When it comes to medical care, it is very important that the patient is handled by trained professionals. However, at the Employee State Insurance Corporation (ESIC) hospitals, the Nursing Orderly, after an experience of about six years is being promoted to the position of Laboratory Assistant, for which technical in nature. This promotion is being done purely on the basis of experience and does not consider the qualification of the said Nursing Orderly.
This is highly dangerous to the patients involved. The work of the Lab assistant requires the candidate to have completed 10+2 (science) with a two-year diploma in Medical Lab Technology, and the Nursing Orderly post requires the candidate to have completed education till 8th standard.
Recruitment to the post of Laboratory Assistant
The Employees’ State Insurance Scheme is an integrated measure of Social Insurance embodied in the Employees’ State Insurance Act. It is introduced to protect the “employees” against the impact of sickness, maternity, disablement and death due employment injury and to provide medical care to insured persons and their families. Those coming under the ambit of ESIC are factories and other establishments viz. Road Transport, Hotels, Restaurants, Cinemas, Newspaper, Shops, and Educational/Medical Institutions wherein ten or more persons are employed. However, in some States threshold limit for coverage of establishments is 20.
As of today, the Employees’ State Insurance (ESI) scheme is implemented at over 830 centres across 31 states and union territories, applying to 7.23 lakh factories and benefitting about 2.03 crore insured person/family units of workers.
The persons recruited on the post of Nursing Orderly join the department as Group-D staff, the education qualification required for which is an 8th standard pass candidate, whereas the education required for the post of Laboratory Assistant is 10+2 with diploma in Medical Lab Technology approved from AICTE. Before the revision, the recruitment to the post of Laboratory Assistant was 50% through Direct Recruitment and 50% through promotion.
After order of Ministry of Health & Family Welfare (ASH Division) O.M. No. F. No. A-28020/11/2008-PMS (Part-1) Dated 17/07/2015 the requirement 10+2 Science with 2 years Diploma in Medical Lab Technology approved from AICTE with one-year experience desirable Bsc in Medical Lab Technology was mandated and the 50% promotional recruitment was replaced by 100% direct recruitment.
This requirement guidelines are being followed in other institutes like All India Institutes of Medical Sciences (AIIMS) and Jawaharlal Institute of Postgraduate Medical Education and Research, however the hospitals under ESIC are continually defying these guidelines by promoting the Nursing Orderly to the post of Laboratory Assistant after they complete service of six to seven years, although they do not possess the requisite qualification.
The work profile of the Nursing Orderly includes attending to the personal hygiene of the patients and help them in works like washing, changing clothes and giving the enema. Apart from this, the Nursing Orderly assists the nurse in making beds for ambulatory and non-ambulatory patients, among other works. In the Laboratory, their work is to ensure clean test tubes, slides etc.
On the other hand, the nature of work of the Laboratory Assistant requires knowledge of Anatomy Physiology, Hematology, Biochemistry, Microbiology, Histopathology, blood banking, among others.
Even after such stark differences in the kind of work that is undertaken, the Nursing Orderlies are being promoted to the posts like that of Laboratory Assistant, Operation Theatre Assistant and CSSD Assistant.
Reportedly, this is in contempt of the decision of the Delhi High Court, which laid down the mandatory requirements for the said post. (CWP No. 3018/2000, Central Administrative Tribunal Principal Delhi Bench OA NO. 787/2008 MA NO.667/2008 & Central Administrative Tribunal Principal Delhi Bench O.A. NO. 638/2010).
Laboratory medicine is the backbone in the medical treatment, diagnosis and prevention. Laboratory diagnostics influence 70–80% of hospital health care decisions and costs between 3–5% of total healthcare costs. Laboratory attempts to improve quality aim to reduce diagnostic errors and decrease turnaround time with traceability of all laboratory procedures.
One of the sources said, “Personally I know many nursing orderly who are not versed in the techniques involved.Then think about how the promoted Lab Assistants/Technicians will understand which tests doctors have requested for or which specimen is required at what time? How will they collect the specimen, with proper Labelling, with proper anticoagulant or without anticoagulant? How will they run the test of a specimen in advance computerised machine within proper timing because many of test run within a certain time? Finally, how they understand that report is acceptable or something happening wrong with machine or chemical? It’s completely life-threatening for patients.”
This recruitment on promotional basis is being reportedly practised in ESIC hospitals even after Delhi HC’s orders.
“To challenge this All India ESIC lab cadre employees submitted Order of Ministry of Health & Family Welfare (ASH Division) O.M. No. F. No. A-28020/11/2008-PMS (Part-1) Dated 17/07/2015 on August 2015 to Director General ESIC Headquarter, Delhi through proper channel, thereafter reminder with new evidence submitted subsequently. However, there was no change made even after this. Apart from this, the Mumbai ESIC Lab Cadre, operation theatre (OT), Central Sterile Supply Department (CSSD) employees requested in this regard to Director General and Medical Commissioner, ESIC Headquarter, New Delhi. Even this had no effect.”
The Logical Indian could not reach ESIC Headquarters office, New Delhi for comments even after repeated attempts.
Even after many requests, ESI Post Graduate Institute Of Medical Sciences and Research, Bangalore failed to respond to the queries.
The Logical Indian take
Even after the court orders on the required qualification for the post of Laboratory Assistant/ Technicians, the ESIC hospitals continue to promote nursing orderly to the post of Laboratory Assistant. The nature of job under these two posts is very different. The work of a Laboratory Assistant is technical and requires knowledge of various techniques.
This negligence can prove to be life-threatening to the patients. The Logical Indian urges the authorities to look into this matter on a priority basis and take appropriate actions.