At least a glimmer of sanity flickered uncertainly in the darkness of our health crisis on Wednesday, when it was announced that a strike by the nurses of the Georgetown Public Hospital was to be put ‘on hold’. The strike had been due to begin on October 7, and some nurses had already embarked on a sick-out when they were informed that the Guyana Public Service Union and the government had agreed to negotiate on their demands.
In a general sense those demands in the context of a health crisis could hardly be described as unreasonable. They related to proposals for an increased risk allowance; for extending the risk allowance to medical personnel beyond the Covid-19 unit; for the provision of adequate personal protective equipment; and an increase in the basic pay for nurses, among other things.
One nurse who is attached to the Cardiac Intensive Care Unit at the GPH showed this newspaper images of a medical gown that is part of her personal protective equipment. She was asked to take it home and sanitise it so it could be reused. One does not need to be a medical professional to understand the danger inherent in this. Furthermore, she said, only those who work in the Covid-19 Unit are paid a risk allowance, although other personnel such as herself who are in close contact with patients are not. Some of these patients after being swabbed are found to be positive for coronavirus and therefore would have placed all medical workers who came into contact with them at risk. “With no risk allowance,” she said, “many units have been complaining about not being adequately supplied with PPE. The sisters in charge of the units have to walk to various units seeking assistance for staff to function.”
Some health workers had written to management underlining that it was becoming increasingly risky for them to come to work every day given the prevailing conditions. As we reported, one case they cited was that of a Covid-19 patient who subsequently died, following which 25 staff from the male medical ward had been asked to quarantine.
As far as pay is concerned, the cardiac nurse told us that at GPH the risk allowance is $12,000, while gross salaries for nurses are in the range $74,000 to $104,000. She said the nurses were asking for an increase in the risk allowance to $50,000, and a significant increase in the basic salary. She went on to explain that ministry registered nurses do not earn as much as this, taking home only the equivalent of a GPH nursing assistant’s salary because they benefit from a pension plan or gratuity, which the public hospital does not offer. It might be commented that the present talks may not turn out to be the appropriate forum to negotiate more complicated matters connected with basic pay, as opposed to special allowances.
While quite a few health personnel have taken to social media to air their grievances, they are not all nurses. One of them, a GPH doctor, related how during a 12-hour shift in the Emergency Room her supervisor “had to beg for adequate masks.” She went on to say: “Our overalls are short in stock and our patient load is high. In a 12-hour shift I saw more than 80 per cent of my patients as possible Covid-19. I had a patient boarding for over 24hrs because there was no space on the ward. I had a few sicker patients who had to stay at another hospital with less care because we had nowhere to put them. I had a baby not seen for a while because there was no bed to examine him.”
“We are tired,” she continued; “My nurses are underpaid, risk allowance is minimal if at all, then they are told they cannot protest. If you continue to overwhelm us, underpay us and jeopardize our health…you will lose us!”
One might have thought that in the face of this situation the government would have hastened to open talks; after all, the last thing they should want in the middle of a pandemic is nurses withdrawing their services. And one also might have thought that even they could have understood that putting medical personnel in danger was not the recommended approach in the current circumstances. But no, at first, at any rate, they seemed content with the GPH’s interim arrangements in the event of a strike to ask already overburdened doctors to undertake some medical interventions normally undertaken by nurses, and to reduce emergency care and the like.
It was their AG, Anil Nandlall, who first put forward their position, reflecting as it did a greater acquaintance with the law than with the exigencies of a coronavirus pandemic. In some respects it was all too reminiscent of an earlier public service strike in 1999, when government intransigence almost crippled the country.
In a letter to GPSU President Patrick Yarde, Mr Nandlall maintained that disputes in the public utilities and certain services fell under the Essential Services Arbitration Act, and that this act applied to the nurses. Under its provisions industrial action was prohibited in the absence of adherence to a procedure which was laid down. And the GPSU, he maintained, had not followed the procedure and as a consequence any protest actions were unlawful. “To violate this internationally recognized norm in industrial practice at a time when our nation is facing the worst pandemic in living history amounts to a most cruel, inhumane and unusual abdication of responsibility and may be viewed as conduct amounting to criminal negligence… Citizens may die as a result of the GPSU’s actions,” the AG wrote.
It does not seem to have occurred to him that unless greater cognisance is taken of the complaints of medical staff, they will not only have to continue to operate under stress, but are themselves put at great risk of illness or even death as a consequence of the government’s negligence. In other words, the real violation is not in relation to industrial practice, but in respect of providing the equipment which would allow them to perform their tasks safely in a dangerous context, in addition to their other associated issues.
It should be noted that under the act a worker shall not take part in a strike unless the dispute has been reported to the minister by an organisation representing the workers, and if for one month thereafter the dispute has not been referred for settlement. As mentioned earlier, all the government spokespersons, and not just the AG, insisted that the GPSU had not observed the law, although Mr Nandlall also asserted that there would be no engagement until all protest actions ceased. Fortunately, the government has now retreated from this counter-productive position which could have caused a crisis in our largest hospital.
In his letter to the union Mr Nandlall also wrote that in the absence of the cessation of protest action: “the government will have no alternative but to consider certain options, including but not limited to, the institution of criminal charges, dismissal, termination of contracts of employment, suspension of the collective labour agreement with the GPSU and the suspension of the deduction of the Union dues for and on behalf of the Union.”
It is extraordinary that the AG seriously believed that criminal charges and termination of contracts at a time like this would have produced the results he wanted, or that he would have found much sympathy from the public, even among his own supporters. Whatever Mr Yarde’s motives may or may not be, the nurses have certain fundamental human anxieties in the forefront of their minds, and Mr Nandlall should not confuse the two groups, even if the GPSU is the union which represents this branch of the medical staff. This situation is simply not a replay of 1999, because at bottom it is not a political issue.
In any case, it beggars belief that the AG could think that dismissals, let alone criminal charges, which would involve a diminution in the complement of nursing staff, would be a positive move in this pandemic. President Irfaan Ali should have taken charge of this situation before Mr Nandlall ever sat down at his computer and poisoned the atmosphere for talks.
Thereafter, of course, other government officials had their say about the union’s failure to abide by the law, more especially Minister of Public Service Sonia Parag and Chief Labour Officer Charles Ogle. In addition, former Minister of Finance Winston Jordan joined the debate tangentially in relation to his actions directed at increasing the risk allowance for nurses, actions which he said were thwarted by the Ministry of Public Health’s inability to provide the requisite information over four months. In addition to not agreeing with Mr Jordan’s sequence of events, Ms Parag also claimed that the protests had been “politically instigated” by the union. It was not evidence of much grasp of the realities on her part, whatever, as said earlier, the motivation of the union happens to be.
Acting General Secretary of the GPSU Kemton Alexander for his part has said that the union did communicate with the Permanent Secretary of the Public Service Ministry between August and September on the issues. That aside, there was not too much clarity between the officials about what the nurses had been granted at an earlier stage. It was all enough to cause a citizen’s head to spin.
It may well be that the union has been derelict in terms of the law, but at this stage there are more important questions to consider. If medical staff are not safe, then patients are not safe. And if patients are not safe then their families and the rest of us are not safe either. The government should forget its decades-long quarrel with the GPSU in this instance, and concentrate on the basics. It should come to the talks with an open mind and avoid the threats and the ultimatums.
