The strike by trained nurses and other health workers not in regular government service but had bravely stepped forward to join other frontline fighters to combat the COVID pandemic when it hit the state must not be dismissed as untenable without a thought. They were indeed employed by the state government on mutually agreed upon contract terms and therefore cannot legally claim they cannot be removed from service even after the crisis has come under control. Hence, while we do wish the government were in a position to absorb them as regular employees, if this cannot be because of legal and financial constraints, the matter at one level would end there. But beyond the legal, the issue has many more grave concerns and should not be allowed to be folded up unceremoniously. The most prominent and unfortunate of these is an inherent injustice the nursing profession has been subject in the health services by and large, one which for far too long has been allowed to remain in a blind spot of the administration as well as society. This is despite the indisputable fact that the nursing profession is a vital pillar of the health services and without its professionals keeping the fort, the entire system would collapse. The very fact that at a time of grave emergency posed by COVID19 the government has had to think of recruiting more nurses on short contracts in order to face the crisis is evidence of this. This was when the pandemic left everybody either in a panic, erecting barricades around their localities and even wildly calling for the first COVID patient in the state, a girl returning from her place of study in London, to be abandoned and left to die in the selfish belief that this was in the interest of saving their own skins. There were also others calling for Manipuris stranded outside the state not to be allowed to return home regardless of the misery those stranded were facing at the time, again for fear that they would return with the virus. It should not be forgotten that it was amidst this paranoia and ugly selfishness that the nurses now on strike had courageously and generously stepped forward, braving social ostracism, to be in the frontline of the battle, giving everybody the relief that not everything is myopic and egocentric in this state.
This then is the importance of the profession. This being so, those in this profession need to have the respect due to them, and the most fundamental of the dues denied so far is their service condition in today’s burgeoning and prospering private hospitals and clinics. Indeed, in Manipur’s context, of all the emerging private entrepreneurial initiatives, the health sector probably would rank as the foremost success stories, making many millionaires, and deservingly too. However, among those left excluded a share of this success story are those in the nursing service without whom these success story would have been no more than an empty shell. Almost as a rule, although there are exceptions, their salaries are a pittance, though in terms of workhours extracted, they would probably rank as some of the most exploited in the entire labour market, not just in Manipur, but in much of the rest of India. As a matter of fact, the Supreme Court has taken cognizance of this oppressive state of affairs in a 2011 case filed the Trained Nurses Association of India against the Union of India, and in a ruling the apex court directed the central governments for taking the necessary steps to ameliorate the situation. As per this direction, the central government constituted a committee to look into the matter. The committee after examining the situation in several states, came to the conclusion that nurses working in private hospitals and nursing homes were grossly underpaid and deprived of basic facilities. It also recommended a 3-point measure. First, it said private hospitals with 200 or more beds should pay salaries for nurses at a par with government hospitals. For private hospitals with 100 to 200 beds, it recommended that salary for nurses should be not less than 10 percent of what their counterparts get in the government hospitals, and those with 50 to 100 beds, not less than 25 percent. Even in hospitals with less than 50 beds, it said salaries for nurses cannot be less than Rs. 20,000 per month.
Besides this salary standards, it also said that working conditions in terms of leaves, working hours, medical facilities, transportation, accommodation etc., nurses in private hospitals should be given the same benefits as in government hospitals. It also directed the states and union territories of India to formulate appropriate legislations/guidelines to ensure these recommendations enter their statute books. This was in 2011, and although several states have adopted the recommended norms, Manipur government has remained silent on the matter, and nurses continue to be poorly paid and insecure in their jobs, as their employments remains at the mercy of their employers and not the law. It is everybody’s knowledge that the fate of these nurses in private hospitals is also very much what it is for employees in most other private enterprises. The media included. However, thankfully for the media at least, although journalists are still underpaid, there is an institutionalised national wage-board which determines every ten years the minimum salary payable to employees of different classes of newspapers. There are obviously some media organisation which are unable to meet this expense and they would have to negotiate with their journalists and other employees to come to an agreement on what salary standard is realistic in their given financial situation and until these genuine problems are overcome. However, even if journalists here agree to salaries lower than the wage-board recommendation, they do so out of their generosity knowing fully well the law is on their side, and not at the mercy or coercion of business owners. Why cannot every other in the private sector be given similar dignity even if the institutionally recommended salary standards cannot be adopted immediately.
It is time the government thought of a wage-board not just for nurses in private hospitals, but also other classes of employees in all organised sector private enterprises based on the sizes of their businesses. We can immediately think of private school teachers. Private schools are another booming sector in Manipur today, and understandably many are doing extremely good business. For a state grappling with growing unemployment, where only government jobs have come to be considered as worthwhile and respectable therefore a crowding of job seekers at the government employment exchange, putting immense pressure on the government and reciprocally hiking job prices in the corruption market sky high, it should be considered paramount for it to strengthen as well as add quality to private sector jobs. There is no way for the government to directly employ every job seeker in the state, the only way it can handle this problem is by expanding the extent and quality of the non-government job market. It must, without further delay, set salary standards for the organised sector in the private sector, fair to the employers and employees alike. For the unorganised sector too, fixing and enforcing respectable daily wage standards from time to time is expected.
Editor, Imphal Review of Arts and Politics and author
