Nigeria's two leading labour unions, the Nigeria Labour Congress (NLC) and the Trade Union Congress of Nigeria (TUC), have jointly issued a definitive 14-day ultimatum to the Federal Ministry of Health and Social Welfare. This warning signals impending nationwide industrial action if the government fails to implement the long-pending review of the Consolidated Health Salary Structure (CONHESS). The ultimatum was publicly announced on Friday through a joint statement signed by Comrade General N.A. Toro, Secretary General of the TUC, and Comrade Benson Upah, Acting General Secretary of the NLC.

The unions have vehemently accused the President Bola Tinubu-led Nigerian Government and its relevant agencies of deliberately neglecting the report submitted by the Technical Committee on CONHESS. This crucial report, which aimed to address salary distortions in the health sector, was initially submitted in 2021 under the chairmanship of the National Salaries, Incomes and Wages Commission.

The NLC and TUC assert that the protracted delay, spanning nearly five years since the report's submission, transcends mere administrative oversight. They characterize it as "a conscious act of injustice, bad faith, and institutional disrespect" towards health workers and organised labour, subjecting healthcare professionals to ongoing hardship and inequitable treatment.

A central point of contention highlighted by the unions is the perceived selective application of salary policies within the health sector. They point out that while the Consolidated Medical Salary Structure (CONMESS) for medical doctors was adjusted and implemented with effect from January 2014, the corresponding and equitable adjustment for CONHESS, affecting other health workers, has been repeatedly stalled. This "uneven treatment within the same sector," the unions argue, raises serious questions regarding the government's commitment to principles of equity, fairness, and the maintenance of industrial harmony across the entire healthcare system.

Despite numerous attempts at dialogue and the sustained restraint exercised by labour leaders in an effort to preserve industrial peace, the unions lament that these efforts have yielded no tangible outcomes. They further accuse the Federal Ministry of Health and Social Welfare of responding with a pattern of excuses and silence, rather than offering concrete action.

Describing this unresponsiveness as a "gross abuse of trust" and a "direct challenge to organised labour," the NLC and TUC have declared their 14-day ultimatum as final and irreversible, with effect from January 23, 2026. They demand the immediate implementation of the 2021 Technical Committee report on CONHESS, in strict adherence to established practices within the health sector.

The labour unions have issued a stern warning: failure to meet this deadline will leave organised labour with no alternative but to commence coordinated nationwide industrial action. This comprehensive action is slated to include mass protests, the picketing of health institutions and government offices, and a total withdrawal of services across both public and private sectors throughout the country.

They emphasized that they will no longer tolerate "empty assurances, bureaucratic delays, or the continued marginalisation of health workers," and have stated that the Federal Ministry of Health and Social Welfare will be held fully accountable for any disruption arising from its failure to act decisively within the ultimatum period.

Prior to this latest 14-day ultimatum concerning CONHESS implementation, the TUC had, on January 14, issued a separate seven-day ultimatum. This earlier ultimatum demanded that the Federal Ministry of Health and Social Welfare withdraw a circular enforcing a "No Work, No Pay" policy against striking health workers, specifically members of the Joint Health Sector Unions (JOHESU).

The congress condemned this directive, and the subsequent stoppage of salaries for JOHESU members via the Integrated Payroll and Personnel Information System (IPPIS), as "reckless, authoritarian and confrontational." This "No Work, No Pay" circular was initially issued by the Ministry on January 8, directing chief medical directors and medical directors of federal health institutions to apply the policy.

This critical 14-day ultimatum from NLC and TUC comes against the backdrop of an already ongoing nationwide strike by JOHESU and the Assembly of Healthcare Professional Associations (AHPA). This industrial action, which commenced on November 15, 2025, entered its third month on Friday, January 23, 2026. The strike was declared indefinite following what the unions described as the federal government’s prolonged failure to implement the adjusted CONHESS and address a range of long-standing welfare concerns affecting non-doctor health workers.

JOHESU and AHPA assert that their current action was primarily triggered by persistent delays in implementing the report of the High-Level Body Committee on CONHESS, which was submitted to the Presidential Committee on Salaries and Wages in 2022. Their demand for equitable salary adjustments dates back to 2014, when similar adjustments under CONMESS were implemented for doctors, while non-doctor cadres under CONHESS were allegedly left behind, constituting a breach of the 2009 Collective Bargaining Agreement.

JOHESU has criticized relevant Ministries, Departments, and Agencies for delaying the matter, attributing it to slow prioritization by the Presidential Committee on Salaries. The decision to embark on the indefinite strike was made following a unanimous resolution at its Expanded National Executive Council meeting on November 14, 2025, in compliance with Section 41 of the Trade Disputes Act.

The impact of the ongoing strike on Nigeria's healthcare system has been extensively documented. Recent investigations by PREMIUM TIMES across health facilities in Abuja, Kano, Kaduna, Akwa Ibom, and Lagos have revealed a healthcare system operating largely on skeletal services. Essential departments such as laboratories, pharmacies, medical records, and diagnostic units are reportedly shut across many public hospitals.

Specific examples include the closure of the Records and Visits Department and the National Health Insurance Scheme unit at the National Hospital, Abuja, forcing patients to seek alternatives or pay out of pocket for private care. Similarly, several departments at the University of Uyo Teaching Hospital in Akwa Ibom were shut down, leading patients to incur higher costs for services elsewhere.

In Kano, patients at Aminu Kano Teaching Hospital experienced long waits for critical care, including blood transfusions, with health workers initially attending to patients but later leaving, placing additional burdens on doctors. Notices informing the public of the indefinite strike are prominently displayed on locked doors across facilities, and many patients are reportedly struggling to access even basic care, a situation described by health workers and relatives as placing undue hardship on ordinary Nigerians.

All TUC and NLC affiliates, including state councils across the 36 states and the Federal Capital Territory, have been placed on red alert and instructed to begin immediate mobilization in anticipation of further action.