10th October 2017 – 146 nurses and midwives from health centres all across the country attended a meeting with the Minister for Health, Jean Paul Adam, on Friday 6th October 2017.

The purpose of the meeting was to discuss proposed changes to the scheme of service for all nurses, following concerns raised about their current scheme.

Following various consultations that had been held with different nurses, as well as a team of nurses that had worked on proposed revisions to the scheme in the first half of 2017, the Ministry used the opportunity of the meeting to address some of the major concerns that had been raised.

The revision also takes into account the recommendations submitted to the Government by the Nurses Association.

Minister Adam opened the meeting with a welcoming statement, thanking all the nurses for their attendance and outlining the topics that would be discussed during the meeting. “We’ve made provision for the 2018 budget to improve conditions for nurses. This is a subject of great priority,” Minister Adam said, opening the floor. He also emphasised that it was important to understand that the nurses’ scheme of service was also situated within the Ministry’s plans of reviewing the conditions of all key health workers – including allied health workers, doctors and other health related professionals.

The nurses and midwives were given a short presentation highlighting all changes that were being proposed in terms of salary, allowances, & gratuity.

The main proposal which has already been incorporated in the 2018 budget proposal is retention allowance of SR 3,000 – representing an increase of 30% on the average nurses’ salary. The nurses were briefed that in this first phase of the review the increase was an allowance, while an assessment was underway to assess the scope of work undertaken by nurses and other health workers – but that the intention was that this would be incorporated in the basic salary as soon as practicable – as soon as the assessment exercise was complete.

The nurses were informed that the Ministry in consultation with the board of the Health Care Agency – being the main employer of nurses – and the Ministry of Finance, Trade and Economic Planning, that it was important to offer a real increment as of 1st January 2018, while this work takes place.

A new gratuity system is also proposed as part of the review whereby the nurses’ gratuities would be calculated as a percentage of their salary over the last five years rather than be based on a fixed sum. In the existing scheme, nurses earn SR 15,000 for their first five year gratuity with gradual increments as they serve longer. The new proposal provides that nurses would receive 6% of their salary and their inducement payments earned over the five year period. In practice, over the first five year the nurses would double their gratuity under this scheme. The time frame for the implementation of the gratuity scheme are still under discussion as it has to be considered in terms of the long term costs as well as keeping in mind related revisions that will need to be made to other health professionals schemes.

Proposals have also been made to increase the rates for non-rostered overtime.

Discussions are on-going to review the inducement allowance and allowances for marketable skills to ensure better recognition of key nursing qualifications and relative to other professions that of other professions. It was noted in the discussions that more value should be given to the Diploma in Nursing, recognising that it is a course that provides an international standard in nursing.

Nurses were also briefed on work that is being done to review the way in which a staff member’s progression is facilitated within the scheme of service. The Minister agreed that one weakness of the current scheme is that too often a staff member is stuck on a particular salary band, and with few prospects for promotion due to unavailability of posts. The review of the scheme in the next phase would take into consideration the ways in which the breadth of a nurse’s experience could be reflected in their salary progression, as well as to also better reflect possible areas of specialisation that they may be undertaking.

The Minister also highlighted that as part of the efforts to improve the health system as a whole, a performance based bonus system is being considered which could be linked to outcomes. However it was stressed that this should be implemented when the appropriate means for measuring performance are fully established. Many expressed their thanks to the minister and other management team for discussing and pushing for these changes.

Though there will still some dissatisfaction with the increments and feelings that it was still not enough. Some questioned the value of their work which involves giving care everyone in the society at all stages of life, which they felt were not reflected in the proposed scheme. Some nurses urged that an increase of up to 60% be considered.

To this Minister Adam committed his full attention though imparting the feasibility of it as well. “Not all requests will be possible to implement. However, we will try to get as much as possible for the work that you do. We will continue to work to ensure that the next phases of the scheme fully reflect the work that you do and reflects the value that you bring to our society. We have all been cared for by nurses at some point in our life. Nurses have a pivotal role in our society and this must be reflected in their remuneration,” he concluded.

Changes in the scheme of service for nurses will be implemented in phases. Some will be effective as from the start of 2018 while others span out 2018-2019. Other nurses who were unable to attend the meeting will also have the chance to appraise the proposal in future meetings including on Praslin and La Digue.

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