THE CHRONOLOGY OF SHAME
The Medical Officers of Army Medical Corps (AMC) of Indian Army are on a warpath against the Officers of Military Nursing Service (MNS), since the formation of AMC in 1948. The cause of heartburn to the Doctor Generals is the Commissioned Rank granted to Nursing Officers as per Section-5 of MNS Ordinance 1943. The powerful Lobbyists of AMC had made the Ministry of Defence (MoD) to abort the plans of re-organising and modernising the Nursing Services of the armed forces, in the line of similar happenings in other Countries. Like the integration of MNS in the regular Army by re-designating as a Corps and forming branches of Nursing Services in Navy and Air Force etc. They have ruthlessly opposed every move to better the Nursing Services and ensured that the MNS remained as an auxiliary force of the army even until today.
By keeping the MNS as an auxiliary force, they have kept the Nursing Officers away from the administration (management of men and materials for patient care) and occupied all those positions. They have taken advantage of the fact that the MNS Officers being part of an auxiliary force cannot be superior officers; therefore, the armed forces personnel need not obey their orders. Today Doctors are managing even most of the Nursing Specific Services. In the Navy and Air Force, except for the direct Nursing Care, there are no Nursing Officers in any level. All such Nursing related positions are occupied by Doctors who are other wise required to perform clinical duties. Due to such posting of hundreds of Doctors in the administrative positions, the clinical field faces severe shortages. This is also causing a huge drain on the national exchequer while considering the Non Practicing Allowance, Post Graduate allowance, higher fixation of pay on joining etc. being paid to them. Such Lobbyists who want to take over the Nursing Services were behind the recent outcry by the Army and Naval Chiefs to lower the MNS Officers pay scales.
The history of MNS post the independence is nothing but a series of successful attempts by them to degrade the conditions of Nursing Services. This has taken a very ugly turn by forcing the Government to lower the pay of the Nursing Officers. The chronology of shame, that is robbing the Nursing Services of their strength, potential, growth, honour and pay etc. are listed below:-
1948-57: The Strategic Moves
Prevented the re-designation of Military Nursing Service in to a Corps of the regular Army and grant of Commissioned Officer rank titles to the Nursing Officers in line with the changes happened in the armed forces Nursing Services of other Nations. The issue was resolved by MoD by granting Commissioned Rank titles to Nursing Officers in 1958 while maintaining the MNS as an auxiliary force (though the Nursing Officers were Commissioned Officers since 1943, instead of the army officer rank titles, the use of professional titles like Sister, Matron etc continued to be in vogue till then).
The MoD aborted the plans to form separate Nursing Services in the Navy and Air Force due to the strong lobbying against this move. The MNS Officers were since then posted to the hospitals of Navy and Air Force (though as per the MNS Ordinance 1943, Section-4, the Nursing Officers are liable for service only with forces and persons subject to Army Act, 1950). The MoD Officials were hoodwinked by making those MNS Officers posted sister services wear the Naval and Air Force Officer rank insignias. This practice of wearing the notional Naval/ Air Force officer rank was discontinued in 2000.
1967-73: The Years of Progress
When the other half of the Military Nursing Service was re-designated in to a Corps of the Pakistan Army in 1967, the issue of making the our half of the MNS also a Corps of the regular army again came up for discussions. The Lobbyists silenced the voices by granting the notional power of command to the MNS Officers through Army Orders (AO) 70/73 and 353/73. The Army Order 70/73 says that, persons subject to Army Act who are placed under the professional care of officers of the Military Nursing Service shall obey and comply with professional orders and direction of such Nursing Officers. They shall be liable to be punished for non-compliance of such orders, under Section 63 of Army Act, 1950 for violation of good order and discipline. The AO 353/73 magnanimously granted the MNS Officers the entitlement of salute and other compliments from the army personnel. Such niceties remained only on paper, even a Sepoy Nursing Assistant tradesmen (lowest rank), who is required to assist her in the patient care does not pay compliments to a Nursing Officer.
1975-82: The Reluctant Acceptance
In theory, the Nursing Services in the Army is managed by the Nursing Officers with the help of male Nursing Assistant (nursing orderlies) tradesmen of AMC. Whereas the Nursing Officers do not have any power of command over them, as they cannot be superior officers. The cases of disobeying the instructions of Officers were a common incidence (even today). There were also series of cases like rape, sexual molestation etc on the Nursing Officers by the army personnel. These were adversely affecting the patient care. The Military Nursing Services demanded to bring it under the full purview of the Army Act, 1950, to have power of command over the army personnel, to ensure the safety, security and honour of the Nursing Officers along with the patient care. The MoD was on the verge of notifying the MNS as a Corps of the regular Army. However, the Lobbyists again successfully prevented it by making some cosmetic changes to the existing regulations/ orders. Like insertion of Para 733 (b), Defence Service Regulations – Army (women officers serving in the Army Medical Corps and officers in the Military Nursing Service will rank equally with male officers of the same titular rank) and AO 11/82 (order of precedence of MNS in the hierarchy of the Arms and Services of the Army) etc.
1994-2001: The Beginning of Alienation
The Article 22(1) of Geneva Convention, 1949 (Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field), ‘grants the right to medical personnel (doctors, nurses, nursing orderlies etc.) to carry and use arms in their own defence, or in that of the wounded and sick in their charge’. Accordingly, the nursing Officers used to get arms training. The Indian Army still have medal winning shooters belong to the MNS. A Nursing Officer, Major Saroja Kumari won the Indian Army’s first Gold Medal in women’s shooting in Common Wealth Games 2006. Incidentally, she was the best shooter during her Initial Nursing Officers Course held in 1991 at AMC Centre Lucknow. However, the Lobbyists according to their long-term strategy of making the MNS Officers a cadre of Non-Combatants had stopped the arms training and Basic Military Training to them.
Every Officer of Commissioned Rank in the armed forces receives a Parchment of Commission from the Presidents of India who is the appointing authority as well as the supreme commander. The Military Nursing Service was established through the Indian Military Nursing Service Ordinance, 1943. According to the Section 5 of the ordinance, “all members of the Indian Military Nursing Service shall be of commissioned rank and shall be appointed as officers of the Indian Military Nursing Service by the Central Government by notification in the Official Gazette”. The MoD was issuing the MNS Officers also with such Parchment of Commission by the President, but the Lobbyists stopped it from 1998 onwards.
Nursing officers were entitled to Leave Travel Concession (LTC) as admissible to other Commissioned Officers with the modification that Nursing officers are entitled to Form G instead of Form D when they intend to avail LTC under Rule 177(B) TR. They were entitled to use Form G instead of Form D when traveling by rail at their own expenses in entitled class. Total number of Form G admissible will be six one-way forms in a calendar year. Husband & dependant family members of MNS officers are entitled to Form D and not Form G, provided further that maximum number of Form D and G together does not exceed six in a calendar year. The Lobbyists got the Form G of MNS Officers discontinued in 2001 and clubbed them along with the personnel below officer ranks (PBORs) on concession voucher IAFT 1720-A, which was formerly meant only for PBORs.
2002-2004: The Coupe De Grace
The Judge Advocates Generals Branch (JAG) of Army generally held that the Officers of MNS are Commissioned Officers of Army, though at times they sent out conflicting messages. Hence, the status of the MNS Officers remained as an unresolved issue. During the late Nineties, the office of the Additional Director General MNS (ADGMNS) actively pursued the case to bring the MNS fully under the purview of the Army Act, 1950. After passing through the usual service channels including the Chief of Army Staff (COAS), the case was once again accepted by the MoD in principle. The Lobbyists were subdued by a no nonsense COAS and dissent within their own Generals. The Lobbyist considered it as a threat to their supremacy in the armed forces medical service (AFMS). They were determined to stop it through any means. In those days the Nursing Officers uniform was white knee length frock as duty dress and similar olive green frock for ceremonial purposes/ administrative/ staff duties. The Lobbyists told the ADGMNS that the case to re-designate the MNS is a done thing (normally such cases take a couple of years). She was pushed on by them to progress to the next logical step before her retirement in early 2000 and claim the credit for herself. That is changing the MNS Officers dress to those worn by the rest of the Army there by signifying the re-designating the MNS as a corps of regular army. They made her to believe that the issuing of gazette notification and subsequent Army Instruction were just a formality. The Lobbyists with the support of the Adjutant General (AG) verbally authorized the ADGMNS to approve the new Dress Code for MNS Officers. Not withstanding the fact that the dress, ceremonial etc. are part of AGs charter of duties the ADGMNS prematurely issued the new dress code through an order dated 25 Jan 2000.
The Lobbyists unleashed a propaganda campaign to malign the Nursing Officers through every medium and forum available to them, which forced the MoD to put the proposal to re-designate the MNS in to cold storage. They made the entire army and MoD believe that the new dress is not patient friendly and MNS Officers after putting on the OG uniform disobeys doctors’ orders, became arrogant and unfriendly and the patient care in the hospitals is being suffered. The Lobbyists flooded the Army Head Quarters (AHQ) with problems from the military hospitals and field units in the wake of the new dress code for MNS Officers. The issues were made out to appear that the patient care is severely suffered. The AHQ modified the dress code by an order issued on 11.9.2001. The new order under the influence of the Lobbyists asked MNS Officers to wear a knee length white coat without any inners. The MNS Officers challenged the said order by different writ petitions before several High Courts, inter alia, on grounds of violation of the Fundamental Rights under Articles 14 and 21 of the Constitution (consequently it was withdrawn). However, to avoid inconsistency in judicial decisions, the Supreme Court admitted the special leave petitions and also transferred all the pending writ petitions to itself by an order made on 28.1.2002 in Transfer Petition (C) Nos.851-857 of 2001.
When these petitions came up for hearing on 6th May, 2002 the Lobbyists represented to the Court that the Union of India wanted to appoint a Review Committee to consider the question of uniform to be worn by the nurses in the Army. The Union of India thereafter constituted a Committee known as 'Military Nursing Service Dress Review Committee' which was composed of the Director General of Medical Services (Army), as the Chairman, and representatives from the DGAFMS, representative from DGMS (Army), representative from DGMS (Navy), representative from DGMS (Air Force), Dy. JAG and ADGMNS as members. The Dress Review Committee held its deliberations on 8th and 9th July 2002 and made a report. Though Major General PK Sethi, ADGMNS and Brig.(Mrs.) Usha Sikdar, DDMNS Central Command, were members of the Committee, they expressed their reservations with regard to the report and gave dissenting notes. The Dress Review Committee meticulously considered the objections and having considered various options and found in favour of the Safari Suit of soothing colour (Beige colour) in suitable fabric with badges of rank on shoulders to meet the seasonable requirements of summer and winter, as the best available option.
The Supreme Court noted that the Section 11 of MNS Ordinance vests in the Chief of the Army Staff the power to make regulations providing for all matters to be laid down and generally for all detail connected with the organisation, pay allowances, duties, discipline, training, clothing, equipment and leave of members of the Indian Military Nursing Service. In exercise of the powers vested in him The Chief of Army Staff prescribed the appropriate uniform to be worn by the members of the Indian Military Nursing Service. The prescribed uniforms were changed from time to time taking into account the advice of special committees appointed by The Chief of the Army Staff to periodically review the issue. The Honourable Court ruled that, “In any event, whether any part of the military services should have any uniform, and, if so, what should be the uniform, is an issue entirely within the province of The Chief of Army Staff by reason of Army Act, the Indian Military Nursing Act and the Regulations made by the Chief of Army Staff by the powers derivable therefrom”. The Nursing Officers dress code was changed accordingly in April 2004.
This was the coupe de grace by the Lobbyists. They have stopped the re-designation of the Military Nursing Service in to a corps of the regular army and formed a negative opinion in the entire armed forces and MoD about the MNS. In future, no Army Chief will ever recommend the integration of the MNS in the army. The Lobbyists won the final battle of minds, and the MNS will remain as an auxiliary force of the Army, until its disbandment. In the wake of the Supreme Court Order, the Lobbyists stopped the introductory Officer training to new MNS Officers. They have started addressing MNS Officers as members of MNS in all official correspondence, withheld permission of Brigadier/Major General Ranked MNS Officers from flying flags on official vehicles and prohibited the MNS Officers from wearing formations signs on uniform. Since then many clubs and organisations run for the recreation of the Service Officers have stopped granting membership to the MNS Officers. The isolation and discrimination against the MNS was apparently complete; atleast the Nursing Officers thought so until the submission of the Sixth Pay Commission report!
2008: Sixth Central Pay Commission
The recommendations made by the Army HQs to the successive pay commissions are a reasonably fair indicator of the changing attitude of the Authorities towards the Military Nursing Service. In 1986, the Armed Forces proposed to the Fourth Pay Commission, “to grant the same pay scales to MNS Officers as for other Service Officers”. To the Fifth Pay Commission in 1996, the armed forces recommended that, “the Pay Scale of the MNS Officers of Lieutenant to Colonel should commence one increment below the start of the general list cadre (same scales for Brigadiers and Major General as general list cadre) and to compensate for merit and responsibility of higher ranks, rank pay should be introduced”.
The Sixth Central Pay Commission (VI CPC) remarked that, “Officers belonging to Military Nursing Service (MNS) have a starting pay equal to the Group A civilian starting scale. MNS cadre follows same designations as the officers of the Army, however, their pay scales are slightly lower ……...”. “The Fifth CPC had additionally observed that it would not be fair to give parity between civil nurses and MNS officers keeping in view the all India liability and military service element of the latter category. The observations made by the Fifth Central Pay Commission regarding absence of any justification for drawing parity between civil nurses and MNS officers are apt”. “The Commission, however, is of the view that no differential in salary of officers belonging to the Services or MNS is justified and that the pay band and grade pay of similarly designated posts in Service Officers cadre and MNS cadre should be same. In line with the other Defence Forces personnel, Military Service Pay (MSP) would also need to be extended in their case. The rates of MSP would however need to be kept suitably lower keeping in view the fact that MNS officers are not primarily meant for combat duties”. The Commission accordingly recommended the same pay band and grade pay with a lower rate of MSP for the MNS Officers. The Commission added that, “The scheme of time bound promotions upto the level of Lieutenant Colonel, already available to the Service Officers, should be extended to MNS officers as well”. The recommendations of the Sixth Pay Commission may be considered as the best recommendations ever, as the MNS cadre is concerned.
The Service Chiefs were busy in highlighting the so-called attempts by the bureaucracy to down grade the Officer Cadre of the Defence Officers. Accordingly, the Chiefs of Staff Committee (COSC), in a letter dated 15 Apr 2008 projected the anomalies of the report to the Defence Minister. The top brass were too preoccupied with comparing the Lieutenant Generals status against the Director General of Police. Therefore, the Lobbyists could not include any points regarding the so-called ‘equal pay to the MNS cadre vis-a-vis AMC Doctors’. However, the relentless efforts by the Lobbyists made the COAS to see the danger. He in a letter dated 20 Jun 2008 addressed to the Cabinet Secretary, stated that, “Efforts of the VI CPC to meet the just aspirations of Nurses with regards to Pay, Grade Pay and status, be it in the civil or Armed Forces Medical Services is well appreciated. However, selective upgradation of Basic Pay, Grade Pay and hence the status of Nurses only in the Armed Forces to equate them with Doctors will seriously impact on the functional relationship and command and control in the Military Hospitals, which would adversely affect patient in the long run. Hence, there is a need of reconsidering those aspects and keeping the Pay and Grade Pay of MNS Officers distinct from the Service Officers”.
Apparently, the Navy Chief also wanted a piece of action. He in his letter of July 2008, expressed "serious reservations" about commissioned officers "being equated" with Military Nursing Service officers, holding that this will create "functional imbalances" in military hospitals and "impact" patient care. He stressed that some "important course corrections" were needed to "raise the satisfaction level" of the armed forces, which could be done at "minimal cost to the exchequer", such as lowering the Pay and Grade Pay of MNS Officers. The Air Chief avoided all controversies probably, because there was near mutiny in IAF after the V CPC, over the difference in the flying pay between fighter and transport/helicopter streams. The News Paper reports of those days indicated that, he was very much convinced about the need to down grade the MNS cadre.
The Doctors are the most highly paid of the Officer Cadre of the armed forces. The Sixth Pay Commission observed that, “officers belong to the Armed Medical Corps (AMC) are given higher entry level pay scale as compared to other commissioned officers. The initial entry scale recommended by the Fifth CPC for Lieutenant and Captain in the Armed Medical Corps tentamounted to 3 and 4 advance increments respectively. The existing position needs to be maintained. The Commission, accordingly, recommends that Lieutenant of the Army Medical Corps, Army Dental Corps, Remount and Veterinary Corps should be given a start that is 7.5% higher than the minimum of the pay band PB-3 of Rs.15600-39100 along with a grade pay of Rs.5400 attached to the post of Lieutenant. Similarly, Captains in the Army Medical Corps should be given the entry pay that is 10% higher than the minimum of pay band PB-3 of Rs.15600-39100 along with a grade pay of Rs.5700 attached to the post of Captain”. The Doctors from the Civil join the AMC as Captains, that too with a 10% higher fixation and NPA. After four years, they become Major’s and Lt Colonel at just eleven years. They draw the fattest pay package and faster promotion than any other Defence Officer. Whereas the MNS Officers attains the rank of Captain after five years, Major after twelve years and Lt Colonel at twenty years. While considering the direct Captain rank, higher fixation and faster promotion of the Doctors, where is the equality, which the Services Chiefs so much harped on. The equality of the Nurses vis-à-vis Doctors was nothing but a myth created by the Lobbyists to reduce the MNS Officers pay; the dirtiest trick anyone can play. It is the only incident in the history of Pay Commissions that, the head of an organisation has asked to lower its employees pay.
The weak government at the Centre wanted to pacify the fuming Generals. It had sacrificed the Military Nursing Service disregarding the Pay Commission recommendations in order to make the Generals happy. Hence, the Grade Pay and Pay Band (only Lt. Colonel) of MNS Officers is lower than the Service Cadre. The Lobbyists did not stop there, they made the MoD to issue separate Army Instruction for the MNS Officers new scales. In addition, they have not been included in the letter authorizing the revised travel entitlement to Defence Officers. From proposing, the same pay scales to IV CPC in 1986 for MNS Officers and asking the V CPC in 1996 to place them one increment lower, the armed forces have changed a lot. In 2008 after the VI CPC, the Army Chief proposed to lower the Pay Band and Grade Pay of MNS Officers to the level of Civil Nurses (starting at a Grade Pay of Rs 4600, which is equal to a Subedar’s). This is proof enough that the Lobbyists have literally influenced the mindset of the entire armed forces as well as the Government.
The Prime Minister’s Office has announced in Jan 2009 that, the next time onwards there will be a separate Pay Commission for the Defence Forces. That will truly be a ‘Pay Commission by the Generals for the Generals’. I wonder, what will such a Pay Commission do to the MNS Cadre? I sincerely believe that, they will not try to lower them below the Sepoys. However, with the Lobbyists around, nobody can be sure of that. Long live the Lobbyists, this is our Army! Jai Hind.
Lt Col Ramani Natarajan (Retd)