Nurses' strike: Govt cracks whip, but were their demands fair?
Nurses are the crucial link in the chain in our health care system. It's clear to see how their skills, knowledge, interventions and compassionate care help patients manage their medical needs.
Which is why one would think that a demand to raise minimum wages would be taken more seriously by the government.
But on 2 September, hours after the All India Government Nurses Federation (AIGNF) launched a strike in New Delhi demanding higher wages; the government responded by calling the strike "illegal" and condemning those who took part in it. Around 20,000 nurses of various hospitals run by the Delhi and central governments participated in the indefinite strike.
"The LG has approved the government's proposal to invoke ESMA against agitating nurses," a top official said.
The Essential Services Maintenance Act (ESMA) allows the government to declare a strike illegal in public interest.
A Delhi government statement read, "The names of absentee nursing staff are being taken and FIRs would be lodged against them if they fail to report for duty. Action will be taken against them under ESMA which involves arrest and detention with the likely consequences of termination of services."
A day after the strike, the Centre said that Maharashtra, Delhi and Uttar Pradesh had been "partially affected" by the strike at a time when the number of cases of dengue has been on the rise.
A Delhi government's statement read, "Medical services in the fever clinics and the OPDs are being managed only with contractual nursing staff. However, patient care in the wards is affected. And while emergency surgeries are being carried out with the aid of interns and student nurses, scheduled surgeries have been postponed."
According to the AIGNF, the core demands include that the entry pay grade for staff nurses be increased to Rs 5,400 from the existing Rs 4,600 and that the nursing allowance be raised to Rs 7,800 from the current Rs 4,800.
Introduced in the Sixth Pay Commission, the grade pay apart from basic pay depends on the category/class of employee. The sum of basic pay and grade pay is used to calculate dearness allowance and other allowances. It remains fixed unless the employee gets a promotion. All in all, an entry level nurses get about an average of Rs 10,000 to Rs 13,000 per month.
Nurses have always been placed at the bottom rung of the Central Pay Commission. This means that they have fewer opportunities for a pay hike, increments and allowances.
Their other demands include a risk allowance and night duty allowances that is provided to all other government employees.
Delhi hospitals hit
After the Delhi government invoked ESMA, the protesting nurses still refused to call of the strike. The strike was eventually called off on Saturday night after being assured by the Central government that it would look into their demands.
On Friday, the Delhi Police also detained over 80 nurses of Ram Manohar Lohia Hospital for going ahead with the strike and threatened to file FIRs against any who chose to continue.
The agitation affected hospital services badly. Medical superintendents told the government that the state of the Capital's health services is "critical" and there "is much rush of patients" in the fever clinics and the OPDs on account of the upsurge in dengue and chikungunya cases. Postponed surgeries, harassed patients, wards without adequate nursing support and overworked staff seemed to be the norm in all major government hospitals.
A double game
While the timing of the strike can be questioned thanks to the various health crises, it should ne noted that the Union decided to strike on the same day as laborers across the country took part in the Bharat Bandh.
But the government, instead of increasing the wages, decided to hire more contractual staff to help doctors and patients. Contract workers cannot avail any of the benefits of a full time employee.
When the government briefed the media on the strike earlier this week, union health secretary C K Mishra condemned the timing of the strike.
He however said that there has been a consensus on seven of the nine demands and said there would be further talks on 12 September. The two demands which have not been met, deal with the salary of nurses as recommended by the Pay Commission.
Liladhar Ramchandani, spokesperson of AIGNF, has said that instead of meeting and discussing their concerns, the ministry has decided to force employees to go back to work by giving them an ultimatum. According to Ramchandani, the ministry did not respond to their proposal of setting up a meeting for days before the strike started. She added that the AIGNF has been struggling for over nine months seeking a hike in the entry level pay scale.
Even on the second day of the strike, when a delegation of 16-17 nurses, from various government hospitals in the national capital, were invited for talks by the Ministry of Health, none of the officials met with them.
The AIGNF had also made it clear to all nurses that they would attend to emergency and critical cases during the strike.
Doctors across the board also criticised the strike, calling it "irresponsible". Many complained about the shortage of staff and of surgeries and operations getting delayed or canceled rather than showing solidarity with the plight of nurses.
Even the media hasn't given much space to the plight of nurses. Most headlines and stories focused on the disruption of services and not on the nurses' legitimate demand of higher salaries.
More in Catch - 80% of docs treat only 28% patients. Swasth Bharat, anybody?