Nurses’ Unions in India Demand a Voice in Nursing Workforce Policies

Nursing unions and associations across India have written an open letter to the Ministry of Health and Family Welfare (MoHFW), demanding meaningful consultation in drafting the MoHFW’s guidelines on working conditions of nurses across all establishments.

The letter is signed by 11 unions representing nurses in the public and private sector across India.

The MoHFW released the draft guidelines (Notification No. Z. 16015 / 12/ 2022-N) on its website on 1 August 2022. The guidelines aim to address the conditions of work of nursing personnel across both public and private sector establishments. The MoHFW asked for written feedback on the guidelines from interested stakeholders to be sent to the Nursing Department of the Ministry within a period of 30 days from the date of publishing. 

While unions welcomed the government’s initiative to address the working conditions of a workforce that has worked through the pandemic under extremely stressful conditions, often facing harassment and heightened pressure, they also expressed disappointment at the failure to engage in social dialogue in developing the draft.

The letter states that “A policy on working conditions of nursing personnel will be crucial in setting standards for the sector and requires more extensive planning and consultation, especially with the nursing workforce who have expertise in identifying relevant concerns and ways in which they can be addressed” and highlights that “The process of written submission regards us as passive participants, whereas the nursing workforce should be active decision makers to provide substantive inputs in developing the draft.”

Raman Kannan PSI Sub Regional Secretary for South Asia

Nurses deserve respect and to have their collective voice respected when forming policies that impact on them.

During the pandemic, health care workers have faced multiple counts of harassment and violence across the country. Several reports have highlighted the compounded harassment faced by nurses, a largely feminised workforce, including long hours of work without breaks, lack of PPE equipment forcing them to work in high risk conditions, inadequate and often delayed payment of wages, as well as shaming and stigmatisation by society even as they continued to serve the country putting their own lives at risk. 

Kannan Raman, PSI Sub Regional Secretary for South Asia said that “Nurses deserve more than applause. They deserve no less than their right to secure and safe working conditions, living wages, training and professional development. They deserve respect and to have their collective voice respected when forming policies that impact on them.”  

Commenting on the role of nurses in strengthening health systems, General Secretary of the All India Government Nurses Federation (AIGNF), G.K.Khurana said that, “It is not possible to achieve health for all without nurses.”

The letter points out omissions in the draft guidelines that nurses want addressed including, “mandating nurse to patient ratios, addressing the issue of increasing contractualisation of nursing workforces in private hospitals, accountability measures, especially for the private sector to ensure implementation of the provisions, among other gaps.”  

Highlighting the plight of nurses in the private sector, UNA Maharashtra State President, Jibin T. C. shared that, “Nurses in the private sector in India face some of the worst working conditions. It is high time that they are given their dues beyond the rhetoric clapping of hands”. 

The letter urges the Ministry to uphold the spirit of social dialogue and conduct a joint consultation with nursing unions and nursing workforce representatives to develop and finalise the guidelines. 

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Open Letter to Shri Mansukh Mandaviya Ji (India's Union Minister for Health & Family Welfare)