From Fred Ezeh, Abuja
The “hurricane wind” that swept through the civil service a few years ago has begun to have its negative impact on the public service system, particularly the health sector.
Aside from the “japa” syndrome that hit the health sector recently, resulting in the mass emigration of healthcare professionals, notably doctors, nurses, pharmacists, and others, the healthcare sector is also losing some of its experienced administrative and management staff.
This was a result of the recently revised Public Service Rules (PSR) that became operational in 2023. The revised PSR guideline directed that no civil servant should stay beyond eight years at Grade Level 17, which is the directorate level.
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In 2023, the implementation of the revised Public Service Rules (PSR) guidelines took effect, bringing along some shocking administrative changes, particularly for civil servants at Grade Level 17 (directorate level).
The new rule stated that a director (GL 17) or its equivalent, as may be prescribed by other Ministries, Departments and Agencies (MDAs) of the government, shall compulsorily retire upon holding the office/position for eight years. This is outside the existing conditions for retirement, which could be by age (60 years) or length of service (35 years).
Expectedly, there were mixed feelings regarding the decision. Affected civil servants were unhappy with the decision, while others, mostly subordinates, were happy because of the career stagnation they might have suffered and the growth opportunity that would be provided, which was the original intent of the revised PSR guidelines.
Sadly, over 500 directors in the public service across different MDAs who were affected were asked to proceed on mandatory retirement, which they had no choice but to comply with, following the directive from the Office of the Head of Service of the Federation.
Surprisingly, the Federal Ministry of Education, alongside its parastatals, was exempted from the tenure policy. This was because they were employed as teachers, hence were bound by the decision of a previous administration of the late President Muhammadu Buhari on retirement age and years of service.
Prior to the new PSR operational guidelines, which took effect in July 2023, the late President Muhammadu Buhari, at an event to mark World Teachers’ Day a few years ago, approved an elongated service period and retirement age for teachers.
Health sector concerns
Operators in the health sector are advocating for an amendment to the PSR guidelines as they affect workers in the health sector. They are suggesting an amendment that would offer the same opportunity as was provided to the education sector or a more improved one that will possibly extend the service years and retirement age of its directors.
Daily Sun investigations revealed that in the last two years, experienced directors in the health sector have been “forcibly” retired in compliance with the revised PSR guideline, and their absence is strongly felt in the running of the sector, particularly with regard to policy and programme development and implementation.
The investigations further revealed that many of the directors who retired recently left a serious vacuum in the management of the health sector, as they took with them critical knowledge and experience that have been difficult to fill. Sadly, neither the Ministry nor its working partners, local or international, have engaged these experienced retired directors to, perhaps, tap into their wealth of knowledge and experience.
According to a senior health ministry official, the “health sector is not like other sectors. They are essential service providers. It’s a complicated career path that requires experience and knowledge, which are not acquired in a day, weeks, or months. It takes decades for such experience and knowledge to be gathered.
Many of the employees, particularly doctors, are employed at level 12, entry point, at, perhaps, a young age, while others start at level 8 for some reasons that are peculiar to the health sector. Promotion is expected every three years.
“Sadly, career growth in the civil service is, sometimes, riddled with corruption. Unfortunately, when it’s time to utilise the knowledge and skills acquired over the years, the bell of retirement will ring. And expectedly, a lot of investment might have been made in some of the directors who retired recently in terms of training, exposure, and assignments.
“It was gathered that some of them have spent some time abroad on training. Some others also participated in several other local training sessions, including those at NIPSS. Many of them designed and implemented several programmes that have had a great impact on the lives of people. So, for them to retire like people in other sectors is not good for health sector management.
“For instance, there’s an indication that about four directors or more in the Ministry will retire later this year. This is in addition to a few others who retired early this year with lots of experience and knowledge. This fate might befall many others across the MDAs in the Federal Ministry of Health.
“A few months ago, there were pronouncements that the retirement age for health workers has been extended, but that has not been implemented after several months. The pronouncements were made, and there was no follow-up action. Seriously, there’s a danger ahead because the quality hands required to pass on knowledge and experience to the coming generations are being retired sooner than expected.”
Late Buhari’s incentives
Former President Muhammadu Buhari approved several reforms for Nigeria’s education sector: reintroduction of bursary awards and stipends for education students with automatic employment after graduation; TETFund funding of teaching practice; and higher entry standards for the profession.
He also directed the creation of a special salary scale, allowances, and pension scheme, alongside raising teachers’ retirement age to 65 and service years to 40. Other measures include a career path policy, conversion and ICT training, rural housing, annual refresher training, and expanded teacher awards linked to national honours. These, he said, were to motivate and restore the lost glory of teachers in Nigeria.
The way out
Former Director General of the Bureau of Public Service Reforms (BPSR), Dr Goke Adegoroye, in his submission, noted that the implementation of the tenure policy programme, especially for officers in Grade Level 17, has many shortcomings.
He said: “The tenure policy has some glaring shortcomings, both in content and application to Grade Level 17 officers. In content, there is the error of ascribing the same number of years to the tenure of director and Permanent Secretary.
“In application, there is the error of lumping professional officers on GL 17, who are not heads of departments, with director/HOD GL 17 officers. Ascribing the same number of years to the tenure of both director and Permanent Secretary is gross inequity and injustice.
“This is because, for a 56-year-old director who has spent seven years in the post and gets appointed as Permanent Secretary, instead of leaving the service at 57 when he would have spent eight years as director, the officer has the advantage of a four-year tenure as Permanent Secretary for a total of 11 years in the tenure grades.”
Dr Adegoroye made reference to a book he authored in which he suggested that the more desirable way would be to ascribe 12 years to the tenure of a director, and four years, renewable for another four years, to the tenure of Permanent Secretary, provided that the combined total number of years an officer could spend in the two grades of director and Permanent Secretary would not be more than 12 years.
“In other words, only officers who get appointed Permanent Secretary at the point of spending four years or less in the director grade can spend up to eight years as Permanent Secretary. Fixing the same eight years as the tenure for director and Permanent Secretary connotes an inability to appreciate the need for officers to acquire any length of experience in the grade of director before being appointed Permanent Secretary.”
Meanwhile, an anonymous official who will soon retire from the Federal Ministry of Health and Social Welfare pointed to the insensitivity of the government to the sustenance of quality and expertise in the health sector.
He stated that, from his vantage point, he could confirm that the healthcare sector will experience a manpower crisis if the PSR guideline is not reviewed to exempt officers in Grade Level 17 from the retirement process.
“The health sector is already experiencing a manpower crisis because of the growing interest of essential health workers, notably doctors, nurses, pharmacists, and even medical laboratory scientists. If the experienced hands at the Ministry who formulate and implement several policies are not protected, there will be a serious crisis in no distant time.
“In an ideal situation, these experienced hands should be offered roles as consultants so the government could tap into their wealth of knowledge and experience. But that is not done. The government should design a way to effectively engage these experienced hands so their wealth of knowledge could be useful to the health sector.”
Workforce migration policy
In 2024, the Federal Government took a drastic step that it believed could solve the problem of the massive brain drain being experienced in Nigeria’s health sector.
It noted that in the last five years, the health sector in Nigeria has witnessed an unprecedented shortage of manpower as a result of the decision of some healthcare workers in Nigeria to seek professional opportunities and experiences abroad.
In response to the growing public concern, President Bola Ahmed Tinubu signed a policy document titled “National Policy on Health Workforce Migration” designed by the Federal Ministry of Health and Social Welfare, with inputs from various stakeholders to discourage the migration of health workers.
The government noted that available data indicated that the emigration was not limited to doctors alone, as nurses, optometrists, laboratory scientists, physiotherapists, pharmacists, and several other professionals in the healthcare delivery system not only indicated interest but left the shores of Nigeria for foreign practice.
Key aspects of the policy include the Nigeria Human Health Resource Programme, aimed at reviewing and improving working conditions for health workers, particularly in rural and underserved areas, ensuring they receive proper recognition and rewards, a crucial initiative for retaining healthcare professionals within the country.
There is the digital health infrastructure component that emphasises the integration of advanced health technologies such as Electronic Medical Records (EMR), telehealth, and a comprehensive health workforce registry, which are innovations expected to enhance the efficiency and equity of healthcare delivery across Nigeria.
There is also the capacity building and continuous professional development policy that highlights the importance of training and development for healthcare professionals, including opportunities for international training. It focuses on human capital development aimed at empowering and retaining the healthcare workforce.
Also, there is the return and reintegration of diaspora health professionals, designed to encourage Nigerian health professionals abroad to return home by offering streamlined registration processes and attractive incentives; and also the Bilateral and Multilateral Agreements that advocate for reciprocal agreements with other nations, ensuring that the exchange of health workers benefits Nigeria. One key proposal was a 1:1 match, where recipient countries train one worker for every publicly trained Nigerian worker they receive.
The work-life balance and well-being component provides for routine health checks, mental well-being support, and reasonable working hours to create a supportive work environment for healthcare workers, particularly younger doctors. These measures are aimed at reducing burnout and improving job satisfaction.
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