John (not original name) is not used to raising slogans. He prefers to give words of comfort to patients. But in the last one week, sloganeering is all that he has done. He is one among the 1500 nurses who braved the extreme heat and gathered in front of the Victoria memorial hall near Madras Central three days back to fight for their rights.
He has been working in the Fortis Malar hospital in Madras for the past two years. His salary of Rs.5000 is less than even the monthly interest on his education loan amount of Rs. 5 lakhs. Leave alone savings, this youth hailing from Trissur district in Kerala has to depend on his not so well-to-do family to even repay his loan. This is not an isolated story. It is a sad commentary on the nursing profession in India that this is the case with most of the nurses working in private hospitals in India. A Government nurse gets a starting salary of around Rs. 20,000 while abroad it is in lakhs.
Many of the nurses I met talked about the pathetic working conditions that they are subject to. In many hospitals, they end up doing the work that is meant to be done by the housekeeping staff. They pointed me to an ad for nurses put up by one of these hospitals on Naukri, listing food preparation and cleaning as part of their duties.
The case of night duties is even worse. “We are stipulated to work eight hours daily. But usually that stretches to ten hours and sometimes to double shifts. We are not paid extra for that. For night duty, we get a paltry 15 rupees per night,” says John. Most of the hospitals have put up cameras to monitor whether the nurses are sleeping while on duty. “Even if we close our eyes for a minute, we have to give explanation the very next day,” he added.
Removal of the bond system is another of the nurses’ demands. By this system, if they have to resign from the hospital within 2 years and go for a better option, they have to pay Rs.1 – 2 lakhs to the management. Their certificates are with the management. So they can choose to not return it and scuttle the plans to resign.
The nurses’ strike got its first spark in October last year at the Mumbai Asian Heart Institute when Beena Baby, a nurse committed suicide as she was unable to pay the amount for breaking the bond. From there, it spread to Kerala, where it snowballed into a major strike with nurses from almost all major private hospitals staying away from work. This resulted in the managements agreeing to revise the salaries.
The strikes in Kerala saw the hospital managements unleashing dirty tactics on the striking nurses. When the strike started in the Amrita hospital in Ernakulam, the management there spread the rumour that Christian groups are behind this. The strike also saw the unveiling of the real ‘kind’ face of the MATA with many of the association leaders getting beaten up ‘mysteriously’ inside her abode and getting hospitalized. Maybe, this was part of ‘Her’ magic trick to bring the nurses back to the hospitals.
When the strike reached Angamaly Little Flower hospital, the nurses were branded as having anti-christian leanings. The church joined the management in support by reading out statements against the nurses during the Sunday mass and by even taking out a protest march. Thankfully, most of the people didn’t fall for this religious propaganda and even jeered the church authorities who took out the march. In the end, all of these hospitals fell in line and agreed to the nurses demands.
Jinu Varghese, National Secretary of All India Private Nurses Association said, “Till few years back, the nurses used to join the hospitals in India just to get the experience certificate to go abroad, where we are highly paid. But after the recession, the jobs there have shrunk and so most of us are working here for the long term. That is when we started questioning the ridiculously low wages and other unfair practices like the bond system and confiscation of certificates that are followed by hospital managements all over India”
“Ideally, it should be 8 hours work, 8 hours of sleep and 8 hours for ourselves. But after the duty which exceeds 10 hours, we hardly get any time for anything else.”
They also talked about the procedure called ‘Code blue’ used in hospitals. This is used to indicate a patient requiring urgent attention. In case of an emergency, the person who is with the patient raises this alarm and within a minute a specified team of doctors and nurses rush to the spot. This is mostly used in case of cardiac arrest. But even if it was not a case of cardiac arrest (patients do get unconscious sometimes), once code blue is raised, the particular patient is billed Rs.10,000. The reason the hospitals cite for this is usage of ‘manpower’. But nurses who are part of this ‘manpower’ are not paid anything.
Most of the private hospitals have very high nursing procedure charges are part of all hospital bills. Though this particular item in the bill is for the services rendered by the nurse, little of that goes to their salary slip. The main aim of the private hospitals is to increase the number of patients and decrease the number of staff.
The nurses’ strike started in three private hospitals in Chennai last week. Apollo, Fortis Malar and Madras Medical Mission Hospital, reeled under the impact of the strike as the nurses stayed away from work en masse. To tide over the crisis, Fortis Malar had flown in 70 nurses from their Delhi branch this Sunday whereas Apollo depended on the student nurses from their medical college. Even then, these hospitals could not handle the situation and refused to take in new cases, unless it was an emergency.
The strike at Madras Medical Mission hospital ended on Monday itself with the management agreeing to double the current salary of Rs.6000 and also to do away with the bond system. The week saw many failed rounds of mediations with the labour commissioner acting as the go-between. By the end of the week, both Fortis and Malar agreed to increase the salary to Rs.12,000.
“There is no doubt that the hospital managements are exploiting the nurses and they have every right to protest. But before going ahead with the strike they should’ve approached the labour department and tried to sort it out. They should’ve kept in mind that nursing is an essential service,” said C.Subburajan, Additional labour commissioner.
Lekha(name changed) says that they had given prior notice to the management and went ahead with the strike as there was no response to the notice. “We are not paid enough or given enough respect for the kind of work that we do. We can’t even pay off our education loans with the salary that we get here. We had no other way but to go on strike.”
“Last year, Fortis Malar had a profit of over 100 crores(I went through the annual report and realized that it is actually 136 crores). Even if they agree to pay us the salary that we are demanding, only 3 crores will be reduced from the overall profit,” she added.
Most of the hospital managements refused to talk to me on this issue. Apollo people redirected me to their HR department, where the HR head seemed to be in a perpetual meeting mode. The phone number that they gave me never answered the call.
One of the officials from a private hospital here agreed to talk after I made a second visit. According to him, his hospital is providing accommodation and transport (which they've valued at about 7000) to the nurses. So effectively they are already drawing a salary of more than Rs. 10,000. He evaded my question on how one can survive with less than Rs.5000 in a city like Chennai, even considering the accommodation and transport part. He also pointed to the huge number of private nursing colleges churning out nurses who are not up to the standard. This prompted a question on their selection process which he said is stringent. But he did agree to the fact that the nurses were paid very less all over the country owing to a lack of wage standards.
In the coming days, we will most probably see this strike spreading to other parts of the country. The private hospital managements should appreciate the efforts of nurses, who are the backbone of the health sector. When you make crores out of this business, when you pay lakhs to a doctor, you should also acknowledge the poor souls who are doing the maximum work.
