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Angels in Distress

Angels in Distress

They are known as ‘angels of consolation’. But in God’s own country they are ‘angels in desolation’. For all the hype created around the ‘Kerala-model healthcare system’, the state’s nurses remain the worst paid lot who unsung and underpaid slog through long hours of service. Being in a state that stubbornly remains one state which has not yet implemented most of the recommendations of the Dr. Balaraman panel on improving the service conditions and salaries of nurses, Kerala’s nurses  had nothing to cheer about when a couple of months back the world celebrated ‘Nurses Day’.

With the paltry pay they receive, the poor working conditions they put up with and the ill treatment they suffer in the private sector hospitals, the nurses have been reeling with resentment. Earlier in 2010, the suicide of a Malayali nurse due to the harassment by the management of a private hospital in Mumbai had sparked off an emotional fire among the nurses across India and drove some voluntary associations and professional organizations registered under the Kerala Societies Act to organize nurses’ strikes in different hospitals across India. 

The nurses’ stir in Kerala is an irresistible outburst against the injustice meted out to them.  Nurses working in Kerala’s private hospitals have been at a receiving end for long. With a pittance pay and pathetic service conditions they have been a distressed folk but not sans grit and determination to battle it out until justice is done to them.  From 2012 onwards the ‘angels in white’ have been turning ‘red’ with their grievances simmering like a volcano bound to erupt sooner or later.

Nurses’ agitation in Kerala has been a long and tough journey through the winding steep of panels, governments and courts, right from the Balaraman panel (2012) to the Supreme Court directive (2016). The current protest of the Nurses’ Unions is the last nail on the coffin of injustice they’ve been bearing with. The six-member Balaraman committee had recommended a salary of Rs 18,000 to 22,500 to the nurses which the then hospital managements opposed. The government found it hard to take a decision, hence resorted to the minimum wages Act whereby the nurses' salaries were raised from a minimum of Rs 5,000 to Rs 8,700. The nurses, still dissatisfied, persisted in their strike which compelled the government to promise revised salaries in January 2016 only to fall back on its promise. 

The aggrieved nurses once again launched a strike forcing the government to appoint another committee to fix revised salaries. At the delay of the panel’s implementation, finally the Supreme Court set minimum salaries of nurses at Rs 20,000 on 21 January 2016 and directed the Central government to implement the order within six months.  As per the SC directive to all state governments, private hospitals with more than 50 beds are supposed to pay a basic salary of Rs. 20,000 to nurses.  The government then appointed a committee and asked all states to enforce the order. Kerala's response to it was that it had appointed a panel and would enhance the salaries only after getting its report. The state government then dissolved a panel appointed by the previous government and named a new one in October last year. The new committee yet hasn't submitted its report as a consensus eludes it. The nurses’ stir demanded nothing more than their rightful salary Rs 20,000 as per the Supreme Court Directive last year.

True to the adage ‘Adversity unites people’, the persistent strike of the nurses’ unions has united the varied hospital associations in Kerala. In a first, all five associations of healthcare providers in Kerala, namely Association of Healthcare Providers of India-Kerala (AHPI),  Kerala Private Hospital Association (KPHA), Association of Advanced Speciality Healthcare Institutions (AASHI), Qualified Private Medical Practitioners Association (QPMA), Catholic Healthcare Association Of India (CHAI)  representing most of the private hospitals in the state have come together and made a ‘joint plea’ to the protesting nurses’ unions to  refrain from taking the token strike forward. Thus went the joint plea, which however failed to make the protesting nurses buckle: "If the nurses go on strike, the private hospitals, which provides 70 per cent of the healthcare services in Kerala, will not be in a position to admit any new patients and would be forced to discharge the admitted patients, This would lead to an unavoidable increase in number of patients in the government hospitals, which were already packed due to a fever epidemic”.

While the joint plea of the hospital associations sounded nothing more than a ‘request’ to the aggrieved nurses to refrain from their protest, it was the urgent call of Cardinal George Alencherry, the head of Syro-Malabar Church albeit late to the management of private hospitals earlier this month asking them to ensure that nurses get salaries at par with those in the government sector that was heartening. However, whether his appeal is practicable and how many 50+bedded private hospitals especially in rural sector given the multiple perspectives involved in it are capable of abiding with his ‘just wages call’  is a matter that  lay subject to  difference of opinion and discretionary measures.

The age old discriminatory treatment meted out to nurses by hospitals and society in general has to stop. The strict hierarchy existing among health care professions with doctors on top and nurses clubbed with radiographers, pharmacists and lab technicians have to change.  Nurses are not to be pushed to the lower rung of the hierarchical ladder where they are treated as second class citizens. By virtue of their professional qualifications, nurses are skilled professionals who apart from the medical care they give to the ailing, render their emotional support and bring solace to them. They are ‘consoling angels’ who round the clock serve the sick as dedicated caregivers. They certainly deserve a better economic status and good working conditions in hospitals.

The private sector of the hospital industry in India is dotted with hospitals economically poor as well as rich. The Catholic Church long since has been in the forefront of battling for social justice and been providing employment for millions in her institutions. Social justice is an umbrella term that includes everyone in the society. In health sector social justice is to be done to the caregivers as well as to the cared.

(Published on 24th July 2017, Volume XXIX, Issue 30)