NHM workers demand regularisation of their posts
On the 17th of January 2018, the National Health Mission workers went on a national strike. According to the Central Trade Unions, more than one crore scheme workers are working under various central and state government schemes including around 27 lakh Anganwadi, Mini Anganwadi Workers and Helpers under the ICDS Scheme, nearly 28 lakh Mid Day Meal Workers under the MDM Scheme and around ten lakh ASHA Workers under the NHM, lakhs are working under SSA, NRLM, NCLP, Small Savings Schemes etc. These schemes deliver basic services of health, nutrition education, and small savings mobilisation etc. These workers are not recognised as workers but as volunteers. They are not paid minimum wages nor do they have any social security benefits but an ‘honorarium’ or ‘incentive’ they are paid a pittance as low as Rs.1000 per month for ten months a year in the case of mid-day meal workers. The 45th Indian Labour Conference recommended that these workers must be recognised as workers. Various trade union federations of scheme workers have been conducting struggles raising these demands independently and jointly.
Over and above these, the entire medical, nursing, technical and administrative staff works on a contract basis under NHM. This entire vast workforce has been working for over a decade, at lower salaries than the regular staff in the health services.
This year 2018, the entire work force went on strike at the state and national levels. Their demands were not only for the regularisation of their own positions and for their own remuneration and social security. They also demanded a stepping back of the privatisation of health services. The following demands were made:
- Implement the recommendations of the 45th ILC on scheme workers: recognition as workers, minimum wages not less than Rs.18, 000 per month and social security including monthly pension not less than Rs.3000 to all scheme workers. Give coverage of EPF and ESI to scheme workers.
- Adequate financial allocation in the Union Budget 2018-19 for the Centrally sponsored schemes including ICDS, MDMS, NHM, SSA, NCLP etc. to ensure increase in wages for the workers to the level of minimum wages and universalization of the schemes with adequate infrastructure and quality services.
- No privatisation of the schemes in any form and no subversion by way of cash transfer or exclusion of beneficiaries.
The outcomes of the strike weeks down, is scattered. While the strike has been called off, the assurances and gains are scanty. In the North-East, the salary arrears have been promised. Kashmir, Haryana and Punjab have assured regularisation and benefits in the future, according to the news reports. There are reports available that Maharashtra is contemplating regularisation, but there is no time frame. And here lies the crux of the matter. The NHM is proposed by the Centre and implemented by the States. Therefore the demands fall between two stools, with neither of the governments, taking the onus for making any decisions. In the meanwhile, the future course of the joint struggles will be decided after the Central Budget according to the response of the government, as per the Central Unions.
The continual non- regularisation of NHM has several fallouts:
- This is a mass infringement of workers’ rights, as pointed out by the strikers. There are other fallouts too.
- We must not overlook also that it is an institutionalised exploitation of lakhs of village women as most of the scheme workers are women. Demoralisation is setting into these first generation women participants in the workforce.
- The informalisation of public health care work force ensures that the state abdicates its responsibility towards health and health workers, while it does not stint to take credit for achievements like improved immunisation coverage and child survival.
- If we do not regularise NHM, we run the risk of steadily moving towards privatisation and thus squeezing out the poorest from free coverage of health care. These are likely to largely be women, elderly and challenged persons.
References:
http://www.citucentre.org/414-all-india-strike-of-scheme-workers-on-17-january-2018
https://kashmirreader.com/2018/01/05/nhm-employees-strike-health-dept-submits-regularisation-proposal-to-finance-dept/
https://timesofindia.indiatimes.com/city/chandigarh/haryana-formulates-policy-for-nhm-employees/articleshow/62330249.cms
http://www.dailypioneer.com/state-editions/chandigarh/7th-pay-commission-benefits-for-nhm-contractual-staff.html
http://www.easternmirrornagaland.com/nhm-employees-call-off-strike/
http://odishatv.in/odisha/body-slider/nhm-nursing-staff-launch-stir-healthcare-services-hit-261674
http://indianexpress.com/article/cities/ludhiana/after-42-days-nhm-staff-call-off-strike/
