Nurses to get a fair deal in Kerala: will the others follow suit?

The “jasmine revolution,” the spontaneous series of strikes by nurses that spread across the country recently has met with its first official success in Kerala, the catchment area for the country’s nursing industry.

The Kerala government said it will implement an expert committee’s report that recommends substantial rise in their salaries and improvement of their working conditions.

 Nurses to get a fair deal in Kerala: will the others follow suit?

Nurses feel that this legal lacuna might lead to their exploitation and might push them to the streets again. AFP

On an average, nurses, who otherwise work in severely exploitative conditions will get at least 100-300 percent hike in their salaries. The committee has recommended a minimum basic salary of Rs 12,900 with an annual rise of Rs 250 and duty-time not more than eight hours.

At present some hospitals pay nurses as little as Rs 2,500 to 3,000 and make them work for 12 hours and more.

Nurses with three years of service will get 13,500 and head nurses 15,150. Their annual increments will be Rs 300 and Rs 350 respectively. A nursing officer will get Rs 21,360 with an annual increment of Rs 500.

The committee also recommended guidelines for leave, housing, bonus, working hours and various allowances including for additional working hours. The maximum working hours are to be capped at 48 hours.

Recently, thousands of nurses went on strike in big corporate and private hospitals in Delhi, Mumbai, Chennai and different cities of Kerala demanding better wages and decent working conditions. Although the hospital managements in all the striking locations tired strong-arm tactics for several days, they had to reluctantly accede to the demand of the nurses as their operations ground to a near-halt.

The private hospitals agreeing to the revised working conditions and salaries in big cities, however, has been bilateral deals signed between individual managements and nurses. What is seriously missing is the institutionalisation by state governments of these changes and the legal establishment of salary structures and employment conditions for nurses in the private sector.

Nurses feel that this legal lacuna might lead to their exploitation and might push them to the streets again.

In most places, the baseline for their salaries had been the minimum wages prevalent in the state.

The strikes are still on at some other locations, and the exploitative conditions of nurses in small towns are still an unheard, but bigger part of the story.

The Kerala government’s move, in this context, is a progressive trail-blazer. It will have far reaching consequences beneficial to the Indian health industry. At present, a large number of trained nurses leave India, mainly to the Gulf, North American and European countries, for better salaries and career prospects.

The demand-supply gap for nurses in the country is about 50 per cent
and one of the main reasons for this trend is brain-drain and poor salaries.

“The developed world fills its vacancies by enticing nurses from other countries, while developing countries are unable to compete with better pay, better professional development and the lure of excitement offered elsewhere,” says a WHO bulletin. India would need 2.4 million nurses by 2012 to reach a modest ratio of one nurse per 500 patients.

With universalisation of healthcare assuming considerable importance under the12th plan, the country needs tremendous capacity-addition for nursing and paramedical staff and the only way to attract and retain new talent is to end exploitation and improve salaries and employment conditions.

Except in rare cases, nurses had been paid extremely poor salaries and had been subjected bonded conditions in most of India. It is almost a routine practice across the country to bond them for a few years at very poor salaries. To ensure that they remain bonded and silent, the hospitals retain their educational certificates.

The recent strikes by nurses, a rare and spontaneous community movement without the patronage of any political party, was a warning call for the healthcare industry and public health mandarins. And the Kerala government has responded admirably. This is a cue that other states need to take urgently.

If the central government has to realise at least a semblance of the vision of the High Level Expert Group (HLEG) of the Planning Commission that proposed “essential primary, secondary and tertiary health care services that will be guaranteed by the central government,” the fundamentals need enormous attention.

Nursing care is among the most critical of these fundamentals. A central government that is frequently charged with usurping the powers of the state will be well-justified to take an affirmative action on this.

The steps taken by the Kerala government, which has a remarkable public health record, can definitely show them the way.

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Updated Date: May 03, 2012 14:23:49 IST