Professional tensions have boiled over in Nigeria’s already fragmented healthcare sector as pharmacists clash with doctors over professional boundaries. The Pharmaceutical Society of Nigeria (PSN) Lagos State Branch has fired back at the Nigerian Medical Association (NMA) Lagos State Branch following controversial statements about implementing the Consultant Pharmacist Cadre in federal health institutions, deepening divisions in the country’s troubled medical ecosystem.
NMA Issues Ultimatum Over Consultant Pharmacist Appointments
The controversy began when the NMA Lagos expressed disappointment over the compliance of two federal health institutions in Lagos with federal government circulars authorising the consultant pharmacist cadre. The medical association has rejected these appointments, claiming they offer “no clinical value” to the healthcare system.
In what the PSN describes as an “unfortunate memo,” the NMA Lagos issued an ultimatum to the Chief Executive Officers of these institutions to immediately reverse the appointments, regardless of their legality, or face a warning strike by NMA members at the affected facilities.
The NMA Lagos has also mandated its leadership to write to the Federal Ministry of Health about what they term the “inherent danger” of the consultant cadre in pharmacy while issuing what they called a “clear and strong warning” to other medical directors and chief medical directors who may be considering implementation of the cadre in their institutions.
PSN Lagos Condemns “Declaration of War”
The PSN Lagos has characterised the NMA’s statements as “uncouth,” “unduly aggressive,” and amounting to a “declaration of war,” promising to respond in kind if necessary. The pharmaceutical body questioned the authority of the NMA to issue warnings to government appointees bound by official circulars and public service rules.
“For far too long in the annals of our health system, the NMA and its appendages have perfected a culture of medical elitism which manifests as an insulting but very well-entrenched institutional arrogance,” the PSN stated, calling on “responsible citizens” to join hands with them and other stakeholders to address this issue.
Global Best Practices vs. Nigerian Reality
The PSN Lagos highlighted that consultant pharmacist roles are the norm in healthcare systems around the world, including the UK, USA, Canada, Australia, Poland, and African nations like South Africa, Ghana, and Sierra Leone, without disrupting patient care.
According to the PSN, “Global healthcare currently embraces collaborative interdisciplinary care with premium emphasis on consultant pharmacists to improve medication safety, reduce prescription errors, better manage profiles of chronic diseases and professional inclined stewardship roles in the sales, usage, prescription and dispensing of anti-infectives.”
They emphasised that the world is moving toward Universal Health Coverage, which requires task shifting and task sharing in health delivery—something they suggest the NMA is resisting.
The Value of Consultant Pharmacists
The PSN firmly asserted that pharmacist consultants bring “immense benefit to patients and the efficiency of health institutions” as they are “reservoirs of knowledge in medication management, pharmacokinetics, pharmacodynamics and therapeutic drug monitoring.” They maintain that these roles complement, rather than compete with, other members of the healthcare team.
According to the PSN, the integration of consultant pharmacists enhances patient safety and optimises treatment outcomes in cost-effective ways, which they describe as “the main goals of drug therapy.”
History of the Consultant Pharmacist Cadre Approval
The PSN Lagos detailed the extensive approval process for the Consultant Pharmacist cadre:
- In 2011, the National Council of Establishment (NCE) first approved the cadre after due process
- The NMA reportedly worked to obstruct its implementation
- In 2020, the NCE reaffirmed its earlier approval
- On September 11, 2020, the Head of the Civil Service of the Federation (HCSF) issued a circular approving the Scheme of Service for Consultant Pharmacist Cadre
- On June 9, 2021, the HCSF provided guidelines on the applicability of the scheme for Pharmacists on CONHESS 13 to 15
- Further clarifications were issued on September 6, 2023
- Following requests for establishment positions, evaluation teams visited Federal Health Institutions
- On November 4, 2024, the Federal Ministry of Health directed all relevant institutions to make provisions in their manpower budgets for eligible Pharmacists
Allegations of Systemic Bias in Lagos Healthcare
The PSN Lagos made serious allegations about what they perceive as systemic bias against pharmacists in Lagos State’s healthcare system. They claimed that “godfathers of the NMA in Lagos State” have prevented pharmacists in Lagos State Government from enjoying consultant cadre status by proposing to change the designation from “Consultant” to “Specialist.”
Additional concerns raised by the PSN include allegations that:
- The Lagos State Ministry of Health is pushing to require that the Chief Executive Officer of its proposed Drug Management Agency be a medical personnel, despite the Pharmacy Council of Nigeria (Establishment Act 2022) stipulating that only a pharmacist can superintend drug-related activities
- The Ministry has proposed renaming its College of Medicine as a “University of Medicine/Medical Sciences” rather than a broader “University of Health Sciences,” which the PSN suggests is designed to ensure only physicians can become Vice Chancellors
PSN Promises Strong Response
The PSN Lagos concluded its statement with a warning of its own, stating that the “ruinous rhetoric of the NMA claiming what it wants as benefit package for itself and dictating as well as restricting colleague and employees in the civil service will be halted.”
They cautioned that if the government “allows itself to be bamboozled by NMA theatrics of strike action,” the PSN will respond with “a full complement of all other stakeholders” in the healthcare industry.
The organisation called on “patriots to knock civility into the heads of the juntas in medical practice before the sun sets on our healthcare industry,” signalling their readiness for a prolonged professional confrontation if necessary.
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