In Nigeria, the CONMESS, or the Consolidated Medical Salary Structure is a system that regulates the salaries and other allowances of healthcare professionals in the public sector. This framework aims to provide equity in salary and a motivated human resource in the healthcare system.
In this article, we will analyze all aspects of the Consolidated Medical Salary Structure (CONMESS) in Nigeria including its components, recent changes, challenges, and likely solutions.
See Also: Consolidated Public Service Salary Structure (CONPSS) in Nigeria (PDF Download)
About the Consolidated Medical Salary Structure (CONMESS) in Nigeria
CONMESS is an all-inclusive salary structure that defines the salary scales, allowances, and benefits of different classes of health workers in Nigeria.
It serves an important purpose, of ensuring that there is a unified remuneration strategy in the public health system.
The structure has various grade levels allocated to it, and with each grade is a specific amount allocable in salary and benefits.
The Consolidated Medical Salary Structure (CONMESS) in Nigeria is largely used to focus on compensation among various stream of health personnel at the various levels of the government.
It will also indicate how much differences there are in salaries earned by various medical practitioners, how Nigeria’s system compares with those of other countries and forecast trends in CONMESS in Nigeria.
History of CONMESS
To resolve the challenges that have been associated with the remuneration of medical professionals, the Consolidated Medical Salary Structure (CONMESS) was introduced in Nigeria in the year 2009.
Prior to the introduction of CONMESS, the salary system for medical personnel in Nigeria was fragmented and inconsistent. Different category of health care worker had their own salary which was creating an imbalance and discontent among health workers.
The introduction of CONMESS was a landmark event in the development of Nigerian health care system. It intended to create a common salary structure for all medical doctors, dental health officers and other health allied workers in federal government hospitals and institutions.
The salary structure was intended to ensure that medical personnel were fairly rewarded for their work enhancing their motivation and avoiding the brain drain problem.
The Federal Government through the National Salaries, Incomes and Wages Commission (NSIWC) was responsible for the design and operation of CONMESS. With time the pay structure has experienced a number of reviews to take into consideration the economic trends in the country especially inflation as years went by.
Categories of CONMESS
CONMESS comprises eight categories, each representing a different level of seniority and specialization:
- CONMESS 1: House Officers (Interns)
- CONMESS 2: Medical Officers (Junior Residents)
- CONMESS 3: Senior Registrars (Senior Residents)
- CONMESS 4: Consultants (Specialists)
- CONMESS 5: Senior Consultants (Senior Specialists)
- CONMESS 6: Principal Medical Officers (Principal Specialists)
- CONMESS 7: Deputy Director (Medical)
- CONMESS 8: Director (Medical)
The salary ranges, allowances, and benefits that are associated with each grade are subject to periodic adjustments in order to take into account the fluctuating cost of living and the economic conditions that are in place.
Components of the Consolidated Medical Salary Structure
CONMESS is an all-inclusive salary package that is composed of diverse elements aimed at ensuring the welfare of medical practitioners. Major elements within the cover of CONMESS include the following:
• Basic Salary: This is the fundamental unit of the salary exchange and denotes a constant amount of salaries and allowances made to medical practitioners’ staff according to the classified grade and length of service. The basic pay provides a base value to which all allowances as well as other emoluments are derived.
• Call Duty Allowance: As part of their responsibilities, medical professionals will generally have to be on call even after ordinary working hours, nights, weekends, and holidays as well. The Call Duty Allowance is designed to pay them for this work and the sacrifice of their time.
• Hazard Allowance: Those employed in the health care sector are exposed to many hazards which includes infections, exposure to radiation, and other health hazards. The Hazard Allowance is designed to pay healthcare workers against these hazards and motivate them to maintain practice regardless of the risk.
• Clinical Duty Allowance: This allowance is paid to the medical personnel who perform clinical duties like the treatment of patients and other medical Work. The persons involved in these activities are important in the system and such provision is made to appreciate it.
• Teaching Allowance: This allowance is given to medical personnel who teach students like resident medical officers, interns and other to as well as train them. It appreciates the extra work and skills associated with the act of teaching.
• Specialist Allowance: This allowance is given to medical practitioners like consultants who have attained a higher level of training, experience, and expertise. This Specialist Allowance is a motivational strategy to encourage a health worker to have more of this practice by obtaining a higher degree in the given area.
• Rural Posting Allowance: All health workers except the upper management are usually stationed far from cities and urban slums and therefore health care workers posted in such areas are given this allowance to appreciate certain hardships experienced in that particular area. It is also meant to motivate medical practitioners to go to the most necessary parts where health services are required.
• Shift Duty Allowance: This allowance is awarded to medical personnel in shifts like nurses and midwives. It reimburses for the physical and psychological effects of working irregular hours and stresses related to the shift systems.
• Accommodation and Utility Compensation: Understandably, adequate housing is a major concern for healthcare workers, which is why some of them receive accommodation allowance to cover rent or housing matters. A utility allowance may also be offered for essential services such as electricity, water, and other related services.
• Transport Compensatory Allowance: An allowance is usually granted to medical specialists for reimbursement of expenses incurred while traveling to and from their workplaces or executing official assignments.
• Consolidated Salary Structure: The meaning of a consolidated salary aside from considering basic salaries includes all the allowances earned by medical professionals under CONMESS as it will be their net salary. The objective of the consolidated salary has been to ensure that it is enough to attract the right talent who would have the requisite skills, experience, and responsibilities in the sector.
CONMESS Salary Scales and Grade Levels
The salary paid to different levels of medical practitioners included in the consolidated medical salary Structure is also paid out on category basis as contained in the different grade levels.
The different grade levels are based on one’s educational qualification, experience, and the particular area of medicine practiced by the physician.
House Officers (Grade Level 10):
The newly resident practitioners, who are also known as house officers, have a designated grade Level 10 for them. At this level, they are paid a composite salary, which consists of basic salary and various allowance.
The salary at this level will be lower than the rest of the categories since it is only suitable for beginners in the profession.
Medical Officers (Grade Level 12-13):
Medical officers are one step better than the house officers and these are doctors who have done internship or residency training. Depending on the years of experience and qualification, they are given Grade Level 12 or 13, which is expected.
With such Grade levels, the salary becomes appreciable and so does the allowances received, and others such as the Specialist Allowance are attached to it.
Consultants (Grade Level 15-17):
Consultants are medical professionals who have acquired a significant level of specialization with respect to the practice of medicine.
They belong to Grade Level 15, 16, or 17 based on the number of years worked and the value they have added to the healthcare system.
At this level, the remuneration is the most competitive in the CONMESS structure and consultants get extra allowances to reflect their professional status.
Other Healthcare Professionals:
Aside from doctors and nurses, CONMESS also pertains to other healthcare professionals such as dental surgeons, pharmacists, and medical laboratory scientists.
Their salary scales and grade levels are determined based on their specific functions, training, and experience.
Impact of CONMESS on the Healthcare Sector
The acceptance and operationalization of the Consolidated Medical Salary Structure has transformed the healthcare sector in Nigeria. Some of the notable impacts are:
Improved Remuneration:
CONMESS has invariably improved remuneration levels of the medical practitioners in Nigeria giving them an upper hand concerning salaries than other professions in the land.
This has enhanced the number of skilled healthcare workers and minimized the cases of brain drain.
Improved Job Satisfaction:
The provision of a common salary structure has also seen enhanced job satisfaction levels among medical practitioners.
This is as a result of the various allowances provided under CONMESS which appreciates that health workers operate in a very demanding environment increasing their morale.
Reduced Frequency of Industrial Actions:
Prior to the imposition of CONMESS, industrial actions the Nigerian healthcare system used to experience frequently during that period was due to salary disparities and unpleasant working conditions.
Promotion of Rural Posting:
The Rural Posting Allowance under CONMESS has encouraged physicians to accept postings in rural and privileged regions. This has increased the number of health facilities and services in the areas that were hitherto neglected.
Training Enhancement:
The Specialist and Teaching Allowances under CONMESS have made it evident to the healthcare professionals why they need to go for higher education and specialization in the course of their career which has led to the advancement of the health sector in Nigeria.
Challenges and Controversies Surrounding CONMESS
Even with the positive effects of CONMESS, there have been challenges and controversies regarding the implementation and effectiveness of the system, some of which are:
Lack of Support:
One of the major challenges facing CONMESS is the lack of support from the government in terms of budgetary funding. The structure of salaries is largely dependent on the federal budgetary provisions, which is always not enough to meet the total implementation of CONMESS. This has resulted in late salaries and unpaid allowances.
Unequal Pay:
One of the key aims of CONMESS was to streamline the salary of all health workers so that there would be no pay discrepancies between the different health worker cadres. However, this is not the case as differences in pay still exist among the varying health care workers. For instance, some stakeholders such as nurses and pharmacists feel that the salaries they received under CONMESS do not reflect their responsibilities and inputs in health provision.
Sociocultural Factors and Economics:
Career salaries offered to medical professionals on CONMESS have lost significance on account of inflation and the normal cost of living conditions in Nigeria. Even after being reviewed from time to time, there are still concerns that most of the medical professions are low in terms of economic trends.
Industrial Actions:
While the frequency of CONMESS usage has been on the decline, disputes on salaries and allowances persist. Medical practitioners went on strike intermittently in the efforts to seek better pay and better working conditions. This indicates the existing disquiet on the implementation of CONMESS.
Brain Drain:
Even with the improvements CONMESS has rendered in the health sector, Nigerians still suffer the consequences of ‘brain drain’ relative to that sector. A majority of medical practitioners are still emigrating overseas to seek better-paying jobs, especially in countries with developed health systems.
Corruption and Inefficiency:
The healthcare system is susceptible to corruption and inefficiency, both of which can impede the successful implementation of CONMESS and divert resources away from their intended locations.
Solutions and Recommendations
Several approaches can be taken to solve the problem and the efficiency of CONMESS can be improved.
Conducting Regular Reviews and Updates:
It is just as imperative to do regular reviews of the wage structure as there will be a need to make it relevant and competitive with the growing demands of health practitioners.
Centralized Implementation:
In the course of implementing CONMESS, it is always imperative to create a central body that would be responsible for the implementation of CONMESS and ensure that there is uniformity in the implementation across the country.
Increased Funding:
No sector is viewed higher than the healthcare sector in terms of resources. The healthcare sector should get a resource influx for a pay rise, benefits, and enhancement of service delivery.
Precautions to Prevent Corruption:
There are need to enforce strict anti-corruption policies so as to reduce the chance of corruption and also make sure that the available resources are well spent.
Pay Based On Performance:
Healthcare professionals who possess a drive for performance should be rewarded handsomely and hence performance-relevant remuneration systems should be considered in healthcare organizations.
Collective Bargaining:
For just salaries and agreeable conditions of work, it is necessary to promote health professionals’ employers and workers’ collective negotiations.
Training and Development
If you want to increase the career possibilities of healthcare professionals and boost their skills and expertise, you should invest in training and development programs.
Benefits of CONMESS
Set Salaries:
CONMESS programs guarantee all medical employees equal remuneration for the same level of job, thus eliminating any disparity in salary that may be present amongst them.
Career Development:
Further Encouragement of Specialization and Advancement in One’s Work. The system provides where specialists in the field of medicine can advance their careers and specialization.
Enhanced Compensations:
Housing, transportation, and rural posting allowances are features of CONMESS aspects to improving the welfare of medical practitioners in terms of their enhanced welfare.
Talent Retention:
This organizational structure helps to keep skilled medical personnel in the public sector, thus decreasing the extent of brain drain.
CONMESS PDF Download
To download the complete Consolidated Medical Salary Structure (CONMESS) in Nigeria, a link to the official National Salaries, Incomes, and Wages Commission page where you can download CONMESS is given below:
Conclusion
The Consolidated Medical Salary Structure (CONMESS) in Nigeria is an important component in the process of regulating the manner in which healthcare professionals in the public sector are paid. Although great progress has been made in providing equitable compensation, it continues to face obstacles such as disparities in salaries, delays in payments, and a lack of resources.
By resolving these challenges through regular evaluations, centralized execution, greater funding, and anti-corruption measures, Nigeria would be able to establish a workforce in the healthcare industry that is highly desirable and sustainable.