Sascha Wil­son

Se­nior Re­porter

sascha.wil­son@guardian.co.tt

The Trinidad and To­ba­go Na­tion­al Nurs­es As­so­ci­a­tion (TTNNA) is threat­en­ing le­gal ac­tion against the North Cen­tral Re­gion­al Health Au­thor­i­ty (NCRHA) over what it de­scribes as il­le­gal four-hour shifts for nurs­ing and mid­wifery per­son­nel.

Speak­ing with Guardian Me­dia af­ter the TTNNA is­sued a state­ment on the mat­ter yes­ter­day, as­so­ci­a­tion pres­i­dent Idi Stu­art said the al­ter­ation of the shifts by the NCRHA was done with­out any pri­or con­sul­ta­tion or agree­ment with the union.

He said if man­age­ment can­not iden­ti­fy the pol­i­cy, col­lec­tive agree­ment, reg­u­la­tion or con­trac­tu­al pro­vi­sion that au­tho­ris­es the NCRHA to re­quire nurs­ing and mid­wifery per­son­nel to re­port for du­ty un­der such an arrange­ment, then they should refuse to work those shifts.

“Nurs­ing per­son­nel have al­ready in­formed the as­so­ci­a­tion that they have been ask­ing for this pol­i­cy, the man­age­ment say­ing they can’t send the pol­i­cy, some­thing will be is­sued short­ly. So al­ready we are re­al­is­ing that who­ev­er gave that di­rec­tive was re­al­ly speak­ing from a place of ig­no­rance, think­ing that they could ac­tu­al­ly have done some­thing like that.”

Stu­art said he had sent a let­ter to the CEO re­quest­ing a meet­ing yes­ter­day; how­ev­er, the as­so­ci­a­tion’s at­tor­neys have al­ready been en­gaged.

“If the NCRHA doesn’t pull back on this di­rec­tive, we would ini­ti­ate le­gal ac­tion against the NCRHA. And if it’s 400 nurs­es af­fect­ed, we will in­di­vid­u­al­ly take ac­tion on each and every sin­gle mem­ber. So, the court will be bom­bard­ed with le­gal ac­tion if this lu­di­crous po­si­tion is not re­scind­ed.”

In the state­ment, the as­so­ci­a­tion said the de­ci­sion comes at a time when the au­thor­i­ty con­tin­ues to grap­ple with a se­vere short­age of nurs­ing and mid­wifery per­son­nel.

“Rather than im­ple­ment­ing sus­tain­able mea­sures to re­cruit and re­tain staff, the TTNNA com­plained that the NCRHA has pro­gres­sive­ly re­duced the avail­abil­i­ty of ex­tra-du­ty (“pool”) shifts, leav­ing many units crit­i­cal­ly un­der­staffed.”

The as­so­ci­a­tion fur­ther claimed that nurs­es are in­creas­ing­ly be­ing placed in un­safe work­ing en­vi­ron­ments, with some be­ing pres­sured to work alone or in sit­u­a­tions that fall be­low ac­cept­ed stan­dards of safe pa­tient care.

“Now, in­stead of ad­dress­ing the root cause of the cri­sis—the chron­ic short­age of staff—the NCRHA has in­tro­duced a four-hour shift arrange­ment that has no known ba­sis in the ex­ist­ing terms and con­di­tions of em­ploy­ment for nurs­ing and mid­wifery per­son­nel and was im­ple­ment­ed with­out mean­ing­ful con­sul­ta­tion.”

The as­so­ci­a­tion said em­ploy­ers can­not uni­lat­er­al­ly im­pose new work­ing arrange­ments that sig­nif­i­cant­ly al­ter es­tab­lished con­di­tions of ser­vice with­out due process, con­sul­ta­tion, and le­gal au­thor­i­ty.

Be­yond the le­gal im­pli­ca­tions, the As­so­ci­a­tion said the de­ci­sion has prac­ti­cal and fi­nan­cial con­se­quences for staff.

Weigh­ing in on the mat­ter, for­mer health min­is­ter Dr Fuad Khan said that, un­der the RHA Act, the min­is­ter can give both gen­er­al and spe­cif­ic di­rec­tions to an RHA.

“So, you have to be very sure who is giv­ing the RHA chair­man the strength and the ap­proval to do that be­cause I haven’t heard the min­is­ter give any ut­ter­ances in this whole re­gard.”

Khan, how­ev­er, said an RHA can­not uni­lat­er­al­ly make such a sig­nif­i­cant change to nurs­es’ work­ing arrange­ments.

“They’re not sup­posed to take away con­sid­er­a­tion or change terms of work with­out prop­er dis­cus­sions, ne­go­ti­a­tions and ac­cord­ing to the In­dus­tri­al Re­la­tions Act that has to be tak­en in­to con­sid­er­a­tion,” he said.

Mean­while, NCRHA chair­man Dr Tim Gopeesingh de­clined to com­ment, say­ing the au­thor­i­ty would no longer be mak­ing any pub­lic com­ments on such mat­ters and would in­stead fo­cus on pa­tient care.

In re­cent months, there have been on­go­ing dis­putes be­tween the TTNNA and the lead­er­ship of the NCRHA over is­sues in­volv­ing the union, its mem­bers and the health au­thor­i­ty. The dis­agree­ments have cen­tred on stag­nant salaries, staffing short­ages and work­ing con­di­tions.

Nei­ther Health Min­is­ter Dr Lack­ram Bo­doe nor Min­is­ter in the Min­istry of Health Rishad Seecha­ran re­spond­ed to re­quests from Guardian Me­dia for a com­ment.