Their demands include a five day work week for nurses employed in the railways (against the current six day week); night duty allowances at par with all other government servants; qualification allowances as were previously given; field allowances for Public Health Nurses (PHNs); and full salary during child care leave, among others.
Various nurses’ organisations have been raising their concerns since the recommendations of the 7th CPC were submitted to the government in November last year. Despite several requests for meetings with officials of the Ministry of Finance, AIGNF has been ignored by the authorities, leaving the union no other choice but to take their struggle to the streets of Delhi. Early in February, strike notices were served to major government hospitals announcing a 15-day relay hunger strike starting from 12 February.
Instead of responding to the demands of the AIGNF in good faith, the nurses have been called ‘anti-national’ and been threatened with prosecution under the Essential Service Maintenance Act (ESMA) if they go ahead with their agitation.
The relay hunger strike was a great success with different hospitals taking up responsibility for different days while ensuring that care for patients was not affected. As neither the Ministry of Finance, nor the Ministry of Health and Family Welfare have given any satisfactory response to the agitation, AIGNF intensified its struggle, acted on its earlier announcement, and called for a mass casual leave on Friday 26 February.
PSI congratulates the AIGNF for their success and unity among a large cross section of nursing staff. According to reports from Delhi and Chandigarh, there was close to 100% implementation of the mass casual leave in all major hospitals, including Safdarjung, Lok Nayak Jai Prakash (LNJP), Guru Teg Bahadur, Govind Ballabh Pant, and Employee's State Insurance Corporation’s hospitals in the capital and the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh.
Junior resident doctors had to perform the work of nurses in order to maintain essential and emergency services. Over 250 surgeries were rescheduled in Delhi itself on 26 February, including over 80 in Ram Manohar Lohia (RML) Hospital and over 50 at Safdarjung Hospital. According to figures released by AIGNF more than 12,000 nurses were off-duty on Friday. Other states such as Uttar Pradesh, Rajasthan and Karnataka were also affected.
The General Secretary of AIGNF, G.K. Khurana, explained that while earlier nurses were only required to have a diploma, they are now recruited based on a degree, or a diploma plus one year of experience. Due to this change in qualification requirements, the pay band of nurses should also be increased, from the current PB-2 (Pay Band 2) of Rs 4,600 to PB-3 of Rs 5,400. In addition, existing allowances should remain and allowances given to other public servants should also apply to the nursing staff.
There is ample evidence that health care is best delivered by adequately resourced public services funded by public revenues. Remunerations in line with qualifications and legitimate allowances are part of the resources that need to be invested to ensure quality healthcare.
However, as it was evident in the Union Budget for 2016-17, presented on 29 February, the current government has no intention to take the public health system out of its current state of neglect. The budget allocation for healthcare (INR 38,206.3 crores / US$ 5.6 billion) is smaller than the profits reported for the Drugs and Pharmaceuticals sector, which stood at INR 41,120 crores / US$ 6.1 billion (before tax), as per budget papers. The Union Budget demonstrates the government intent to continue with its policy of starving publicly provided healthcare services of funds while these public services are increasingly outsourced to the private sector.
Other strategies used allegedly for cost cutting purposes includes recruiting workers through agencies and employing staff in perennial and core activities on short-term contracts. Both deprive workers of their rights and divide the workforce.
Significantly the contractual nurses have also responded en mass to the call. This unity has been nurtured by unions of permanent workers who have been taking up negotiations on the working conditions of contractual nurses. In central government hospitals especially, the union has demanded that the use of short term contracts be time bound and linked with a commitment to filling existing vacancies from among the contractual staff. This is an important experience to learn from.
PSI will continue to stand in solidarity with the struggle of AIGNF and other health workers’ unions fighting for their legitimate right to decent work and congratulates the commitment of public service workers to provide quality healthcare to the populations they serve.