Articulation of concerns of nurses in various categories – A seminar by Nurses Joint Action Commitee

What does it mean when a Government committee directed by Supreme Court recommends that wages of nurses in private sector be on par with those in public sector when in reality, the wages in public sector are lower than the private sector? What does it say about proletariat conscious governance in India, when workers under a Left Government have to strike to demand implementation of minimum wages and equal pay for equal work? These were some questions that were highlighted in a seminar organised by Tamil Nadu Nurses Joint Action Commiteee(NJAC) on August 18th in Chennai.

As a response to a legal case filed in 2011 by Trained Nurses Association of India which had highlighted gross violation of workers’ rights in private hospitals, in February 2016, the Apex Court had directed the Central Government to investigate these issues and come up with recommendations. In September 2016, a set of recommendations were laid out to improve the wages and working conditions for nurses in private sector. According to Dr. Ravindranath, honorary president of Nurses Federation, the committee had recommended wages from Rs 20000 to Rs 34800. The committee had said that the minimum wages for nurses should be set at Rs 20000 and a scale be defined based on number of beds in hospitals. For instance, the committee has recommended that hospitals with more than 200 beds should give the same wage for their nurses as the Government hospitals providing same service.

In this context, Tamil Nadu Nurses Joint Action Committee has been formed comprising of private nurses’ unions, government nurses unions and trainees’ unions.  This initiative to articulate the issues of private hospital nurses has come few years after the   spontaneous strikes that arose in 2012 in several private hospitals including Apollo, MMM, Vijaya.

The committee has put forth the following demands in an effort to organise workers and push the cause of working rights of nurses in Tamil Nadu.

  • Implement minimum wages of Rs 20000 for all nurses in private hospitals and clinics as per Supreme Court Committee recommendations.
  • Enact Independent Nurses Practitioners Act in India as has been done in developed countries.
  • Implement social welfare protections such as family benefit fund, group insurance and retirement benefit, leave benefits, free medical care and Rs 5 lakh death insurance benefit for private hospital nurses on par with Government hospital nurses.
  • Penalise medical services that provide medical care and surgical care using unqualified nurses.
  • Setup a district wide mechanism to resolve issues of nurses arising from their work. Setup a Directorate to handle administration services for defining and implementing trainings, working conditions for nurses etc.
  • Implement wage for tutors in private nursing schools on par with government nursing schools.
  • Abolshing bond systems, mandatory contract services such as keeping the certificates being enforced in private clinics
  • Implement annual wage increments, wage board, dearness allowance for nurses
  • Implement 8 hours working time for nurses.

A male trainee nurse who had attended the event spoke to Thozhilalar Koodam and said that his and others’ aspirations was for a Government employment. He said that even though there was a recommendation that Government hospitals only recruit MRB(Medical Services Recruitment Board) qualified workers, several of his seniors were working  for 4-5 years only in contract services. He also said that it was difficult to get information regarding vacancies in Government hospitals.

Speaking to Thozhilalar Koodam, Hepsiba, a nurse in a private hospital and treasurer of NJAC, said that nurses in private hospitals were only getting Rs 7000 to Rs 8000 and in rural areas, it was as low as Rs 3000 – Rs 5000. Even for this low wage, the nurses are made to work in 12 hours duty. She said that in rural areas where there are not enough doctors, nurses should become the first line of providing medical service. Comrade Hepsiba said that the Bond system using mandatory contracts and bond certificates is prevalent in the private medical institutions and has to be banned. This is significant as the Apex Court Judgment cited above had struck down on the allegation by the petitioners merely because Indian Nursing Council had said that this practice has been banned. However according to Comrade Hepsiba, this practice is still continuing in reality.

Comrade Gopinath of TN MRB Nurses Empowerment Association said that earlier Government hospitals would only recruit nurses from Government nursing schools but after a legal judgment determined it to be discriminatory, MRB qualified nurses from both private and Government schools are being recruited. However, these new recruits are employed only as contract workers with wages ranging from Rs 7000-Rs 8000. He asked why equal wages for equal work is not a reality even when there is a law for the same.

Comrade Mutharasan, CPI State Secretary, reminded that AITUC had taken a rally of 15000 workers for implementation of Equal Pay for Equal Work two weeks ago.  Speaking on implementation of such acts, he said that in India, it takes about 10 years to enact a law and another 10 years to even see a modicum of implementation. He said that while left had been demanding implementation of these laws, somehow it has not been able to convince the common people of the impact of neo-liberal agenda. He cited the rising unemployment due to neo-liberal development as primary anxiety which is pushing the working population to work for very low wages in inhuman conditions. He said that the Federation should pay special attention to the privatization of Government hospital where there is a push for leasing of the hospital infrastructure to private players. He questioned the new form of profiteering where even the infrastructure is built by the public for private players. He congratulated the organizers for launching this important initiative in spite of a low turnout and called for a sustained struggle.

Speaking to Thozhilalar Koodam, Comrade Gopinath confirmed that services are being privatized or outsourced. He said that pharmacy, lab services and ANM are being outsourced. He did not expect the nursing to be outsourced because of the judgment but mentioned that lots of NGOs such as Egam Foundation, Banyan are playing into the privatization process.

Comrade Ravindranath recalled the 2012 strikes in Chennai in Apollo and other hospitals. The hospitals retaliated by turning off services such water, electricity and hostel services. In spite of this, the workers persevered and were able to win an increase in the wages – from as low as Rs 4500 to Rs 12500. He said that asking for wages on par with Government workers is not valid in Tamil Nadu where Government hospital nurses are earning as low as Rs 7500 and private hospital nurses are earning Rs 12500 and instead pointed out that wages should be on par with Central Government Hospital nurse scales. He said that when we ask for such demands, the immediate reaction is that nursing is a noble service. To this, he responded that if the society is ready to give everything free for this service, then the nursing community is also ready to service. He appealed to the organisers to also reach out to students in nursing schools to build this movement.

The issues of nurses were brought to limelight when nurses in Kerala led a month long stir demanding dignified wages for the service they provide (For a detailed information, read The stir ended with partial success when the State Government and private hospitals agreed to implement the minimum wage of Rs 20000 for nurses. In Tamil Nadu, public services have been dismantled structurally by paying the public service workers abnormally low wages. Hence, recently employed public sanitation workers in municipal corporations, anganwadi workers and sweepers in Panchayats and nurses in Government hospitals, teachers in Government schools and colleges are paid lower than their counterparts in private employment. Still, it is Government work that is the dream of majority of the workforce in Tamil Nadu, mainly, because of a sense of security associated with such employment. The seminar and the work of Nurses Joint Action Committee has brought together various factions of nurses and trainees, who are articulating their various concerns and trying to forge a common platform for building solidarity.


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