The following article was written by Manjunath Naganur, a staff nurse working at a private hospital in Belgaum, Karnataka. The issue relates to the travails faced by the nurses everywhere in India with lack of job opportunities in government run hospitals to extreme exploitation in the hands of private/ corporate hospitals. The proliferation of private nursing educational institutions has led to churning out a large number of nursing graduates who have little choice but to join private/ corporate hospitals often at extremely low wages.
At the heart of the problem. as many nurses have realized, is the lack of fighting unions to espouse their cause. And the blame for this falls squarely on the shoulders of the Central Trade Unions like the CITU and AITUC who have completed neglected this important section of the working class. At the same time, it is important to also fight for a quality public health system (as against policies favouring more and more private/ corporate hospitals) that not only caters to the needs of the masses but also provide job opportunities to the unemployed and the underpaid millions.
Condition of Nurses in India
Nurses form the backbone of any medical services or patient care in the health sector. But in India, this important section of workers are highly exploited, with lack of respect and dignity at workplaces and more importantly paid extremely low salaries with lack of job security. It is in this context that nurses across the country should unite and confront the hospital management and the government on these issues.
Many nurses, who mainly come from poor backgrounds, have to pay lakhs of rupees to get a nursing degree and hence have to take huge loans thus leaving them indebted. But after graduation, what really confronts them is lack of opportunity in government run hospitals. Despite shortage of nurses and other staff in government run hospitals, the government deliberately follows a totally unscientific method of recruitment which keeps the majority of aspirants from getting a post in the government services and at the same time recruits nurses on a contract labour at extremely low wages to fill some of the gaps.
In the private sector, the nurses are confronted with extremely low paying jobs (between Rs. 3000 – Rs. 4000 a month) as against the labour standard of around Rs. 6000 (which is also pathetically low). Even the most experienced ones only get paid about Rs. 8000 – Rs. 9000. Many have to sign a 2-3 year bonded contract that inevitably binds the nurses to the hospital and breaking the contract often entails shelling out Rs. 50,000-Rs. 100,000 for obtaining their release. Otherwise, all their certificates are held by the hospital management.
Most of the nurses are forced to work beyond the mandatory 8 hrs working day, to more than 10 to 11 hrs. Apart from low wages, none of the nurses are given employment benefits like Provident Fund (PF) and gratuity. The nurses are not even given health coverage despite facing higher risk of infections.
Another aspect that does not find much of a mention anywhere is the human rights violation in the form of sexual harassment to female nurses. There is also the lack of work place ethics and respect for the nurse profession, with harassment by either doctors or the management by constantly accusing them of dereliction of duty. With the labour department and government neglecting the problems faced by the nurses and lack of unions fighting for the nurse’s cause, many are forced to silently bare these injustices.
It is not as if nurses have not gone on strike. Last year saw many strikes in Kerala and several other places including Bangalore. About 4700 contract nurses from Government hospitals across Karnataka went on a hunger strike for 8 days in February of this year. In Bangalore, the private/ corporate hospitals like Narayana Hrudalaya and Manipal have threatened police action against the nurses if they dare go on strike. Ultimately, it is the lack of union that is holding many nurses from taking strike action.
- Trade Union rights for all the nurses
- End the bond system. Stop confiscation of educational and experience certificates by the hospital management at the time of resignation
- No to workplace harassment by doctors and the hospital management. All nurses should be treated with respect and dignity.
- Standardised Wages at-least according to the minimum wages fixed by the Government. Wages to be revised and adjusted to the cost of living, with mandatory yearly increments.
- 8 hr working day, overtime allowances, yearly leave and other social security benefits.
- Health coverage for all nurses to be borne by the hospital management.
- End the contract system in government hospitals. All nurses should be recruited on a permanent basis and remove all bureaucratic impediments in recruiting nurses in government run hospitals.