New Delhi: Ignoring representations from nurses and patients to be included in the deliberations on safety inside hospitals, the National Task Force dominated by senior doctors has created four sub-groups that have only doctors and bureaucrats as members. While the 14-member task force had 11 senior doctors and three bureaucrats, the sub-groups have added eight more doctors, all from central government-funded hospitals in Delhi and from the office of the directorate general of health services in the union health ministry.
Trained Nurses Association of India (TNAI), one of the oldest unions of nurses, has filed an intervention petition in the Supreme Court seeking representation in the task force. Patients have also filed an intervention application seeking the same. “Since the task force and the health ministry have ignored our representation to be included, we are forced to approach the court,” said Dr Roy K George, president of TNAI.
“Nurses are the largest segment in the workforce and more than 90 per cent of nurses are women. They face harassment from doctors and co-workers to patients and attendants. It is shocking that they have been excluded so completely. There are so many very senior nurses in the government who could have been included. But if nurses are included they will definitely bring up the issue of sexual harassment within the health system and that could be the reason why doctors wouldn’t be keen to have them,” said Dr George. He added that nurses would have to speak for paramedical staff and the janitorial staff as none of them have pan-India unions and because nurses knew their concerns better than doctors as they interacted more closely with them.On Thursday, the health ministry announced that four sub-groups have been constituted on the recommendations of the NTF to address concerns and areas suggested by the Supreme Court. The four areas include strengthening infrastructure of medical institutions, strengthening security systems in medical institutions, revamping working conditions of health care professionals and strengthening the legal framework across all states. The health ministry announcement stated that they would hold meetings with stakeholders who have submitted their views on the ministry’s portal and those who they “deem fit to ascertain their views first hand”. The TOR states that the sub-groups are to make “effective recommendations to remedy the issues of concern pertaining to safety, working conditions and well-being of medical professionals and other related matters”. It explains that the phrase medical professionals encompasses every medical professional, including doctors, medical students undergoing internship as part of the MBBS course, resident doctors and nurses, including nursing interns.“The terms of reference (TOR) of the sub-groups are flawed because they are only looking at it as a security and legal issue. The make-up of the task force and the sub-groups is flawed because it doesn’t have any representation from the largest number of people in any hospital, the patients. It doesn’t look at the contributing factors for violence inside hospitals which would need reforms to the practice of medicine. Patients are often at the receiving end of violence for different reasons and the eco systems are totally different in government and private hospitals. But they are also choosing to ignore the responsibility of healthcare institutions towards patients and their families, who are at their most vulnerable,” said Malini Aisola of the Campaign for Dignified and Affordable Healthcare.
