r a c t i c e s , H e i n ~ n _ g - n Prof es5ional ; ' ub l i she r s Ltd. , London.

/

Dunlop J.T. (1977) a d u s t r i a l R&lations System?, Ned York, Arct..!riis h o k s ~ t r

Hymn k (1 964) Indua t r i a 1 R e l l a t i ons. A Merxis t A p ~ ~ u a c h Thomaa Nelson and Sorm Ltd., London.

Olewe B. N. (1 995) Development Admini s t r a t i o n , Grace Vent a r e s , ~ b a :

Otobe D. & Omole M. (1987) Read!&& i n Indus t r ia l , Relations in W i ~ e r i a , Lagos SIaithouse Preav .. .

c'-.

S.elekman B. If. (1 958) P r o b l m s of T,abs.._r Yela t i o n s , 2nd Edit ion, MoGraw Ili l ls, N s w York.

Stewart R. ('967) The Real i ty of Manfigment, Pitman Publ i shers , ~z'3.d.on.

S t raus & Sayles (1 972) Personnel: The Human Pr.oblem8 .. .. - of M~nafl ement , Prel?. t i .? e-38 11 , In t erm ti o m 1 , London.

Ubeku A.K. (1 975) Personnel Mana~ement i n N i ~ e r i a , Ethiope Pub11 qhing Corporati on, Benin Ci ty .

\Villiam F.C. (1979) _Mam~ernen.made Simple, W.I-!, Allen, London,

Dudley S e w s , The Menning of Development, Eleventh Wo, i d Confe~e!,c, r b of the Society f o r Interna t i o n a l Development, New Delhi,

Shehu Sule Nations!. Health Summit, Abuja, 1986.

POLICY PgLUMRNTS

Federal Repub11 c of Niperie Cone t i t u t i o n , 1979

Nazi onal Heal th Pol icy , 1988

National TIeboilr Pol icy, 1 975 - N ~ t i o l l a l Speech, Federal Government of I l i ~ e r i a Budget,

1991.

NEWSPAPERR AND MAOAZI NES 7

World Heal th Organisat ion, Alma Ater Declaration, Swi tzwland - Nati onal Heal th Pol icy, 1998.

Finance and Development, I, hlFo Pub1ici;tions Services, ',;'c2;kiing ton Do C. S c e r ~ t t h R o , I 985.

Fine ncc and Development, 1 .M.F. Publ icat ions Services , Washington D o c . T i n ~ e r A. , ? 391.

Health Policy: i n a Changing World. Hoepital Mamgemcnt I n t e r n a t i o n a l , S te r l ing Pub l i ca t ions , EngJ-md , Beske F ( 1 9 9/41 . Newswatch Magazine, Newswatch pub l i cat ion, Ugoe 1985.

Management i n Niger1 s , NIM Publ l ca t ions , Lagos (Igweonu "lozle) 1980.

Guard1 an Newspapers, I I t h January, 1989

Ouardi an Newspapere, Ibido ,

Sunday Vanguard, kune 23rd, 1996.

Teach1 ng Hospi ta ls Recons t i t u t i on Decree NO. 10 , 1985.

Teaching Hosp i t a l ' s Recons t i t u t i o n Decree, OR. ' C i t

Eaet Cent ra l S t a t e Edict NO. 1 1 , 4 970.

Federa l Oovcrnmmt Decree NO. 23, 1974. .

Federa l Oovernment Decree No. 58, 1977.

~ e d e r a l b7overmment Decree No. 74, 49751.

Trade Meputee ' Essent ia l Serv ices Decree No. 23, 1976.

Trade Unione Decree, 1973.

Trade Meputes Decrees, 1968, 1969, 1973 & 1979.

Wo~kmen'e Compensation Decree NO. 17, 1987.

Decree Noe. 9 at 10, 1994.

UNPUBLISF?$D DISSERTATION --I .-

CHAPTER T m --- BACKG-?OU-PD INFORMATION ON THE CASE STUDY (UIYTH ENUGU) .

The Uni versic.y of Nigeria Teaching Hoepit a1 i s

by no means an a l i e n i n the annals .of t h e hsitory d

t e a c h i w h o s p i t a l s i n Nigeria. It i s amonp +he f i rs t

genera t ion h o s p i t a l s of t h a t s t a n d a r d and has over the

year8 b u i l t up f o r i t s e l f a r epu ta t ton coinlnensu.*ate with

i t s g i g a n t i c ~ t c t 20 RS 6 Centre of Xxceilence i n

Cardiothortlcic Medicin wl t h i n and o u t s i d e Nigeri a,

A8 a teaching h o s p i t a l , i t performs the

t h r e e acolaimed cardl nu1 func t ions o f au&

i n e t i t u t ions v iz : teaching, therapy and raa earch.

These ahd already been quotw-1 i n the UNIVSTISITY

T U C H I r J O HOSPITALS (RY.~ON~~ ' I 'CUTIC>N OF BOARD ETC)

DBXEE NO. 10 OF (4985; ~ 4 8 ) .

There i s no d o u ~ t tha t a ? 1 t h e c a r d i n a l functiom,

a ~ d i ts rrff-ehoot elready highl ighted are airn~d a t

attrrining the k m . 1 of' the Nat.tom1 Health Policy (1988':9),

nThe p o s l crf the National Heal th Pol iay E ~ R L ? be a l e v e l of' h e a l t h tha t w i l l enable a l l Nigerians t o achieve s o c i a l l y

. and economic ~l ly pi-oduc t i v e Lives, The Yetional health systems s h l l be baseC on primai? h e a l t h ca rew,

Since t h i s research, work i a a c a s e a tudy,

using t h e Universi t y of Nigeria ~ e e c h i n ~ Hospi tal

a8 a baae, it is only f a i r t h a t we ha ve an overview

of t h e h i s tory end gro~vth of t h e i n s t i t u t i o n , i t s

o rgan iza t iona l s t r u c t i l r e and some aspect8 o f i t 8

i n t e r n a l dynarnfca,

The Univers i ty of Nigeria Teaching Hoap i t a l

has had a chequered h i a t o r y , but no t a chequered

repu ta t ion . Everyone a s u w ib tee with can

t e s t i f y t o t h e l a t t e r ,

It s t a r t e d a a t h e African Hoepital and l a t e r

assumed the s t a t m of a General Hotxpital. With the

Eest Cen t ra l S t a t e Edict No, 4 1 of 1970, i t s s t a t u e

was upgraded t o t h e t of a Speci f i l l s t Hoopital which

a l s o changed i t 8 r o l e d r a a t i c d l y , I n 1972, i t was

handed over to the Univers i ty of Nigeria, Naukka

Council t o manage, T h i ~ interim arratq; men t las:ed

f o r about f i v e yea r s and was bese t with aeveral

admin i s t r a t ive problems.

By Decree No, 23 of 1974, t h e Federal

Oovefnmmt f i n a l l y took f t over as a fu l l - f l edged

teaching h o s p i t a l , but p r o v i ~ f ona l ly managed once

again by t h e Council of t h e University o f Nigeria,

* . 6.5 b

Nsukka, In Awdst, 1977 nnd by v i r t u e of Decree

I No. 58 which took r e t r o ~ p e c t l v e e f f e c t from l e t

Apr i l , 4976, the Federal Government gave t h e

Hoapi ta l i t s f l r a t autonomous management Board.

In 4 978, v i ~ Decree No. 74, the .ndminis t ra t ive

S t r u c t u r e wa3 medifled and t h e pout of t h e Chief

Executive was t r a n s f e r r e d fron t h e Di rec to r of

A d ~ n i n i ~ t r a t i o n t u t h e Medical ~ r e c t o ~ y / D e a n of t h e

Medicnl College of the a f f i l i a t e Untversi ty

(Univerai ty of !Vl.eeria), T h o began the decancll

system h e ~ e b y t h e Dean or Provost of the associate

' Jniverui ty autome t s c a l l y assumd, t he exaccltive

headship of the teaching hospital. The decanal

aystem t e m i n a ted with the eqergenc e of Decree No*

40 of 1985 which separa ted the deanahip/yrovos t s h i p

from t h e neu Chief' Medical Direc tor who beca3ne a

f u l l t ime s t a f f of t h e teaching h o s p i t a l and a '

Federa l Governmat appointee, while t h e former was

given t h e s t s t u s of a b o a ~ d rncmber,

2 . ~ ORGANI ZATIONAJ,+ ,~RUC TUB.

~ t a t u t o r y changes which charac ter ized t h e

h i s t o r y of t h e Univers i ty of Nigeria Teaching

Hoegi ta l a l s o brought ad lp in i s t r a t ive changes,

The current organogram (appendix .1) was approved

by the Management Board i n November, 4986,

The Mansgment Board l a a t the p innac le of

t h e h ierarchy, and l a t h e pol icy making organ.

M r e c t l y below the Board i s the Chi& Medical

M r e c t o r , who i s t h e Chief Executive and Accounting

Off icer . Under the Chief Medica!, Director , a r e

the Direc tor o f A h i n i a t r ~ t i on/Secretary t o the

Manag ement Board n nd the Chairmen, Medic a1 Advi sory

Committee. The former i s respons ib le t o t h e Chief

Yrdica l M r e c t o r fob the proper funct ioning of a l l

the a dmini s t n - a t ? x u n i t e - Main Admini a t r a t i o n ,

Personnel, Public Relat ions, Dhta Bank, Tenders,

a l l i n Adminiatration Department. There a r e also

the Works, Laudry, Secur i ty and Catering

Departments. The p o s t is statutory and pensionable.

It i e the p re roga t ive of the Board t o appoint - t h e

Direc tor of Administration. I n t h e absence of a

Board of Management, t h e Federal Min i s t ry o f Health

rind Sbci a1 Service8 ( t h e Hosp i t a l ' s ) parent U n i s t r y

appoints them. .

The Chairman, Medical Advisory Committee

(formerly, Direc tor of C l i n i c a l Servi cea and

Training) is ~ Z s o an a p p o i n t s , ? of tht: qosrd. H e ie

8electaR from tht. c o n ~ u l t n n t s t a f f o f the n f f i l i s t e

V n i ~ t ? ~ 8 i t y (UN$ a d i s , himself a l l honorary

Cnrvju!.tant to t h e hosp i t a l . It i s a s t a t u t o r y

p o s i t i o n but not pensionable. The Chairman, ..

Medicel Advisory Commit t a e i u respons ib le t o the

Chief M e d i c ~ i Di rec to r f o r running the c l i n i c a l

departmente, t r a i n i n g schools ~ n d the o the r cl1nic:al

sub-units under the m b r e l l a of t h e hospital..

These a r e t h e Nuruing Sc rv lc ta , t h e Labo r a t o r y

Departments ( C h e m i c ~ l P~+,holop.y, Haemntolo~y,

Microbilogy and Morbid ~ n a t o m y ) , Iharmcy,

Phyn'.otherapy, Accident & Ehl-rgency and. the

General o u t p a t i e n t s department. T?c t r a i n i n g

achoole have a l ready becn s p e c i f i e d on pages 30 & 3q.

These t h r e e p r lnc i p a l f u n c t i o n a r i e s c o n s t i t u t e

th? Management Committee. It is pper4Jnent t o s t a t e

t h a t t h e m u l t i - d i s c i p l i n ~ ~ y na t w e end complexity . .., of h e a l t h c a r e s e r v i c e make i t a matrt x organiza-

t i o n which William F o Coventry (?979:19) 8 8 W 88

t h e o r e t h i c a l l y cona i s t inp oJ' 8 l a r g e g r i d 8ystan .*-.

demonetrati-& Lhe impact of e ~ c h indus t ry In turn

Fred Rlggs d id conceive development as

depic t ing r i s i n g l e v e l s of autonomy and d i s c r e t i o n

i n dec ia ion making by t h e s o c i n l s t r u c t u r e s (de f f r -

ac t ion) . He s t r e s ~ e d t h a t d e f f r o c t i o n w i l l produce

development only u i t h hiph leve l of co-ordinetion

and blenA?.ng of t h e n c t i v i t i e ~ o f the s o c i a l

syatems. T h i s i s the only WRY t o reduc:e wastes,

d~l_nl ica t lon , ~ n d enhance un i ty of purpose and

g o a l a t t a i m e n t . . -

This is marl1 f e a t i l l a teechilyr; h o s y i t ~ l system

where for ins tsnce t h e A s s t . Di rec tor o f Finance

and t h e A s u t . M r e c t o r A u d i t r e p o r t t o both the

Chief Medical Direc tor and Direc tor of Administra-

t i o n a t d i f f e r e n t tines. :dost Of f i ce r s ere alRo

a n ~ v d e r ~ b l e t o more then one n e e t e r h e n c e the

emphasis on ~ E I m o r l i s a t i on.

Th.e man R f z e ' ~ t arm of t h e Ilniversi ty of Nig e r i e

T e ~ c h i n g ' Foepitt l l e l ~ o epresds t o o t h e r s p e c i a l

progrurameo 11 k e the Rural Comp rehens i v e Health Cent reg,

two of which It manages a t Obukpa (Enugu s t a t e ) and

Abagana. (~nurnbrs 8 t a t t?) Add1 ti onul ly, i t . includea

t h e I n s t i t u t e of .Child Hea l th which renders maternal and

ch i ld c a r e , 1m:nunization and heel t h education f u n c t i on=

to both urban anc? remote 'r'urtil communitieno These

three sub-units ahow how the hospital i s involved

and committed t o the exec.;tic.r! Ruccesfi of the

primary heal th care propr3rnl:e on 6Nch the N a t i o n ~ l

Health Pol icy revc~lves .

8 - Allen Louie (?58:57) def ined orgeni8a t lon a8

, ,- \ -

a process o?? Iden t i fy ing and groupfng work t o be

done, d e f l n i . ~ and do1 e g a ' t i n ~ resyons ib i l i t y and

author1 t y and e s t a b l i s h i n g r e l a t i o n s h i p thut w i l l

e n ~ b l e people work together eff 'cct ively t o achieve

spcc i f l e d oq:anisa t lonal goals ,

I n , the rJarne vein, Many Parker F o l l e t eaw

organ iaa t ion a8 a ~ c n s ! . ~ - ~ l e working a~rangementa ,

* i l e Adebayo A, ( I 979) agreed t h a t i t i s a

combination of human be ings , ma te r i a l s , t o o l s ,

equipment e t a , all brought together i n 8ystematic

and erf 'ective c o r r e l a t i o n t o accompliah some d e s i r 4

object ive.

Management which we have defined from Rosemary

Stewart8 View po in t a s n a ~ c i d i n g what should be done

Grid g e t t i n e o t h e r people Cjo do itt', does not take

p l a c e i n a vacuum. It takes p l a c e within t h e frame-

work of o rgan i sa t ions , Without o rgan i sa t ions , a c t i v i t -

i e s w i l l ' b e chout ic ~ n d d u p l i c a t i o n of e f f o r t @ an8

waste of r e sources w113. be r i f e , Organieation as

a l r k u c i y hinted meanu a conception of an o b j e c t i v e or

a' ,cls?tives, conceptual is inp; how th t idea could be

conver te i , tou r e a l i t y f o r t h e beneei t of people and

f o r t h e well being of those f1o~~tix-g t h e idea , It

involves t h e i e e n t i f i c a t i o n of funct ions , deciding

on the t a sks and d u t i e s ' o f t h e perfionnel and t h e i r

8pec i f i ca t ione , t h e i r r e c r u i tmenl, departments and

t h e r e l a t i o n s h i p of t h e s e segments arid func t ions,

p rov i s ion of f n c i l i t i e s t h t w i l l . f a c i l i t a t e t h e s e

work. For ins t ance , if i t I s an office, r e f i i e t e ra

and typewr i t e r s wi 11 h v e t o be provide f o r t h e *

c l e r k s and tvp?.sts. There must be telephone, t e l e x

and f a x f o r communication, i n t e s n a l l y and externally. .

Teachiw h.ospi t a 1s a r e o r g m i s ntione. They have

i d e n t i t i e s conferee on them, e n d i w w i t h the Decree

lo ( l985) which also s p e c i f i e d w h s t t h e i r functions

72

B.I. F u n c t l o n ~ of t h e Rohrd

It a h a l l be t h e duty of the Bonrd - t o equip, maintain and opera te t h e h o e r p i t ~ l So

as t o provide. f a c i l i t i e s ' f o r diagnoaia, c u r a t i v e ,

gromat ive and r e h a b i l i t ~ t i v e service! i n medic a1

t reatment;

t o obns t ruc t , equip , m i n t p i n and opera te such

t r a i n i n g schools and s i m i l a r institutions a s the

Board c o w i d e r s necessary f o r providing t h e

.hospi ta l a t a l l t imes with a proper s t a f f of

h o s p i t a l t echn ic ians and nurses;

t o c h a k c t , equip, m i n t a i n end opera te euch

c l i n c s , out-pat ient departments, l a b o r a t o r i e s ,

~ e 8 e ~ r c h or experimental s t a t i o n s and o t h e r l i k e

i n s t i t u t i o n s a8 t h e Board considera necessary f o r

the e f f i c i e n t funct ioning of t h e hosp i tn l .

The duty of opere t ing t h e h o e p l t a l imposed by

t h e f ore-poiW sub-a e c t i o n aha 11 include, wl thout

p r e j u d i c e t o t h e e x t e n t of what duty a p a r t from

this sub-aection, t h e duty of providing proper

courses of i n a t r u c t i o n f o r medical s tudento of '

t h e a s s o c i e t e Universi ty and t h e Board may

perform t h e l a s t mentioned duty by arranging

with t h e approval o F t h e mini^ t e r , f o r s tuden t s

of such a s s o c i a t e Universi ty t o a t t e n d courses

a t o t h e r i n e t i t u t i o n s not c o n t r o l l e d by t h e

(3) The Board shall secure t h a t the s tandhlrds of

teaching provided a t a l l es tabl ishments

-J contro1,led by i t s e l f and t h e s tandards of

t reatment and c a r e provided for p a t i e n t s a t

thoee establiehmen+.s do not a. f a l l below thoee

usua l ly provided by s i m i l a r eatablishmente &

i n t e r m t i o n a l repute.

(4) Sub jec t to t h i a k c r e e , t h e Board. a h a l l have b

power t o do snyt'hinp chich, i n i t 8 opinion, i a

calculated. t o f a c i l i t a t e the car ry ing out of

it '8 f u n c t i o n s under t h i f i Decree.

Be 1 D i s c i p l i n e

Natwit>standing anything t o the contrary

contuined i n any 0 t h ~ ~ enactment, where i t appears

t o t h e i o a r d t h a t any atudent of the Hospitz31 has

Seen g u i l t y of mis conduct, t h e Board mag, without

p r e j u d i c e t o o t h e r d ' i sc ip l inary powers confer red

that, tA,e s t u d e n t s h a l l not , durinp such period

afl mng be epecic?ed i n t h e d i r e c t i o n , p a r t i a l p -

a t e i n such activities of t h e h o s p i t a l , o r

make use of auch f a c i l i t i e s o i the Hoopits l a8

my be s o ayecified.; o r

t h a t 'he k c t i v i t i e s of the student s h a l l , during

auch p e ~ i o d as m y b e s p e c t i l e d i n t h e d i r e c t i o n

b e reg t r i c t e d i n such m n n e r as may be a a

s p e c i i i e d ; o r

t h a t ^he etudent be ru.%ticated f o r such period

aa m y be mnecified i n t h e d i r e c t i o n ; o r

thnt %he s tuden t b e expelled f ~ o h the Hosgital .

The f a c t t h a t RP appeal i r o n a d i r e c t i o n i s

brought i n puru.ance of t h e l a s t foregoing subsec t ion

a h a l l no t a f f e c t t h e ope-at?.sn of t h e d i r e c t i o n while

t h e appeal is pending.

The Soard may d e l e g a t e i t 8 powers under t h i s

a e c t i o n t o a d iac lp l ina ry conmi t t e e consis tiw of such

menbera or t h e H o ~ p i t n l a s the Board mqv nominate.

~ o t h i n g i n t h i s s e c t i o n s h a l l be c o n o t ~ u e d as

prevent ing t h e r e s t r i c t i o n or te rminat ion of a s tuden t ' e

a c t i v i t i e 8 a t any Hospi ta l otherwise than on t h e

ground of nisconduct,

A d i r e c t i o n under eubaect ion (1) (a) above may

be conbined w i th a d i r e c t i o n under subsec t i on (I ) (b)

A ~ O V C ~

Nothing i n t3 .s Decree shall a f f e c t t h e provis ions

of any enactment re1atj .w t o t h e d i s c i p l i n e of medical

p r a c t i t i o n e r s , pharnaciq t s , midwives, nurses o r

aen5ers of aw o the r y rc r?~ss ion o r c a l l i n g ,

If i t apgoa&i to the Board t h a t t h e r e a r e

reasons f o r b c l i w i n g t h a t aRv Qerson eroployed as a

senber of t .ht! c l l n i c a l , adminis t r a t i v e o r technic a1

s t a f f of t h e Hospi ta l , o t h e r than the Chief Medical

Direc tor , should b e removed Prom his o f f i c e o r

emlplo~ment, the Board s h a l l r e q u i r e the s e c r e t a r y

to:-

a f f o r d him an opportuni ty of maklng repreRenfations

i n person on the matter t o t h e Board; and

g i v e & % i c e of those reasons t o t h e person i n

quest ion,

i f t h e person i n ques t inn 80 reqiiests w i th in

a p e r i o d of one month beginning w i t h the d a t e

of t h e not ic*, making arragernents -

(i) f o r a committee t o i p v e s t i g a t e the matter .and

r e p o r t an i t t o t h e Board; and

(ii) for t h e person i n ques t ion t o be.. a f forded an

' L opportuni ty of appearing before and being heard

by thp investiga+,i.ng committee wl.+.h r e spec t t o

.. . t h e matter ; and it .the Board, after connidering

t h e r epor t of the investigating cornmittee, i o

eat i f f i led t.ht the person i n ques t ion should be

removed as aforesaid, the Roard may s o remove

him by a l e t t e r signed on t h e d i r e c t i o n of t h e

Bon rd ,

The Chief Medical Director may, i n a case of

misconduct by a member of the sta?Y' which i n the

opin ion of t h e Chief Medical Director is P r e j u d i c i a l

t o t h e i n t e r e s t of t h e Hospi ta l , suspend any such

member t t r ? . sang such suspension s h a l l fo r thwi th be

rcpor ted t o t h e Board.

For good cause, any member of t h e s t a f f nay be

suspended from h i s .at i e a o r h i s appofn%aent aay be

terminated or he may be diemissed by the Board; and

f o r %he puwooes of th ia s e c t i o n , "good c lausen means -

a convic t ion f o r any of't'ence wl~ic h t h e Board

conaidera t o be such as t o render t h e person

concerned unf'i t f o r t h e d i scharge of' t h e funct ions

before the exp i ra t ion of a p e r i o d of t h r e e mont-ha a f t e r

t.h.cz da te of such guapension cons ider t h e case a g a i n s t

t h a t person and come t o a dec i s ion a s to+

(A) Whether t o continue s x h person 's suspension and

' i f ~ 9 , on what terms (including t h e propor t ion

of h i = - - elnorlurn.ents t o be p a i d to him) ; o r

of h i s o f f i c e ; o r

conduct of a scandalous or o t h e r d i sg race fu l

m t u r e which the Board corlr;iders t o be 8uch as t o

render the person concerned u n f i t t o continue t o

hold h i e o f f i c e ; or

conduct which the Board cons ider t o be euch as

t o c o n s t i t u t e f a i l u r e or i n a b i l i t y of t h e peraon

concerned t o discharge the funct ions of h i s ' o f f i ce

c\r t o comply wlth t h e t e r n s and condi t ions of h i s

serv ice .

Any person suspended s h a l l , sub jec t t o subsec t ion

and (3) above be on b l f pay and t h e Hoard s h a l l

78

Whether t o r e i n s t a t e ~ s u c h peraon, i n which c a s e ,

t h e Board s h a l l r e a t o r e his full emolument8 t o

him with etfect from t h e date of suspension; or

whether t o t e r n i n a t e the appointment of t h e person

concerned, i n which case, such person e h a l l not

be e n t i t l e d t o t h e propor t ion of h i s emolument8

with h e l d during t h e pe r iod of supension; lor

whether to t ake R U C ~ l esser ~ s c i g l i n a r y a c t i o n

a g a i n s t such person (Ancluding t h e r e s t o r a t i o n

of h i s emoluments th t mjaht have been with h e l d ) ,

as t h e Board m a y determine; end i n any c a s e where

the Board, pursuant t o t h i s s e c t i o n decides t o

c o n t i w e a versons suspension o r decides t o t a k e

f u r t h e r dlsc.iplinary uc t ion agairm t a pereon, t h e

Board s h a l l before the e x p i r a t i o n of a per iod of

t h r e e months f r o m such dec i s ion come t o a f i n a l

determinat ion i n r e spec t of t h e c a s e concerning

any such person.

It s h a l l be t h e duty of the person by whom a

l e t t e r of removal is signed i n pursuance of eubeecti on

(1 ) above t o u s e bes t endeavours t o cause a copy of

t h e l e t t e i t o bd served a s Boon a s reanonably

p r a c t i c a b l e on t h e peraon t o whoa i t re la tee ,

79 . a

Nothing i n the foregoing provis ions of t h i s

s e c t i o n s h a l l prevent t h e Ronrd from making such

regu la t ions not i n c o n s i s t e n t wi th the provisions o f

this Decree f o r the d i s c i p l i n e of s tuden t s and a l l

o t h e r ca tegor ies of employees of the Hospi ta l as t h e

Board m a y p r e s c r i b l e .

Regulation8 made under subsec t ion ( 6 ) above

need not be publ ished i n Gazet te but t h e Board s h a l l

bring them' t o the n o t i c e of a l l e f f e c t e d persons i n

such manner a s it m a y from time t o time determine.

If any junior s t a f f is accused of misconduct o r

i n e f f hi ency, t h e Chi ef Medic a 1 Direct o r may eusgend

him f o r not more t , h n t h r e e months mid fo r thwi th a h a l l

d i r e c t a committee - (A) t o c o m f d e r the case; and

(B) t o make recommendations a s t o t h e a p p r o p r i a t e

a c t i o n t o be taken by t h e Chief Medical Director.

I n a l l cases u n d e ~ t h i s s e c t i o n , the o f f i c e r shall

be infforaeci o? the charge aga ins t him and shall be . g iven reasonable opportu2i t y t o defend hima e l f .

The Ch?. pf Medical Director may, nf + e r cons ide r ing

t h e recommendation made i n pursuant t o subsec t ion

(I) (b) of t h i s s e c t i o n , dismiss , o r t a k e such o t h e r

d i u c i g l i n a r y a c t i o n agtaim t t h e o f f i c e r concerned.

Any psraon ~ g r r i e v e d by the Chief medical

Direotolr'e dec i s ion under subsec t ion (3) of thls

e e c t i o n may, witMn a pe r iod of 23 -days from t h e date

of t h e l e t t e r communicating t h e d e c i s i o n t o h i m ,

address a p e t i t i o n t o t h e Roard t o recons ider h i s

case.

B. 111. M i s c e l Z - - . '

(1) The Board may, with the approval of t h e min i s t e r ,

make bye-la we ;

(A) a8 t o the access of menbere of t h e publ ic e i t h e r

g e n e r a l l y or of a p a r t i c u l a r class, t o .prem;tses

under t h e c o n t r o l of the Board and as t o t h e

o rde r ly conduct of members of t h e publ ic on those

gresiseo; and

( R ) f o r safeguarding any property belonging t o o r

c o n t r o l l e d by the 3onrd from dnmege by members

,of the pub l i c ;

Sye-law8 iinder 'thj.8 s e c t i o n s h a l l not come i n t o

f o r c e u n t i l they a r e confirmed (with o r without

modif icat ion) by t h e min i s t e r and publ ished i n such

manner as he may d i rec t .

I

Rye-law m ~ d e under t h i s s e c t i o n m a y providea

t h a t a breach of t h e bye-l erd o r of a p n r t i c u l a r

p rov i s ion of: the bye-lew s h a l l . be punishable by a f i n e

(not exceedinu wW) and i n defaul t of payment of t h e

f ine by imprisonment f o r s ~ w h a term as may be spec i f i ed ,

n o t exceeding 7 daye.

B r ~ - l a . w made under this sec t ion s h a l l not apply

t o any member of t h e R m r d and s h a l l not , i n t h e i r

a p p l i c s t i o n t o a p a r t i c u l a r i n s t i t u t i o n , apply t o an

off:cer o r servant of t h e B o ~ r d employed i n connection

with t h e i n s t i t u t i o n o r t o a s tuden t a t the i n s t i t u t i o n . - 4

The ~ ? . n S ~ t e r , t h e permanent s e c r e t a r y of t h e minis t ry ,

t h e Di rec to r of medical s erv ic es and Tra in ing and

(on production i f 80 requdr9d of h i s a u t h o r i t y ) any

person author ized i n t b t behalf by any of t h e persone

a fo resa id m a y a t any time e n t e r and inspect any

i n s t i t l l t i o n c o n t r o l l e d by the Board.,

The Board s h a l l render t o t h e Director of

Medl c a l Services and Tralning a t such tlmea and i n *

such form a A he may spec i fy , such s t a t i s t i c a l and o t h e r

r e t u r n s ae he may f r o n tirne t o tirne require.

The Board s h a l l p r e p m e and subp i t t o t h e Federa l

Executive Council, through the min i s t e r , n n t l a t e r than

t h e 30th day of June i n each year , a repor t i n such t

form 88 t h e min i s t e r may d i r e c t on t h e a c t i v i t i e s of

t h e Ronrd durJ the immediately proceeding f i n a n c i a l ,

y e a r ~ n d s h a l l inc lude i n such repor t a copy of t h e

aud i t ed accounts of tk Board f o r t h a t y e a r and of t h e

a u d i t o r '8 r e p o r t thereon.

The Board s h a l l be reypons ib le f o r lay ing down

genera l p o l i c i e s and gu ide l ines r e l a t i n g t o major .., .

expansion programmes of t h e Hospi ta l and t h e provie ion

of f a c i l i t i es f o r the tqt ininp, of medical s tudent8

of t h e a s s o c i a t e u n i v e r s i t y end i t s h a l l be the duty

of t h e Board t o execute such p o l i c i e s and t o keep

within a uch guide l ines .

The Board s h a l l s u b j e c t t o t h i s Decree have

power of promotion, advancement, d i s c i p l i n e and t h e

determinat ion of appointment of lnemb&s of e t a f f of

t h e Honpital.

The min i s t e r m a y g i v e t o the Board d i rec t iona . '

of a genera l c h a r a c t e r o r r e l a t i n g genera l ly t o

p a r t i c u l a r matters (but not t o any i nd iv idua l person

o r c a ~ e ) with regard. t o e x e r c i s e by t h e Board of i t ' 8

func t ions :under t h i s Decree,' and i t s h a l l be t h e

duty of the Board t o comply with the d i r e c t i o n s ; but

no d i r e c t i o n shall be given wfil.ch is i n c o n s i s t e n t with

t h e d u t i e s of the Board-.under t h i s Decree,

The Head of' t h e Federal Mi l i ta ry Government nay,.'.

notwithstanCilng any provis ion of t h i s Decree, t ake

such measure8 as o c c a ~ i o n nay warrant i n o rde r t o

improve t h e e f f i c i e n c y o r due adminig t ra t ion of t h e

teaching Hospitals s p e c i f i e d i n t h e schedule t o t h i s

Decree,.

, For t h e p u r y m e of subsec t ion (1) of t h i s s e c t i o n ,

the Head of t h e a p p c i n t b n t of m i l i t a ry commandant t o

+,=!:a charge of i h s e&mlnis t ra t ion of any of t h e teaching

Hospi ta ls s p e c i f i e d i n t h i s Decree f o r such periacl a8

nay b e 8 t i p u l a t ed i n t h e a u t h o r i t y ,

The appointment a t any t iue before the d a t e of

the making of t h i a Decree of a mi l i t a ry commandant f o r

any of t h e teaching Hospite s s p e c i f i e d i n t h e echedule

t o t h i s Decree shall 'be deemed t o have been made

pursuant t o t h e provision^ o f t h i s Decree.

The p rov i s ions of the Decree show managers a t

diff e r e n t leve ls . here is t h e management Board

composed of human beings regarded a s expert8 i n t h e i r

own f i e l d s , Below them is the management team,

comprl-aing t h e Chi e l Medical Direc tor , the Chairman,

M,,.A.C and M r e c t o r of Adminis t r o t i o n . Under them are

t h e i r i m e d i e t e surbordina tes and o t h e r profess ionals .

and g e n e r a l i s t a s t a f f a l l performing various func t ions ,

I n t h e Decree t h e ob jec t ives of e s t ab l i sh ing the

Teuching Hospi ta l have been c l e ~ r l y s t a t e d , It i a t o

render heaJ th a e rv ices t-o t h e c i t i z e n s . By t h i a is

mean$, advis ing them on t h e i r var ioua physical end

mental e i lments , diagnosing tihese oilments , preecr ib ing , manufacturlng/procurring drugs t h a t w i l l g e t r i d of the

problems.

It a l s o covers t he t r t l in i rg of h e a l t h g.eraonne1.

For ins t ance t h e teaching hoep i t a l a t r a i n :

(A) Reoident J)octore

(B) Nurses

(C) Midwives

(D) Medical Lab. S c i e n t i s t s

( E ) Medical Stuaents

(F) Dental T h e r a p i ~ t

TME list i e a t i p of t h e i c e berg, The t r a i n i n g

f u n c t i o n a s i t aff 'ecta au r ses span t u t e l a g e in :

b

General nursing

Cardiothoracic Nureing

Nurse Anaesthet is t

Theatre Numes

Ophtalmic Nurses

Community Health

Health Educatore

In t he Aame vein, doctors a r e t ra ined f o r a l l

epec i a l t i ee l i k e :

General Surgery

uraiogY

Cardiothoracic surgery

ENT Surgery

Paed ia t r i c eurgery

General medicine

Cardiology

Gastroentrology

O b s . and Gynee.

Ophtalmology

~ a d i o l o g y e. t ..c.

The lcope and catchment areas of t he t ra in ing

cover a l l p a r t s of Nigeria all. over a,n_d even

the world a s a whole, F a c i l i t i e s and s t ruc tu re s .such

as machines and consumables of a11 kinds have t o be

grovided - Theatres', of f i c e a , conference roome,

classrooms m d warde. The populace need t o be aware

o f .the f i n c t i o n s of t h e Teaching Hospi ta ls t o

p a t r o n i z e and bencfi t from t he i r serv ices ,

Teaching Hospi tals a r e a l s o exgected t o perform

reaearch func t ions t o update knowledge, discover new

knowledge and so lve problems, This l a t h e reason

f o r va r iou8 l a b o m t o r i e a e c a t t e r e d - a l l over the place,

Although pure r e s ear& i s prepondorent, appl ied resea rch

a l s o takeRglRce both in t h e c l . i n i ce l regi onu and

admin i s t r a t ive s e c t o r s ,

They f inance t h e i r a c t i v i t i e s f r o m subvention8

granted them by the Federal Ooverment through t h e

Federal ini is try o f Health and Social Services , ,

Teachf ng Hosp i t a l s a1 so genera te revenue b u t not t o

a Aegree o f e elf-euetenance.

2,C _Indus t r i e l Je$ ions i n T e a c h l z Hospitals ,

Au thor i t i e s on the aub3ect of i n d u u t r i a l

re lat ' iona have seen it from diPferent p o i n t a of view.

This is not su rp r i s ing a 6 a l l courses i n the s o c i b l

ec iences have s t rong l i n k with human beings, It I8

well-known t h a t when mat tem concerning human beings

come i n t o focus the exactness of the n a t u r a l and

p h y s i c a l sciences does not hold,

Allan Flanders 9avv i n d u s t r i a l r e l a t i o n s a s t h e

s tudy of' job i n s t i t u t i o n s and t h e r e l a t i o n s h i p between

t h e e~nployers and employees and amongst employees

themselves. Richard Hyman s a i d t h a t i n d u ~ + r i ~ l

r e l ~ t i o n s is centered on c o n f l i c t and r e s o l u t i o n or

c o n f l i c t , This is der ived f raom t h e maxis t ' s view

p o i n t of confJ.ict arid s t r u g g l e between t h e s e r t s and

t h e Lords, H i s d e f i n i t i o n a l s o has strotlg c o r r e l a t i o n

with t h e defi n i t i o n of f landers s i n c e the r u l e s 1

governing re l a t ionsh ipa a e poo tu la t ed by t h e l a t t e r

a l s o ghoul'd n o r m l l y cover means of obviat ing and '

resolv ing c o n f l i c t s , John DunZop saw t h e szbjec t a s

a sub system of t h e t o t a l S o c i e t a l System Comprising

t h e P o l l t i c a l , Rconomic Soc.1 a1 a nd Technological

(PEST), Nigerians l i k e Ubeku, Akpala, Otobo and

~ a s h o ~ i n " 8 d e f i n i ti on8 do not depert s i g n i f 1 c a n t l y

from those of' t h e f orelgners .

4

As al ready s t a t e d teaching h o s p i t a l s a r e

mul t i -d isc ip l inary i n s t i t u t i o n s , E d k a t i o n give8

t h e educated e n l i ~ h t e n m e n t . It a l s o develop8 the

ind iv idua l , T h i ~ is why t h e teaching h o s p i t a l

envimnment Is complex. Not only is i t multi-

d i s c i p l i n a r y but a l s o most profess iona l s i n t h e

system can s t and with p r i d e on t h e i r own. grounds and

would withstand chnllengee o r r e fuse t o t o l e r a t e

chal lenges from o t h e r prof e s s iona la ?'or a b e t t e r

apprec ia t ion of' t he a r r n y s of d i s c i p l i n e s , l e t u s

look a t medicine f o r example. The teaching h o s p i t a l s

have t h r e e c l e a r cu t l e v e l s - t h e consu l t an t / l ec tu re r s ,

t h e Resid.ent doctors and t h e House o f f i c e r s 4

The consul tan ts a r e a u t h o r i t i e s i n t h e spec ia l -

i t i e s spanning over 35 c l e a r a r e a s and over 1 5 o t h e r

8ub-spec ia l i t i e s . . For ins t a m e , i n surgery you w i l l

normally h v e - General surgery

Neuro surgery

Orthopaedice. .

These s p e c i a l i t i e s heve sub s p e c i a l i t i e s , One

can s e e t h e v a r i e t y of sub jec t8 when i t is considered

t h a t i n medicine you hove aver t e n d6partmenta.

Down the ladder , you h ~ v e the l abora to ry

e c i e n t i a t s , t h e pharmacists, t h e Nurses, Radiogra-

phers , t h e Accountants, t h e Engineers and t h e

Administrators. These para medical and non-medical

gpoupa know t h e i r onions i n t h e i r d i f f e r e n t f i e l d s .

As moat af t h e s e d i s c i p l i n e s a r e independent, s o

do they have t h e i r d i f f e r e n t trSade miens and

p r o f e s s i o n a l a s soc ia t ions . So counterva i l ing f o r c e s

come i n t o bear a r i s i n g from imperfect mobilization.

These groups, exert p r e s s u r e umong themselves on the

one hand and the management on t h e o the r -hand. This

s i t u a t i o n is what Car l Frederich (1908) c a l l e d t h e

hydraul ic t h e s i s depic t i n e a systern of f o r c e s and

p ressu res a c t i n g and reac t ing t o one another i n t h e

formula t ion of pub l i c policy, a l b e i t cc t a micro l e v e l

i n t h i s context. Qu i t e o f t e n , r a t h e r than i n d u s t r i a l

c o n f l i c t with management, it becomes inter-union

squablea l i k e t h a t between t h e N , R . S , U , and medical

and Heal th wol?kers union of Nigeria o r t h a t between

National Associs t i o n of Nigeria Nureee and midwivee

and t h e Aseociat ion of Resident Doc t o r s o r between

Associat ion of Resident Doctors and t h e a s s o c i a t i o n

of phys io the rap i s t s o r medical Laboratory S c i e n t i s t s .

F i r s t demarcation s t r i k e s become r i f e . A l l t h e s e

g i v e management of industrial r e l a t f 011s i n a t y p i c a l

teaching hospi t a l a unique charac ter . Management l a

o f t e n nbt seen a s r a t i o n a l and f a i r because it beam

t h e t r a i t of a p o l y ~ a m i e t with demands from too many

wives And t h e i r children.

The doctors a r e u l t ima te ly r -e~t r rded a s the

l e a d e r s of t h e h e a l t h tean. Thi.s seems t o g i v e then

an edge over o t n e r s and aggruvates the complexity

e a r l i e r h ighl ighted . Doctors a r e seen as the favoured

chi ldren. It is the re fo res not surprif~ing t h a t i n ,

more than one occasion t h e o t h e r groups ~ u b t l y u n i t e

t o f igh t e i t h e r t h e doctors or -nagement. The l a t t e r

a spec t br ings t o r e a l i t y t h e " r e l a t i onahip between

apparent i n the Allan Flanders d e f i n i t i o n of . i n d u s t r i a l

r e l a t i o n s a l ready s t a t e d . Management grapples 'with

euba tan t ive i n d u s t r i a l r e l o t i o n s i s s u e s and a l s o

tr?. es t o r e so lve i n t e r union 'imbroglio.

hospi t~!. has t h e fo l lowing Trade Unions and o t h e r

~ s s o c i a t i o n : ~ ready and wi l l ing to f i g h t f o r and

p r o t e c t t h e i n t e r e s t of t h e i ~ members.

6.1. Trade Ucix

(A) Non Academic S t a f f Union

(B) Medical and Health workers union of Nigeyia

(C) National Associat ion of Nigeria Nurses and

M i dwivea . (PI) Stenographic 'and Al l i ed Workers Union

(E) sen io r Btaf f Assoc i a t i or1 of Teaching Hospitnla

and research i n s t i t u t e s .

(F) Associat ion of Resident Dictora

( ) Nigeria Medical Association.

C. XI Profess iuna l A ~ s o c i a ti o ~ .

(A) Nigeria Phys io therapis t Associat ion

(B) P h u ~ ~ r c & u t l c a l Aaaoc ia t l o n of Nigeria

(C) Associat ion of Laboratory S c i e n t i s t s

(D) Associat ion of Consul tants

('E) National associa t i o n ,.of' s e c r e t a r i a l s t a f f of

It is p e r t i n e n t t o p t r e s s t h e aphoriam %he

enelhy you know 1 3 b e t t e r than the d e v t l who 11 ves

wi th you i n d isguisew. T h e ~ e ex1 ~ t a i n teaching

h o e p i t a l s many i l ~ ~ o r m n l g r o u p which Szl lopyi A.D.

(1980:201) d.efined as wgrollps t h a t ~ e n e r a l l y emerge

n a t u r a l l y from the i n t e r a c t i o n o f t h e mmbero, and

t h a t mey o r m q y not have purpose6 - t h a t a r e r e l a t e d t o

or. congruent with t he goals of the organisat ionn.

Non r e g i s t e r e d o r recognla ed unions and Associat ions

uRe t h e s e t o f i g h t f o r w h a t they consider t h e i r . r i g h t .

They f e e l they would be heard c o l l e c t i v e l y r a t h e r than - 4

puFoue t h e i r case in&Lvfdually.

It was under t h i s kind of umbrella, thdt the

m F a e Anaes the t i s t s , a *veTy important group i n

s u r g i c a l opera t lono suddenly withdrew t h e i r s e r v i c e s

from t h e t h e a t r e i n 1991 and paralyeed eervic es f o r

two days, Management uved i t s big harnmer and gave

them various t e r n s of eunpensions ranging f r o m one t o

two weeks f o r s ide- tracking t h e ~ f f i ~ i a l channel of

communi da t i o n and g s i evance procedures.

Since this i n c i d e n t management h m defined group,

a c t i o n , prefern ing t o d e a l with a union o r Associat ion

a t R time. When union3 u n i t e under J A T U ( ~ o i n t Action

94

of Traae Unions) munag emmt b acorn es apprehensive,

s c e p t i c a l and refuse them both recognition and

dialogue. It was' under the umbrella of 3.A.T.U that

t h e UNTH was he1 d .unUer s i e g e Por over f o u r hours by

Trade U n i m O f f i c i a l s eaeklng bend management t o

meet t h e i r demanda.

T ~ A P T E ~ THREE -. 3.1 Data Yresente t ion. . ..

The data co l l ec ted a t t h e s tudy a r e hereby

presented as f ollow8.

Table 3.1.1

Number o f R~suonden ts Class i f l e d b y Lew t h of Servic e.

Length of Service No o f (years) . Respondent8

%

I Tota l \ 200 a loo

Source: Research Qucst ionnaire admini a t ered on selected sample of' UNTH s t a f f ' - 1998.

To understand the dynamics of i n d m t r i a l r a l a t l o n a

i n an ~ n e t l ~ t i o n l i k e the Teechine; Hospi tal with many

Unions, one needs t o have worked long enowh in t h e

place. The preponderance o f thoae &a had vvorked i n

t h e ~ o s ~ i t ' a l up t o 10 yea r s and above (i.e. 7546 of t h e

respondents) val idates t h i s vlew. Although those who

had spent up to five years were 25%. people i n t h a t

category who a re consciolls, of the events i n t h e i r

environment w i l l a180 be knowledgeable. The views of

t h e s e groups o f s t a , f f can be h e l d as r e l i a b l e on the

sub3 ec t of research.

Table 3.1.2

Source: Research Quest ionnaire administered on s e l e c t e d sample of' UNTH s t a f f - 1998.

Numbership of Trade Union.

Out o'f t h e 200 qu.estionnaire d i s t r i b u t e d , 198

of t h e respondents agreed t h a t they belona t o a Trade

' .

Union. Again, t h e smat ter ing 2 who s a i d they do not

belong t o t r a d e unions i n c i d e n t a l l y are members of one

J

L

a s e o c i a t i o n o r the other . Th i s g i v e s t h i s ques t ion ?Ow

agreement s i n c e both t r a d e unions end profess ional

To t a 1 -.

200

Yes

198

a s s o c i a t i o n s more o r l e s s perform s i m i l a r funct ions.

No

2

T h i s f u r t h e r v a l i d a t e s t h e i d o r m n t i o n i n Tab le 4.2 a s

members of t h e unions a r e involved i n one r a l l y or

meeting from t ime t o time. It i s i n t h e s e f o r a t h a t

dec i s ion on s t r i k e and i s s u e s i n diflpute and r e l a t i o n s h i p

4

-. 97

g e n e r a l l y a r e thrashed out, - with majority support based

on which mandate for a c t i o n i s g iven t o t h e officials

of t h e unions o r a s s o c i ~ t i o n s .

Table 3.1.3

Response of Respondents on No. of S t r i k e s Embarked w o n i n t h e l a s t 10 years.

Has your union gone on s t r i k e / s i n the past 10 years .

Yes NO. of Timm

i - 1

2 - 8, with 4 as t h e node

i (180 times)

Source: Research Questi onnaire administered on s e l e c t e d sample of UNTIi s t a f f - 1998.

A l l t h e 200 respondents admitted t h a t t h e i r union/s

have gone on s t r i k e wi th in t h e p a s t 10 years. This shows

t h a t the union8 have had one problem o r the o the r with

t h e Management o r the Federal Oovernment.

Addit ional ly , they agreed t h a t the frequency ranged

between 1 t o 8 times. The most f r equen t f i g u r e was f o u r

t imes which t h e researcher regasded as' t h e mode having

occured up t o 180 t i i e s . Cursory look a t t h i s f i g u r e may

g o r t r a r y the frequency a s low. This i s not t r u e when

considered s t r i k e s a r e undesirable. In t h e same vein the

dura t ion of t h e , s t r i k e s i s a v i t a l f a c t o r . one of t h e

revenue genera t ion of t h e h o s p i t a l i s put a t N250,000.00

per day as a conservat ive e ~ t i m a t e , a loss , of BI.3,500,000.00

( t h r e e mi l l ion , f i v e hundred thousand ~ a i r a ) would be

incurred f o r two weeks. F o r a s t r i k e l i k e t h e one

embarked upon by t h e nurses i n 1994 t h a t l a s t e d f o r e i g h t 8

moneths, t h e h o s i p t a l 'would have l o s t :

8 months a t 30 days per month - 240 days

240 days x N250,000.00 r ~ 0 , 0 0 0 , 0 0 0 . 0 0 ( s i x t y m i l l i o n ~ a i r a ) .

T h i s is only one aopect of t h e treuma. When t h e

medical labora tory s c i e n t i s t s went on s t r i k e i n 1996 f o r

1 month, t h e Blood Bank l o s t 50 p i n t s of d i f?erent

ca tegor ies of blood donated by ind iv idua l s f o r serv ices .

Using the p r i c e of BZ1,200.00 f o r the 0 + group which l a

the cheapest , t h e sun, of IY1,200.00 x 50 P160,000.00

( s i x t y thousand ~ a l r a ) .

These a r e only two aspects of t h e e f f e c t s of

a t r i k e s on ' f inance alone. Some ot)?pr1: r e emotional and

t h e r e f o r e very depressing but unquantif i a b l e f i n a n c i a l l y . '

Table 4.4 i s more o r l e s s s e l f explantory. The

most prominent s i n g l e cause of s t r i k e i s non-payment and

l a t e payment of' s taff ' s a l a r i e s and i n a s i t u a t i o n of

9.3-

prevalent depressed economy and s p i r a l i n f l a t i o n , no

s i t u a t i o n can be more devastating.

The above i s followed by d i sc r imina t ion i n the

treatment given t o medical doc to r s of a l l kinds i n sharp

c o n t r a d i s t i n c t i o n t o o the r a t a f f . For ins t ance , while a

p r e r e g i s t r a t i o n House o f f i c e r earns over ~10,000.00 p e r

month, a Direc tor of Administration who possesses a

postgraduate c e r t i f i c a t e with over 17 yea r s ~f s e r v i c e

8 8 4 n 8 leas than U8,000.00.- I n t h e same way almost any

request made by a doc to r i s gi'ven a t t e n t i o n o r granted

invar i ab ly whereas those of o ther s t a f f a r e subjec ted t o

c r i t i c a l s e c u r i t y and o f t e n not granted.

There f ollovm non implementation of en tabl i sh~nent I

c i r c u l a r s with 24%. Again research e f f o r t i n d i c a t e s t h a t

t h i s i s a very problematic issue. For ins t ance , c i r c u l a r s

r e l eased i n 199? had been the c a m e of a t r i k e s i n c e 1993.

The Unions have demanded, dialogued and exhausted t h e i r

pat ience. While t h e Management decided t o implement the

dec i s ions a s i t a f f e c t e d t h e doctors , i t did s o i n piece-

meal.

I n t h i s ins tance , t h e doc to r s were not s a t i s f i e d

and o t h e r s t a f f who received no cons idera t ion became

r e s t i v e and uncompramising. . Management i t s e l f waR f a c i y o dilemma s i n c e t h e

Federal OOvernment which approved t h e c i r c u l a r refused

t o . r e l e a s e money f o r i t s implementation. In. most canes,

I t urged ~ n n a g e i e n t which could. r a i s e money t o pay t o

do so. Otherwise, implemeritation should be hal ted. So

teaching h o s p i t a l s which have money pay while those which

do not f a c e p r e t r a c t e d problems. Same s i t u a t i o n appl ied

t o c i r c u l a r I , of 1998 where the allowances due to medical

do c to r s were increased b u t t h e g wernment 'never provided

money for,payment. Most teaching hospi ' ta ls paid and o t h e r s

could not. The r e s i d e n t doctors i n UNTH went on s t r i k e

two times between December 1995 a M February 1998. In

apprehension and t o stem f u r t h e r t i r e d e s , t h e Management

paid doc to r s from t h e gene9al s a l a r y pool and t h e money

f o r ss i la r ies got shor t c i r cu ted c r e a t i w d i s - s a t i s f a c t i o n

a l l through t h e ? n ~ f !.tauti on, .. .

The adverse e f f e c t s of s t r i k e were s l a t e d with .

death o f p a t i e n t s coming a t t h e apex, followed by l o s s

of revenue wiii'crh we have already high l igh ted , d is rup ' t ion

of s 'ervice, low morala and low p m d u c t i v i t y followed.

Boom t o p r i v a t e h o s p i t a l s ~ n d quacks ranked'equal

with d e s t r u c t i o n of. t h e economy.

Loss of c r e d i b i l i t y was next and l o s e of' pc$'tient s

and s t r s i n e d r e l a t i onship between Management and- s t a f f

followed.

The respondents a l ao offered aol.utions t o t h e causes

of s t r i k e and eventual ly t h e i r adverse e f fec t s .

According t o them, prompt payment o f sa l - a r i e s and

allowances ranked h ighes t . I t was followed by c o r r e c t

implftmentation and i n t e r p r e t a t i o n of c i r c u l n r s ,

Implernente$ion of' c o l l e c t i v e agreements, r e l e a s e of . - subventions promptly a d treatment of workers grievance8

prompt l y were ra'ted equall.y,

Theae were followed by judicious use of a v a i l a b l e

reaources by Management and t h e c a l l f o r t r a i n e d adminet-

r a t o r s t o t ake over t h e headshop of teaching hospi ta l s .

1

Table 3.1.5

Contr ibut ion of' Management 4 Federal Minis try of Health t o S tr . ikes. -

---.

Source: Response from Questionnai res administered t o a Selected S ~ ~ m p l e of UNTH S t a f f - 1998,

CONTRIBUTION

FMOH 1180 190 / 20 I

From ~ s b i e 4.5 t h e Federal Ministry o f Health was

blamed f o r t h e frequent ' i n d u s t r i a l a c t i o n i n t eachlr-g

I MANAGEMENT I

10

h o s p i t a l s . While t h e parent Minis t ry got 9m, the

YES (NO.) %

of funds I 5og! 1

! i

I i

Lack of Sup e r v i -

1 ~ ! ~ ~ . M ' n m e - ~ , 8 1 ' ! 2 1 1

a i on and monitoring

I 50%

HOW

FM OH $

Mismanagement I

i

NO (NO*)

1 1 IImdequat e subvent ion

100%

i

Lat e Release of Subventions

1 00%

Favouri- t i a m t o doc to r s

5096

\

Fivouri t ism t o doc to r s

5w

I

,,

I I

Management got about 4$.. Those who exonerated t h e

Federal Minis try o f Health were only 1m and those

who exonerated Management from balme were 1%.

The respondents blamed t h e redbra1 Ministry of

Heal th f o r inadequate f i n d i n p arid l a t e r e l e a s e of

subaentions, These were followed by lack of supervis ion

and mon&toring of gerformanc e while favour i t i sm t o

doctors come l e a s t .

Management was moderately blamed f o r mismamgenent

of f u d s 'and favour i t i sm f o r doctore t o t h e same degree,

Table 3.1 .6

Ade~uecy o r Otherwise of Funding and Rela t ionship Between Funding a n d .Indug t r i a l Peace, I

Funding

Relat ionship Between Funding & I n d u s t r i a l

Inadequate

Source: Response t o ques t ionnai re administered on a se lec ted sample of UNTH S t s f f - 1998.

The ~ e s p o

1 05

nse ma heavi ly t i l t e d (9w) that

the UNTH was inadequately funded only a smetterlng

1 dlaagreed.

Begarding the ~ e l a t i o n s h l p between industrial

peace and finding, 8O$ of the respondents agreed

that there is a etrong relat ionship w N l e 20%

disagreed,

BucWetary All~...tlon Below WHO Prescription:

look at Table 2.2 show8 that the N l p e r i a n

government hns not been heeding t o this c a l l . It

budgetary a l l o c a t i o n has c o n s i s t e n t l y been below WHO #

p r e s c r i p t ion,

30 20 2 ck of Modern F a c i l i t i e s and Poor Maintenance

.. . . , . .c L

This low funding which our t e s t of hypothesis has

proven hae.3adk t h e teaching h o q i t a l s unable to : ,I I

(a) Provide modern p a c i l i t i e s fo r trealrncnt of p a t i e n t s ,

research , diagnosi-S and teaching,

( b ) Maintain and re fu rb i sh .exis t ing f a c i l i t i e s ,

( c ) Sponsor s t a f f f o r t r a i n i n g t o improve t h e i r knowledge.

(d) Respond with adequate s t r e n g t h t o epidemics and

d i s a s t e r s ,

( e ) Pay s t a f f s a l a r i e s and allowances on time.

3.2.3 Annunl P l ~ k e t R e p r a e d a s Ri tua l :

The annual budget e x e r c i s e of teaching h o s p i t a l s a r e

regarded a s mere r i t u a l s . Whatever they present as t h e i r

needs and, however, they defended those requirements, t h e

a u t h o r i t i e s a t the Federal l e v e l J u s t g i v e what they l i k e

t o t h e I n s t i t u t i o h s .

Addi t ional ly , t h e amount so a l l o c a t e d i s not made

known t o the teaching h o o p i t a l s t o enhance planning.

Again t h e teaching h o s p i t a l s a r e regarded a s

I n s t i t u t i o n s rendering s o c i ~ l se rv ices , They a r e not

Permitted, as a matter of pol icy , t o e charge commercial

r a t e s ,

3,2(b) S t a f f Motivat ion at-@ Indus tri a1 Re la t ions ,

Industda!. pence is a sina-quo-non f o r p rog res s i n

any i n s t i t u t i o n and t h e t e a c h i w h o s p i t a l s a r e no exception.

3 2 Eeachinp; Hosp i t a l e -- a r e Hazardous I n s t i t u t i o n s -- : Teaching h o s p i t a l s a r e hazardous i n s t i t u t i o n s and

t h e workers a r e s o exposed. They a r e not motivated, The

UNTH f o r i v s t a n c e , has not promoted i t s s t a f f s i n c e 1991.

The t r a d e unions have complained u n t i l they seem t o have

r e s igned themselves t o t h e i r f a t e , b

To worsen t h e l a c k o f mot iva t ion , t h e s t a f f of UNTH

do no t r e c e i v e r e g u l a r s a l a r i e s , For t h e past ' 10 y e a r s ,

s a l h r i e a hove been always ' three months i n a r r e n r a . T h i s

p u t s t h e s t a f f i n a very t r y i n g and tempting, p i t i a b l e

condi t ion .

3.2.3 Allo-wances Pa id i n In s t a lmen t s o r Piecemeal:

My i n t e r v i e w ' w i t h t h e o f f i c i a l s of t h e t r a d e union

i n d i c a t e t h h t t i m c s was when t h e s t a f f s a l w i e s were p a i d

wi thout a t t e n d a n t a l lowances , p a i d i n i n s t a lmen t s and i n ,

f r a c t i o n s ,

3.2.4 Y-NTH Staff a r e Frudtrated:

Without motivation and f a c i l f t l e s s t a f f a r e f r u s t r a t e d

a s they f i n d no avenue t o express t h e i r s k i l l .

S k i l l Drain:

This has made s k i l l d r a i n a common f e a t u r e of the

teaching h o s p i t a l s and UNTH for t h e p a s t 15 Years. A

s p e c i a l i s t i n neuro-diseases once decided a s a ' p a t r i o t i c

a c t t o r e t u r n home. His v i s i t t o t h e t h e a t r e sent him

p ~ k i n g again. According t o him, t h e f a c i l i t i e s f o r

su?gery i n t h e t h e a t r e were u n f i t f o r monkeys, not t o t a l k

of human be 1 ngs \ C,

3.2.6 Lack of Opportuni t ies t o !.ny Complaints t o JOcecutives.

Some Chief ~ x e c u t i v ' e s ~ d e n y t h e i r s t a m access t o t h e i r

o f f i c e s t o l a y c o m p l ~ i n t . Experience hus shown t h a t a

labourer who was allowed access and spoke c o r d i a l l y wi th ,

t h e Chief Medical Director always f e l t on top of t h e world,

Th i s 1s t r u e a t a l l l e v e l s . When t r a d e unions c a l l f o r

meetings. ,and t h e a u t h o r i t i e s r e f u s e to 'honour t h e c a l l t h e

t r a d e unions o f f i c i a l s f e e l neglected and they g ive t h i s

impression t o t h e i r mcmb ers who end u p developing hatr'ed

f o r those i n au thor i ty .

When the JATU ( J o i h t Action Off: Trade Unions) i n UNTH

h e l d t h e i n s t i t a t i o n on s i a g e i n 1995 it was as a r e s u l ~

of the a u t h o r i t i e s b lu f f ing the c a l l fo r d ia logue by the

union o f f i c i a l s . I n t h e end it was t h e s e r v i c e and

p a t i e n t s t h a t suffered,

3.2(c) C i rcu la r s . I n t e r p r e t a t i o n ~ n d Irnplementati on,

3.2.1 Undue P u b l i c i t y t o Frirws Benefi ts ,

It w m a common f e a t u r e i n t h e publ ic ee rv ice from

1985 t h a t government r e l eased c i r c u l a r s augumenting

allowances urld F r l r @ e b e n e f i t s o r even s a l a r i e s . The

government p u b l i c i z e t h i s a c t i o n and f u e l i n f l a t i o n ,

Unfortunately, t h e gove.mmcnt does not back up the

c i r c u l a r with the f inances f o r implementa tion. C i r c u l a r

1 of 1991 f o r ins t ance , introduced c e r t a i n allowances f o r

c e r t a i n c a t e g ~ ~ i e ~ of h e a l t h workers, Up t i l l now t h a t

c i r c u l a r has not been implemented i n t h e UNTIT f u l l y ,

The unions of' t h e group of' workers a f f e c t e d have appl ied

a l l forms of dialogue. m i l e Mann~ement was i l l i n g t o

pay, i t lacked the finunces. For t h a t c i r c u l a r alone,

over s&en s e p a r a t e i n d u s t r i a l ac t ions have resul ted .

3.2.2 Domination of UNTIl'by Doctors t o t h e Detrim-e& of Others :

I n t h e h e a l t h s e c t o r doctors a r e regarded a s leaders .

Ordinarily a l eader i s supposed to c a r r y t h e l e d along.

This has not been so i n the UNTH. Research f indings

r evea l t h a t doctors dominate the system. They earn f a t t e r

s a l a r i e s . When c i r c u l a r s a r e r e l eased , t h e i r s a r e

implementeh-f irst and near ly a l l r eques t s made by them

a re ' granted. This partiality and d iscr iminat ion whip up

sentiment and acrimony. .It makes the o t h e r s t a f f very

wi l l ing t o v a c ~ t e t h e g l a c e f o r doctors a t t h e :32ightest

provocation.

3.2.3 S t a f f Welfare Undermined by top ~ d m i n i s t r a t i v e S t a f f :

Those i n Administration appear not . to be r e a l l y

i n t e r e s t e d ' i n s t a f f welfare. While a c i r c u l a r on deduct ion

from staf-f s a l a r e i s a r e implemented with speed and t o tHe

l e t t e r , those on s t a f f welfare w i l l not come on time. When

provided from u n o f f i c i a l sources, it,, w i l l be r e j e c t e d a s

u n o f i i c l a l . I ts i n t e r p r e t a t i o n i s o f t e n skewed. This i s

examplified by t h e c i r c u l a r on EXJSS s a l a r y s c a l e which has

been a c a s e of d i s p u t e between Management and s t a f f t i l l

date . Without s p e c i f i c d i r e c t i v e s from anywhere those' i n

personnel and Administration narred o fP ice r s on EUSS 09 and

. - above from running t h e i r incvement up to t h e end, They

were made t o s top a t step. 8 while t h e s a l a r y s c a l e a c t u a l l y

t emi .na ted on a tep 10 and some on 12, Information obtained

from o t h e r s i s t e r i n s t i t u t i o n s have mown t h a t they run t h e

increment a s i t i s on t h e sa la ry sca le . It has a l s o shown

t h a t i n some a r e a s s t a f f allowances i n UNTH a r e under paid,

M i smana~ement of Funds and Monitoring of Performanc r:

3 2.1 M i s a p u r o ~ r i a t i o n of Fund,

It i s .a big problem t h a t a v a i l a b l e funds f o r s e r v i c e s

a r e inadequate. It is worse when t h e l i t t l e a v a i l a b l e i s

mismanaged and f r i t t e r e d away, .The 1995 s i e g e had very

e t r q r e l a t i o n s h i p with t h i s issue. The Unions were

a l l e g i n g t.kt Management should be disbanded t o move t h e '

UNTH forward and t h e Management s tood i t s ground t at i t s

a c t i o n s were contrary t o w k t t h e unions were p ~ r t r a y i n g

t o t h e genera l publ ic .

3.2.2 ,Lack of Ef fec t ive Monitor iw Scheme.

It i s t h e duty of t h e Federal Minis try of Health t o

monitor t h e ' p e r f ormance of teaching h o s p i t a l s , There i s

no evidence t h a t they' did t h i s i n t h e p a s t i n r e a l p r a c t i c a l

t e r n s , The s t a t u t o r y a u d i t exe rc i se has been reduced t o

almost a rout ine , Moreover, it comes i n a r r e a r s , It i s

.. ... , only t h i s year t h a t a team of t h e Min i s t e r ' s r e p r e s e n t a t i v e s

s t a r t e d v i s i t i n g h o s p i t a l s to monitor c a p i t a l p r o j e c t s only.

3.2.3 Lack of E f f e c t i v e Consul tat ion by t h e Minis try o f Health,

There i s a l s o evidence t h a t sometimes the Minis try

O f f i c i a l s determine p r i o r i t i e s f o r h o s p i t a l s without

consul t ing them. P r iv i l eged people a r e J u s t dispatched

with l e t t e r s of awards and t h e teaching h o s p i t a l s o f f i c i a l s

a r e asked t o cooperate with t h e c o n t r a c t o r s from above whom

they a r e a l s o compelled to pay. The t r a d e unions m a y not

know what goes on rind they hen3 t h e blame on Mnnngement.

3.2.4 knapement Incapaci t t l t ion:

Havim come from heaven, t h e con t rac to r s do not

perform l i k e those from t h e m . Since they r e l a t e t o the

powers t h a t ' b e , the Mmflgement f i n d i t s e l - f powerless' t o

c r i t i c i z e them f o r shoddy Jobs f o r f e a r o f b e i n g r e l i e v e d

of t h e i r posts ,

3 . 2 ( ~ ) F i n d i w a from t h e Test of Hypothesis.

3.2.q Reltitionship. Between Government Fundim and 1-dustr i i l l Relat ions. ---

The t e s t was conducted s c i e n t i f i c a l - l y and i t showed

S t~oI lg p o s i t i v e re1 a t ionsh ip b.etween t h e v a r i a b l e s on

f inance and profer red solu{ions to t 1 . r . m by t h e respondents.

Thie but t repsea t h e cornparat ive response ' t h a t t h e r e i s

r e l a t i o n s h i p betvieen funding and i n d u ~ t r i a l r e l a t i o n s i n . .

teaching hosp i t a l s .

3.3 Impl ica t ion of F J n d i w s f o r Administrat ive m f i c i e n c y and Effect iveness ,

.;-- From t h e f i n d i r g e , i t w i l l . be seen t h a t t h e teachfrlg

h o s p i t a l s a s component of the Nigerian environment i s

inf luenced by t h e environmental f a c t o r s ,

Both responses from t h e ques t ionnai re , f indings Prom

i n t e r v i ew and o t h e r ob servot ions and t h e t o s t of hypothesis

have proved t h a t t h e amount of funds given t o teaching

h o s p i t n l s is inadequate,

Th i s inadequacy has r e su l t ed i n a l o t of problems

i n t e r n a l l y , S t a f f s a l a r i e s a r e not paid on t ime and i n

f r u s t r a t i o n they embark on s t r i k e anr! t h i s takes i ts t o l l

on t h e s e r v i c e t o p a t i c n t ? who d i e i n l a r g e numbers

e s p e c i a l l y very indigent ones,

Again t h i s . inadequate resources a l s o mean t h a t even

when s t a f f . a r e ready t o work, the mater ia l s f o r t h e work

are . not the re , A'cons.equence of t h i s i s t h a t blood may

not b e screaned and p a t i e n t s may be forced t o p a t r o n i z e

p r i v a t e h o s p i t a l s and laboratory. Those who cannot a f ford

the charge of these business men simply go home and r e s i g n I

t o f a t e ,

It is', therefore , c l e a r t h a t the input received from

o u t s i d e i ,e f inance play a se r ious r o l e i n t h e processual

i n s t i t u t i o n s (I, e. the teaching hoep i t a l a ) . The q u a n t i t y

and t ime l iness of t h i s input determine, t o a g r e a t ex ten t ,

t h e e f f i c i ency o f t h e system. The e f f i c i ency of t h e

eyetern ( teaching h o s p i t a l s ) determines t h e q u a l i t y of t h e i r

output i , e , t h e number of c h i l d r e n immunized, the number

of samples processed i n t h e l a b o r n t o r i e s and t h e q u a l i t y

of t h e s e services . Therefore, if the i s sues r a i s e d i n the

f i n d i n g s a r e well addressed by the government; the

impl ica t ion w i l l b e t o enhance the l e v e l of adminis t ra t i 've

e f f i c i ency and e f fec t iveness ,

CHAPTER FOUR

4.1 Summary and Conclusion.

This research has been thorough. The ob jec t ive of

r e sea rch is t o so lve prob,lems and c o n t r i b u t e t o knowledge

genera l ly . The ob jec t ive of t h i s work i s not d i f f e r e n t .

It is t o d e t e c t t h e caufies of the cons tan t rift and

i n d u s t r i a l r e l a t i o n c r i s i s i n teaching h o s p i t a l s over t h e

p a s t t e n years. If t h i s c r i s i s i s allowed t o p e r s i s t , the

h e a l t h o f our people a l ready dwindling w i l l nose-dive.

No reasonable person w i l l questj,on t h e importance of

manpower. Since it hae been acknowledged a s t h e foremost cxf

a l l resources , prime a t t e n t i o n should be paid to i t a l so .

Heal th i s a development ind ica to r and a country f u l l

of poor and s i c k l y popul-ace wi J l always be re t rogress ive .

Good h e a l t h enhance3 even proper mental development.

SickiIess i s ' l i k e a p a r a s i t e . It saps national. resou.rces

end reduces product iv i ty . It, the re fo re , says to g ive

h e a l t h utmoot p r i o r i t y .

The problems i n t h e h e a l t h s e c t o r with regard t o

i n d u s t r i a l r e a l t i o n c r i s i s a l s o spread across the education,

lndustrjr , ' ag r i cu l tu re , e t c . This i s an ind ica t ion t h a t

the country i s r e a l l y s u f f e r i n g a very d e b i l i t a t i n g

malaise.

If the r e sea rch f inding and the prof e r red recommendations

a r e implemented a l o t of progress w i l l be recorded.

There is a l s o no doubt t h a t t h e recommendations w i l l

h e l p t o t h e r s e c t o r s , o t h e r than hea l th if they a v a i l

themselves of them,

An equi l ibr ium poin t based on i n d u s t r i a l peace which

i s t h e product of t h e t h r e e major a c t o r s i n the i n d u s t r i a l

r e l a t i o n sys tern - employee and t h e i r unions, t h e employers

and t h e i r a s s o c i a t i o n and the government as t h e r egu la to r of

t h e system i s a sine-quo-non f o r progress and development.

4,2 Recommendations :

The recommendations snounciated below a r e based on

reeearch f ind ings and should improve t h e system if appl ied,

(a) The Federal M i l i t a r y Government should s t r i v e

t o inc rease t h e l e v e l of f inding of teaching

h o s p i t a l s , I t s aim should be t h e WHO

p r e s c r i p t i o n a s 5% of the GNF o r 5% of t o t a l

budget,

(b) To enhance planning, the Federal in is try

of Health should be r e a l i s t i c i n a l l o c a t i o n

of funds t o teaching' h o s p i t a l s , Based on

s e l f l e s s s e r v i c e of' t he chief Medical Direc tor of Obafemi

Awolowo Univers i ty ~ e a c h i & Hospi tal , I l e If e who, when

his tenure expired, had a l l s t a f f r a l l y round him on t h e i r

own and recommended h i s r e t e n t i o n to t h e Federal Mini s t r y

of Health,

(h) The Petroleum Trust Fund is overywhere, They have

s t a r t e d supplying drugs t o eachinp: h o s p i t a l s and

should be encouraged t o venture i n t o o t h e r areas.

(I) The fund aystern of publ ic accounting is gradual ly

being adopted i n most teaching hosp i t a l s . Thus,

p a r i t a l autonomy and commercialisation of major

s e r v i c e a reas l i k e drugs, x-ray, labora tory s e r v i c e s

and mortuary se rv ices have taken place. The innovation

ha8 sus ta ined se ry ices i n these a r e a s , It should be

encouraged and sus ta ined ,

( 3 ) Teaching Hospita1.s a r e s t i l l rci,7arded a s s o c i a l

s e r v i c e s i n s t i t u t i o n s . Consequently, most indigent

people i n t h e s o c i e t y csn s t i l l be t r e a t e d without

charges. The extant Federal Government pol icy s t i l l

r e q u i r e s t h a t d i s e a s e s l i k e leprosy, cancer and

malnut r i t ion , e t c be t r e a t e d f r e e , The teaching

h o s p i t a l s comply with t h e s e d i r e c t i v e s bu t do not

t h i s , what each h o a p i t a l should rece ive in;-:a year 8

as recur ren t subvention and cap i t a l g r a n t s should

b e made known t o them,

(c) With ( b ) above, t h a t amount should be re l eased on

t ime t o enable t h e h o s p i t a l s f inance t h e i r opera t i ons.

(d) The h o s p i t a l s e r v i c e s arm of t h e Minis try should s e t

up a permanent monitoring agency f o r teaching

h o s p i t a l s not j u s t f o r c a p i t a l bu t a l s o r ecur ren t

operations.

(e) The government hoe b,een humrneriq t h a t i t cannot

provide a l l resources required t o move t h e economy

forward, y e t i t is capable of c o l l e c t i n g a l l o i l and

t a x revenues, I n view of t h i s claim, it should no t

de lay f u r t h e r t h e implernentati on of t h e National

Health Insurance Pol icy o r Scheme.

( f ) During the National Heal th Summit i n 1998, t h e

communique i ssued agreed on t h e need to e s t a b l i s h a

h e a l t h bank. This should. be executed,

( g ) Conservation of fund i s a means of i n s t i l l i n g

dl iscipl ine t o publ ic o f f i c e h o l d e ~ s ; they should

understand . t h a t ' serving tile publ ic is serving

humanity end oneself , Pa t r io t i sm r a t h e r t h a n ' self

enrichment should be t h e goal , Most C h l e f Medical

Direc tors i n teaching h o s p i t a l s 3hould emulate t h e

r e c e i v e t h e r e l aburse rna t which i s a component of

pol icy, The Federal Government should fill t h e s e

vacuum t h a t s a p s the r e s o u x e s of th'e teaching b

h o s p i t a l s .

- %

4.2.2 Establishment Ci rcular . I n t e r p r e t a t i o n and ~rnp-at ion.

(a) When t r ade d i spu tes a r e s t a l l e d through

t h e

c o l l e c t i v e agreement, c i r c u l a r s dwelling on t h e

agreements emerge, It negates abso lu te ly t h e

ob jec t ive o f se t t lement if the f i n a n c i a l backing

i s not provided. This has been a thorny i s s u e

i n teaching h o s p i t a l s . It was a l s o p a r t l y t h e

cause of the s i e g e i n 1995. To make se t t lement

meaningful the a u t h o r i t i e s should provide the

funds t o implement them.

A l e s son from t h e UNTH experience i s t h a t non - implementat ion of agreements implementation of

agreements l e a d s t o l o s s of confidence i n the Management.

It l eads to lack of t r u s t and aggr:tvstes i n d u s t r i a l c i r c i s ,

This s i t u a t i o n cAused t h e death of Prof. Bandikpo i n

Ahmadu el lo Univers i ty Teaching Hospi tal , The s t a f f who

be l i eve he had t h e i r ' money b e a t him t o dea th only t o

d iscover t h a t the nan h$d not been given any money.

ts a , : I.-

(b) The Administrators who? e d u t i e s i t 13 t o i n t e r p r e t e

c i r c u l a r s should do s o meticulously not with

v i c t i m i s a t i o n and bad blood i n mind, Modern personnel

management demands t h a t matters of welfare where i n

doubt should b e c l a r i f i e d o r resolved i n Favour of

s t a f f .

( 0 ) The Administrators should a l s o go a f t e r c i r c u l a r s

ear ly . Most of t h e t imes, before c i r c u l a r s on s t a f f !>

welfare reach UNTH, i t i s always very l a t e and s t a f f

g rumb 1 e.

4.2.3 Discrimination,

(a) Teaching Hospitalo a r e mul t i -d isc ip l inary i n s t i t u t i o n ,

The c a r e of t h e p a t i e n t s i s a team work, While t h e

doc to r s a r e regarded 'as l eader s they should a l s o

command f o l l o w c r ~ h i p ~ A s i t u a t i o n where any segment

of t h e s t a f f a r e regarded o r made t o f e e l they a r e

sacred cows should be discouraged, I n the UNTII,

p r e f e r e n t i a l treatment to doctors has made t h e o the r

worker8 s u f f e r and f e e l margi na l i sed , This should

b e discouraged.

( ( b ) c i r c u l a r s denling with we1 Fare of s t a f f should b e

comprehensive, This i s the only my t o obvia te

disenchantment and uncompromising, a t t i t u d e , Research

f i n d i n g s i n d i c a t e thdt s i n c e 1991, a l l c i r c u l a r s

i s s u e d on s t a f f w e l f a r e have excluded o t h e r h o v p i t a l

workers with t h e excep t i on of d o c t o r s , n u r s e s ,

o t h e r c a t e g o r i e s of s t a f f g o t ha s been through

a r b i t r a t i o n o r i n d u i t r i a l a c t i o n i4~lblich i s not t h e

b e s t f o r t h e country .

4.2.4 Mul t i D i s c i p l i n a r y and 1ntep; ra ted Approach. To H e a l t h Munrtgement.

(a) H e a l t h c a r e is i n t h e e x c l u s i v e a s w e l l a s c o n c u r r e n t .

l i s t o f t h e 1979 C o n s t i t u t i o n . It i s t h e r e f o r e a

f u n c t i o n o f t h e F e d e r a l and S t a t e Oovernment, w i t h the

Local Government no t excluded. These segments s h o u l d

b e invo lved t h r o w h p r o p e r a r t i c u l a b i o n and de te rmine-

t i o n of p r i o r i t i e s ' t o avo id waste of r e sou rce s . A

s i t u a t i o n , ~ h e r e s t a t e government embarks on t h e

e s t a b l i s h m e n t o f t e ach ing h o s p i t a l s where one e x i s t s

i s a waste. Most of t h e s e h o s p i t a l s a r e shadows of

what t h e y shou ld be. Such funds s h o u l d b e g iven t o

t h e v i a b l e Fede ra l Oovernment sponsored t e ach ing

h o s p i t a l s t o b o l s t e r t h e i r performance.

(b) The National Hcalth Pol icy reckons good drinking

water, e f f i c i e n t s a n i t a r y and sewage d isposa l system,

p rov i s ion of food and n u t r i t i o n , With these objec t ives

i t i s clear- t h a t the pursu i t of good h e a l t h should be

a mul t i - sec tora l e f f o r t encompassing p rov i s ion of

water, sani ta t j -on and food, The Federal and S t a t e

Min i s t r i e s of Health shou ld l i a i a e and involve t h e s e

o the r Min i s t r i e s I n i t s planning so t h a t everybody

complements t h e goa l s of each u n i t f o r i n t e g r a t e d

f r u i t f u l r e s u l t ,

4.2.5 3cannir-w of Environment t o Detect F e e l i n ~ s . .

(a) Woodruff Imberman st?*essed the need for . employers t o

s c a n t h e work environment t o d e t e c t t h e f ee l ings of

s t a f f s o as t o s t a l l e s c a l a t i o n of gr ivances before

thcy go o f f hand, This i s something t h a t . is lacking

i n t h e teaching h o s p i t a l environment. To a l a r g e

e x t e n t , i t i s a l s o an ind ica t ion of how i n d i f f e r e n t . .

t h e government i s t o the emotions 0.t' t h e i r s t a f f .

This needs revis ion . I n t h e tenchine: h o s p i t a l s t h e

Management could u s e t h e s e c u r i t y o f f i c e r s t o oample

t h e views of s t a f f e s p e c i a l l y during t r y i n g times and

use i t t o dialogue with t h e s t a f f o r union l eader s who

w i l l dieeminate management concern f o r t h e people t o

apprec ia te .

(b) Management should from t ime to t ime address s t a f f 1

under a congenia 1 atmosphere. Seminars and workshop

t o s t r e s s t h e need f o r cooperation among a l l aegments

o f s t a f f should be a r egu la r f ea tu re ,

( c ) When rumours f i l l t h e a i r Management should d i f f u s e i t

by i s su ing c i r c u l a r s c l a r i f y i n g t h e s i t u a t i o n , The

s t a f f may not be completely s a t i s f i e d but they would

have known the t r u t h tihich could make t h e i r

preseverance enduring,

( 8 ) Moreover, gr ievances by s t a f f ard t r a d e union should

not be t r e a t e d w i t ! ) ind i f ference . There was abundant

evidence that t r a d e unions wr i te Management f o r d ia logue

over some i z s u e s bordering on s t a f f welfare but

Management refused t o grant them audi ence. Proppt

response should b e t h e watch word. It w i l l even

br ing l a s t i n g peace i f t h e Mnnagement consu l t s t h e

t r a d e unions of ! . ' i c ia l s r egu la r ly e s p e c i a l l y on

major pol'icy or decis ions l i k e l y t o a f f e c t s t a f f o r

t h e i r welface,

4.2.6 Arres t of Rrej-n- Drain:

The broblcm of b ra in d r a i n has a f f e c t e d t h e hea l th

and educat ion sec to r s adversely. A country where i t s

c i t i z e n f e e l t h e pang o f i n j u s t i c e is doomed, Pres ident

Babangida even c o n s t i t u t e d a s p e c i a l panel t o i n v e s t i g a t e

t h e cause, We know migrat ion t o o the r lands a r o s e a s a

r e e u l t . of d i e s a t i s f a c t i o n with the eystem, The need has

then a r i s e n f o r t h e government t o enhance considerably the

s a l e r e i a and allowances of s t a f f i n t h e h e a l t h and

educbtion sectore 80 t h a t i t s c r e m of manpower could

r e t u r n home t o s e r v e t h e i r f a t h e r land,

4.2.7 Teaching Hoepi t a l s Commie s ion,

The government should save i t s e l f a l o t of -headache

if i t e s t a b l i s h e s a teaching h o s y i t e l e ' commieaion t o

a r t i c u l a t e t h e neede of t h e hospitals, procure needed

revenue, d isburee i t and i f p o s s i b l e monitor t h e i r

performance.

Adebayo A. (1979) P r t n c i p l e s and P r a c t i c e of Public Administration i n Nigeria, Spectrum Books L t d , - Ibadan.

Allen ~ o u l e (1 958) Mana~ement and Oraanleatlon, Mcraw & H i 118, London.

Anderson JaEo (1975) ? u b l l c Pol icy Making, Thomaa Nelson & Sons Ltd, Iondon.

Balogun M o J o (1983) Public Administration i n N i ~ e r i e A D e v e l o ~ m n ~ t a l AA'sproach, MacMillian Publ i shers Ltd, Londa , Yns ing~toktr .

Bentley Arthur (1 908) The Process of Oovernment , Bloomington, Indiana ]Prim l p i a Press.

Collins Fontanp (1 986) Good 'flevi(8 Bib1 e, Willlama C o l l i n s & Sons Co. Ltd,' London.

Drucker P.F. (1985) b m ~ e r n e n t . Taske. _ R e s ~ o n s i b i l i t i e a , P r a c t i c e s - Helnemann PPofef3:;l u n u l P u b l i s hlng Ltd, London.

Dunlop - J.T. (1977) I n f l u s t r i a l ' nelationa Systems, New York, Archunis Books Ltd.

Hyman R o (1964) I n d u s t r i s l Relat ions. A Marxist A p p r a a c t ? , Thorn- Nel602 & Sons L td , London.

Olewe B. No (1 995) D,evelo.~ment Admini a t r a t l on, Evangel Press T.td,. Abao -

Otobo Do & 0mol.e M. (1987) Readiw i n I n d u s t r i a l Rela t ions $n N i ~ e r i a , .Lag08 Malthouse Press Ltdo

Selekman B.Y. (3958) ~ r o b i m ' l b? Labour Relat ions . 2nd Edl ti on, McGraw H i l l , New ?ark,

Stewart R, (1962) The Rea l i ty o f Mana~ement, Pitraan ,Publiehere, London.

S t r a u s & Saylee ( I 972) Personnel: The Human Problem8 of' Managcement , Pren t i c e-Hall , ltnt e rna t iona l , London.

Ubeku AoKe (1'975) Personnel Manaement i n Nigeria, Ethiops Publishing Corportttion, Benin City.

William F.C, (1976) Marmflement Made S i m ~ l ~ , W,H. Allen, ZAndo,

douxmal s & Newapmperer,

Hoepi t a l Mamgement I n t e r n a t i o n a l

Finance & Development, , World, Bank Journal

Finance & Development op.ci t,

Management i n Nigeria, NIM Publi co t l ons

Sunday Vanguard, Vanguard Medie Ltd , Lagos

Sunday Vanguard op c i t ,

Sunday Vanguard op, c i t

Vanguard Newsp apem ,

Gurad I a n . Newsp ~p ers,

Conference papers . . . - .- . - - . .

The Meaning of ~eveloprnent , ~ l e v e n t h ' w o r l d conferendti! o f the s o c i e t y for I n t e r r ~ u t i o n a l 3cvelopment, New Delhl,

Unpubliuhed Thesis ,

Chi j ioke 0. (1 994) An & p r a s i a l of the Effec ts of ~ e d e r h Governm m t Subvent lone i n Nigerian Teaching Hoapit als .

Pol icy Documents and Decrees

~ g t i o n ~ l Heal th Pol icy 1988, F e d e r ~ l Minis t ry of Health .

F e d e s l Oovernmmt of Nigeria, Budget 3p eech, 1991 , Federal Ministry of Information, Lagoo.

Eaet Cent ra l S t a t e Edict No. 1 ? of 1976.

Trade Union Decree 1973. '

Federtil Republic of Nigeria, Decree No. 23 of 4974

Trade Disputes Essent ib l Service8 Decree No. 23 of 1976.

Trade Mapute E s s e n t i a l Servi ces Amendment Decree No. 24 of 4976.

Federa l Republic of Nigeria , Decree No. 58 of 1977.

Federa l Republic of Nigeri a , Decree NO: 74 of 1979

The Cons t i tu t ion of the Federal Republic o f Nigeria, 1979

Trade Disputes Decrees, 1968, 1969, 1973 and 1979.

Teaching Hoepitole Reconeti t u t i o n Decree No. 10 of 4985

Teaching Hospi tsls ~ e c o n a t i t u t i on Decree op. c i t e

Woi.kmen'e Compensption Decree No. 1 7 of 1987.

i

(i.;. , PLdcml way? Y~S/NO

' I

1 -1

I s 1 / I 1 j I - + 8. If y ur enswer t o ' c p o s t i o q (61) i$ ~ o b do you t h i n k t h e

Men8 ement should b e a r t h e blbme: f o r t h e s t r i k e s - NO 1 I ; i