Days before firing 84 nurses, HAHC directed health workers to not quit; nurses move Delhi HC

A nurse rests in a makeshift ward at an emergency COVID-19 care center at the Lok Nayak Jai Prakash Hospital Annexe in New Delhi on 24 June 2020. On 11 July, the capital’s Hakeem Abdul Hameed Centenary Hospital terminated 84 nurses, just nine days after it released an office order directing health workers to refrain from sending resignation applications. T. Narayan/Bloomberg/Getty Images

Five of 84 former nurses of Delhi’s Hakeem Abdul Hameed Centenary Hospital who were terminated overnight moved the Delhi High Court on 17 July to challenge their sudden dismissal. They had been let go six days earlier. The nurses, hired on a contractual basis, demanded action against the hospital administration for firing them arbitrarily and without giving any notice. The termination order, dated 11 July, stated, “Extension in the contract of 84 staff nurses was due between Feb 2020 till 10th July 2020. The cases could not be processed due to prevalence of Covid-19 pandemic.” Nurses I spoke to said they were caught off guard as just nine days before, the administration of the 470-bedded COVID-19 hospital had released an office order directing health workers to refrain from sending resignation applications. 

The petitioners, as well as other nurses, said that the hospital administration was victimising them as they had raised alarm over the lack of precautions taken to protect the staff from the novel coronavirus. “We had to approach the high court because we had repeatedly raised basic demands like drinking water, proper PPE kits”—personal-protective equipment—“and masks before the management. So they released 84 of us,” Aavesh Khan, one of the dismissed nurses and a petitioner in the case, told me. He added that the dismissed nurses include two who are recuperating from the novel coronavirus and one who is on maternity leave. 

The administration gave no indication to the nurses that they were going to be dismissed, Khan and Anjum Sheikh, another nurse who had been dismissed and a co-petitioner, told me. “I received my salary on 1 June,” Sheikh said. “My in-charge said that the process”—of extending the contract—“is done and ‘that’s why your salary came to your account.’ Our in-charges said that ‘if your salary is coming, it means your extension is done.’ So we relaxed.” She said no one told them 11 July would be their last day. “They messaged us on WhatsApp on a Saturday evening, so that we would not even have the chance to question them.”

Khan said he was also given a similar verbal assurance. “In March, we had asked our in-charges whether our contract has been extended,” he said. “They responded that ‘your salaries are being processed, which means that your contract will continue.’” According to him, nurses had completed the requisite procedures for extension of service but they did not receive any documentation to prove it. “They made us work for four months without consent or any official notice about the extension of our contracts.” Moreover, the petition said, the hospital had violated the contract signed with the nurses. “The action of the hospital in dismissing the 84 staff nurses without one month notice is again a flagrant violation of the contract on the basis of which these dismissed nurses were hired,” they wrote. According to a copy of an appointment letter from 2016, which is annexed in the petition, the administration was required to give one month’s notice to a staff nurse before termination of service. 

Since 15 July, nurses whose services were terminated have been organising protests daily within the hospital premises in Hamdard Nagar. A contractually-hired nurse who was not among the 84 who had been discharged from their duties told me she had been also been participating in the protests regularly in between her shifts. The nurse, who requested not to be named, described some instances which showed the administration’s apathy towards the nurses. She said that the nurses had to raise alarm to even get access to clean drinking water while on duty. “They gave us five N-95 masks in the beginning. If your mask gets spoiled, you have to submit an application,” she said. “Do you want to get tested for COVID? There is paperwork. Do you want to get a mask issued? There is paperwork.” 

The nurse said she had tested positive for the novel coronavirus. By her estimate, at least ten nurses at the hospital have contracted the virus since the onset of the pandemic as there is no designated area to safely discard and change COVID-19 protective gear. She told me that the hospital expected them to pay 50 percent of the testing charges. “I fought to avoid paying for it,” she said. “I asked why should I make the payment as a staff of the hospital? But many nurses paid to get themselves tested.”

She sounded frustrated with the care she received as a COVID patient at the hospital. Initially, she shared a general ward with other patients. “When there was an increase in the number of COVID patients, I was shifted to another ward in a floor that was completely empty,” she said. “There was no nursing staff for my medical supervision. They told me that if anything happens, give them a call. If a patient is in a bad condition, how will he make a phone call?” 

The staffers flagged their issues to the administration several times, she said. “On 24 June, we gave our first written complaint to the management. Even before that, we were raising verbal complaints.” According to her, they had a meeting with MS Kidwai, the additional medical superintendent of the hospital, during which they told him about their requirements, including N-95 masks. “He claimed that all of it is being provided,” she said. “But we were not being provided with everything we required.” She told me no one was making sure that the health workers had the equipment they needed. “No one was overseeing distribution. No one from the management was even taking rounds to check whether everything was working well.”

The nurses at HAHC had raised their complaints with the Indian Professional Nurses Association, an association for registered nurses which operates in several states, on 27 June. The IPNA then wrote to Arvind Kejriwal, the chief minister of Delhi, highlighting these issues. Several nurses told me they believed that the administration has retaliated against them for reaching out to the Delhi government. 

Khan said that the administration’s letter dated 2 July, directing health workers to not resign, highlighted the inexplicability of the termination notice. The letter stated that as HAHC had been declared a COVID-19 hospital, “all concerned health workers including doctors and nurses are hereby directed to refrain from sending applications for resignation, resignation notices or requests of leave without pay, citing personal reasons.” It specified that as the novel coronavirus’s outbreak was a national emergency, “such requests will not be acceded.”

Joshy Mathew, the president of the Delhi unit of the United Nurses Association, another association for nurses, echoed the HAHC nurses’ view that the administration was being vindictive. On 11 July and 16 July, the HAHC posted advertisements on its website to recruit staff nurses. The office order which relieved the nurses of their duties also mentioned that the nurses could appear for walk-in interviews to get reappointed. “If they were overstaffed or faced issues like shortage of patients or revenue loss,” Mathew said, “they would not dismiss these 84 and recruit new people, right?” 

Sheikh, who has worked in the hospital for five years, told me the staff nurses did not have to appear for fresh interviews after their contract expired earlier. “Normally, their system is that if someone passes an interview and joins as a staff, they are issued a contract for six months to a year and it is renewed every time,” she said. “It involves minimal paperwork. There was never a system of conducting fresh interviews after relieving them from services.” According to her, this was also an indication that the administration is retaliating as the nurses had raised legitimate demands. She added that none of the nurses had been offered permanent jobs after 2011. 

Mathew and Sheikh said conducting these interviews was a ploy to break the unity of the nurses who were protesting. The nurse who spoke with me on the condition of anonymity said that some of the terminated staff did go for these interviews because of their compulsion to support their families. Siju Thomas, the joint secretary of the IPNA and a co-petitioner in the Delhi High Court case, said 30 nurses had been rehired. 

Multiple people also told me that the reappointment process could be exploitative. “On joining again, they can decrease or increase the salary the way they want,” Thomas said. He gave an example of one of the nurses who has been reappointed. The nurse was earlier earning Rs 67,000, he told me. “She went for the interviews which took place on 13th and 14th. Now, her salary scale is Rs 28,000” He added, “Making nurses work on the basis of a contract itself is a wrong decision.”

A nurse who has been rehired told me on the condition of anonymity that the management was taking arbitrary decisions. According to her, during the ordeal post 11 July, the administration had once said that they were facing a fund crunch. “That is not a valid reason. COVID patients are still getting admitted. This is a charitable hospital. Money is coming in,” she said. “The management is doing whatever it feels like.” 

I emailed Sunil Kohli, the officiating medical superintendent, a questionnaire based on the allegations raised against the hospital but did not receive a reply. This story will be updated if and when he replies.

Kohli had dismissed the allegations levelled against the hospital as a “complete lie” in a video message posted on HAHC’s website on 15 July. He said that the contracts of the nurses named in the list in the office order had expired at different points of time between February and June. “Our HR department arbitrarily extended their contract till 10 July so that their salary till this date could be released—without a contract signed, salaries are not released,” Kohli said in the video. The reinstatement of the nurses would be based on their performance in the past year, he added.

But according to Jose Abraham, the advocate representing the petitioners, during a hearing on 22 July, even the HAHC’s counsels agreed on the point that dismissal or any such action against health workers is not desirable. “The court asked all the counsels to sit together for a negotiation between the counsels and the parties and directed the counsel and the parties to settle this issue amicably,” he said. The matter is now listed for further hearing on 29 July, he told me.

Meanwhile, the protests at HAHC continued till 22 July. But the nurse who had contracted the coronavirus and was not dismissed told me they would now have to be dismissed to make way for the negotiations. Commenting on their hopes from the administration, Khan said, “Either our contracts should be extended for another year or if we are being released, give us three months’ salary and experience certificates.” He, too, sounded frustrated with the administration. “Their motive was that those who are working on a contract basis should not raise their voice.”