Introduction:

With the liberalization of the Indian economy and the increased attention to development has given rise to importance of human resource development. In this regard there is a growing awareness amongst government about the potential role of charitable institute in development.

Charity means the act of benevolent giving. The word derived from the French word “charity” has been understood for helping those in needs. The concept of charitable organization has emerged from these idea and has become a pathway for altruistic intentions to benefit the under privileged.

Charitable hospital has its roots in 19th century when non profit hospitals were engaged in providing free care to the poor. During the independence the negligence of health care led to many unanticipated deaths. At the same time the government was not able to full fill the satisfactory medical services, which gave rise to missionary hospitals with modern satisfactory equipments, both at urban and rural level.

Indian independence brought changes in economic and social environment which in turn gave rise to private sectors. This coupled with importance of health sector gave rise to the growth of “for profit” hospitals. Most of them had limited set of services, with the support from government to initiate a charitable hospital. Till the early 1980’s the growth of a corporate hospitals were less but with advent of liberalization and need for better technology in equipment led to corporate hospitals, handled and managed as a business entity.To curb the limitations faced by the state, the charitable/ for profit hospitals, with the goal of helping the state in furthering its aim of providing free/subsidized treatments for weaker section of the society in exchange of subsidies or some other benefits to the charitable hospital.

Over the years many charitable hospitals were made out of real interest or to exploit the opportunities in the health sector. Many of these hospitals transformed in to super speciality high facility centres. The concessions and benefits provided by state helped these charitable hospitals transform. A new set of undertaking with an agreement of mutual benefit and sustainability of the benefit is required between the state and the charitable entities involved. The onus of the success lies on the both the parties involved.

The private sector organizations have ample resources which can be used to expand health care services in India. For that a new and well defined understanding needs to be developed between the government and the charitable hospitals. In recent times there have been a lot scuffles between the state and charitable hospitals over the misuse of concessions and failure on the part

of charitable hospitals to provide free/subsidized treatment. With the rising cost of health care and infrastructure and rising population has lead to many charitable institutions defaulting on their cause. The lack of support from state and authorities has led to a poor evaluation system which in turn has led to non-compliance on part of charitable hospitals. The lax governance has allowed private entities to take advantage of the government’s offer without really complying to the regulations.

The state provides a range of concessions like fre/subsidized land, tax exemptions, subsidized water and electricity. The state provides all these benefits in full or with liberal conditions which has promoted a lot of private sector players to venture in to the charitable hospital arena.

LEGAL STATUS OF CHARITABLE HOSPITALS

As mentioned before a charitable organization such as charitable hospital will be deemed so only if they are associated with a legal entity, i.e. they are registered under a societies act or a charitable trust act. Charitable hospitals existing in the state of Maharashtra re required to be registered under the BOMBAY PUBLIC TRUSTS ACT, 1956.

Some of the key definitions are given below:

DEFINITIONS

1Sec. 2(13): Public Trust : means an express or constructive Trust for either public or charitable purpose or both and includes a temple, a math, a wakf, church, synagogue, agiary or any other religious or charitable endowment and a society formed either for religious or charitable purpose or both and registered under the Societies Registration Act, 1860.

Sec. 9(1): Charitable Purpose: a charitable purpose includes

relief of poverty or distress education medical relief provision for facilities for recreation or other leisure time occupation (, if the facilities are

provided in the interest of social welfare and public benefit, and the advancement of any other object of general public utility, but does not include a purpose which relates exclusively to religious teaching or worship.

1

In order to be a public trust, it is not essential that the trust should benefit the whole of mankind or all the persons living in a particular state or city. It is said to be a public trust if it benefits a sufficiently large section of the public as distinguished from specified individuals. Also if the beneficiaries of the trust are uncertain or fluctuating, then the fact that the beneficiaries belong to a certain religion/caste does not make any difference.

WAYS OF REGISTERATIONS-

In India, Charitable organization can be registered in four ways: Trust Society Section-25 Company Special Licensing

Registration can be done with Registrar of Companies. There are five main laws governing the non-profit/charitable sector, each of which is

administered by an agency specifically created for the purpose. These are:

The Registration of Societies Act of 1860, a Central Act, and its versions enacted by different states, with a Registrar of Societies in each state to register and regulateorganizations registered under this Act.

There is no Central Act for registering or regulating public charitable trusts. AVariation of the Indian Trusts Act of 1882, which applies only to private trusts, is in force in different states.

Section 25 of the Companies Act 1956, deals with non-profit companies. It isadministered by the Registrar of Companies.

The Income Tax Act, 1961, again a Central Act applicable all over India, providesfiscal benefits to NPOs, the administrative agency being the Department of IncomeTax Exemption.

The Foreign Contributions Regulation Act, (FCRA) a Central Act applicable all overIndia, was essentially a security measure to control external funds flowing to non-profit

organizations, which could be used to threaten national security. In practice it has come to regulate the receipt and spending of all foreign funds going to non-profit organizations, irrespective of security concerns.

This basic legislative framework sets out the parameters within which the non-profit sector can operate. During a hundred plus years of growth, rapid economic and social changes have changed the conditions under which the sector operates but the laws and institutional frameworks have not changed commensurately, though some attempts at change have been made sporadically.

REASONS FOR SO MANY CHARIABLE HOSPITALS-

The reasons why so many hospitals are charitable are:

They get a lot of benefits from government which helps them get easy resources like water, land and electricity. This a cost saver from them and by this way they can also reduce a lot of bureaucracy.

The charitable hospitals get tax exemptions. This is benefitital because not only it increases their income but also the benefit in terms of less depreciation rate and resulting saving help them show a better balance sheet condition.

The purpose of a charitable hospital is to provide medical services at a less rate to lees privileged people. The aim is a noble and noteworthy in any country. One of the main reason for private players to venture is it gives them prestige of being a socially responsible. This especially becomes important for conglomerates who like to add social welfare touch to their values.

The charitable hospitals can raise tax-deductible donations or tax-exempt debt. This gives them easy capital both to start and to sustain.

DISADVANTAGES OF CHARITABLE HOSPITALS-

Charitable hospitals are given a number of tax exemptions and benefits by the government to support the “benevolent” cause that they, by definition, intend to serve. However, in turn these hospitals are required to give free or subsidized services to the weaker sections of the society as per the norms of the applicable government. This leads to several cost cutting measures and reduced transparency towards finances that are followed by these hospitals. In order to justify, there extensive need of finances for development of facilities and serving the people, a number

of practices are followed by these hospitals some of which tests the legal boundaries within which these hospitals are.All of this also impacts labour laws and employee welfare schemes run by these hospitals. The implementation of these schemes are not strictly according to norms and non permanent labour including, 3rd party outsourcing, contractual labour, and temporary and casual staff are increasingly employed. This reduces transparency in the wage standards and benefits given to these employees. There is a lot of hesitation in the hospital community to maintain transparent employee welfare policy and labour law records and awareness about the same is also found to be lesser in organizations of a comparatively lower scale like charitable nursing homes etc.

IMPACT OF COST CUTS ON LABOUR LAWS

LOWER WAGES: Since charitable organizations are faced with a financial crunch the correct wages are often not administered to cut down on costs.

LOWER SALARIES FOR DOCTORS: It also often discussed and noticed that the salaried doctors working in not for profit hospitals earn much lesser compensations than their counterparts in private hospital.

DOCTORS ON CONTRACTUAL BASIS: Because of lower wages many of the medical practitioners work on contractual basis

IMPROPER IMPLEMENTATION OF SOCIAL SCHEMES: Employee welfare social schemes which are applicable legally are also not implemented correctly to lower costs in many of these hospitals

THE HEALTHCARE INDUSTRY:

The Healthcare Industry is witnessing a sudden paradigm shift in last five year. Though this change was inevitable and the Industry has been working towards it for a decade now, this has been visible only in last two years.

All sectors in India are undergoing a change from unorganized to an organized structure and so is also seen in healthcare. Till few years ago healthcare delivery was sole responsibility of Private practitioners and Doctor owned and run hospitals. Since it was also considered only as a social sector so almost all the large hospitals were either Government or charitable hospitals.

A US$ 36 billion industry today and growing at 15% CAGR, the Indian healthcare industry will be a US$ 280 billion by 2022.

Apollo Hospital started the trend of corporate hospital, others followed. There has been a large gap after first corporate hospital and the trend of corporatisation in healthcare delivery in India. Today industry is moving rapidly towards organized sector and more so towards corporatisation of healthcare delivery.

Corporate hospitals: list and number of hospitals and their spread.

Hospital Groups

Number of Locations

Number of Hospitals

Number of Beds

Coverage

Annual Revenue (2005-06 (In Rs. Crore)

Apollo Hospital Enterprise Ltd

11 11 3000 All Metros 779

Wockhardt Hospitals

8 10 1400Bangalore, Mumbai and West India

210

Fortis Healthcare

5 13 1855 North India 100

Max Healthcare

1 6 765 Delhi & NCR 137

Manipal Health Systems

9 11 3000

South India (Mainly Karnataka) and Sikkim

-

Care Hospital 11 14 2000South and West India

-

Last 2 year have been years of dramatic changes. Most of the existing players announced their huge expansion plans and many of large companies with no or very little existence in healthcare delivery declared that they will be putting in huge investments in Healthcare Delivery. The

growth and sudden interest in the healthcare business can be attributed to many factor, one of the most strong of which is the strong Indian economy.

Factors for the “Healthcare Boom” in India

Strong Indian Economy Increasing options for Healthcare Financing Increasing Opportunities in Healthcare delivery

o Better Profitability (15-20% EBIDTA)o Earlier Break Even (2-3 years)o Medical Tourismo Increasing demand from within the county

Saturation of other sectors like IT, retail

Strong Indian Economy

India is predicted to cross United States by 2050. Indian Economy experienced a GDP growth of 9.0 percent during 2005-06 to 9.4 percent during 2006-07. By 2025 the India's economy is projected to be about 60 per cent the size of the US economy. The transformation into a tri-polar economy will be complete by 2035, with the Indian economy only a little smaller than the US economy but larger than that of Western Europe. By 2035, India is likely to be a larger growth driver than the six largest countries in the EU, though its impact will be a little over half that of the US.

India, which is now the fourth largest economy in terms of purchasing power parity, will overtake Japan and become third major economic power within 10 years.

 

Increased options for healthcare Financing

The reach of Insurance have been increasing. The premiums collected from Health Insurance are predicted to increase by around 50% from last year. Two exclusive Health insurance companies have already started selling policies.

  In Rupees Crore  

Insurance CompaniesHalf Year Ended Septembet 2006

Half Year Ended Septembet 2007

% Growth

Royal Sundaram 42 54 28%

TATA-AIG 19 35 83%

Reliance 32 148 365%

IFFCO Tokio 32 45 41%

ICICI Lombard 296 425 43%

Bajaj Allianz 74 125 69%

HDFC Chubb 4 21 415%

Cholamandalam 16 56 255%

New India 348 483 39%

National 182 313 72%

United India 206 276 34%

Oriental 210 262 25%

Star Health & Allied 2 45 2152%

Insurance

Total Premium 1462 2287 56%

Source: IRDA Journal, Dec 07.

Better Profitability

Healthcare is a highest capital intensive service industry and profitability has never been as good to match others. It is all changing very fast. The best of the systems of world are still struggling to achieve a good profitability level for healthcare. Healthcare in United States had a profitability of just above 5% in last financial year. India on the other hand, if we leave the charitable and government hospitals aside, is witnessing a15% to 25% profitability.This increased profitability can be attributed to many factors:

Increased flow of patients Higher Margins

Earlier Break Even

The break even for hospitals has been 5-7 years till last decade. The things started changing as the structure of hospitals moved from unorganized to the organized one.

Hospitals are now able to manage their funds in a better way Though costs have increased still they are able to maintain good profit margins on all

their services.

Medical Tourism

Medical Value travel is one of the emerging global sectors grossing US$ 22 billion. In 2006, more than 2 million medical tourists availed services in South-east Asia from all corners of the world. With revenues close to US$ 450 million, India has a 2% share of the global health tourism.The potential for India to become the hub for medical value travel is huge. All the existing Healthcare Delivery providers as well as the new entrants are in some or the other way eyeing that market.

The potential for India to become the hub for medical value travel is huge. All the existing Healthcare Delivery providers as well as the new entrants are in some or the other way eyeing that market.

Increasing Demand from Within the Country

The demand for quality healthcare has increased within the domestic healthcare consumers. Today’s patients have more choices than ever when it comes to choosing and using health care resources, and they are increasingly taking on the role of active and involved consumers. In the present scenario, providers need to offer innovative services and products that are geared toward health care consumerism — encouraging patients to become better educated about their care and coverage and helping employers offer better choices.So this has put up additional pressure on the healthcare provider to improve their existing services and bring upon better and world class facilities.

The disease profile of country as a whole is changing. One can see that the lifestyle diseases are now taking the limelight from the traditional infectious diseases.Improvements in socioeconomic conditions in the last five decades in doubling longevity from 32 to 64 yrs, steep fall of IMR, elimination of leprosy & yaws, eradication of small pox, & poliomyelitis being on verge of eradication, credits to the success stories post independence. However, the challenge we face with the on-going changes in disease burden that is producing a major health transition. Demographic transition reflects quantitative and qualitative changes in the population profile and the country is facing a double burden of communicable & non-communicable diseases.Communicable diseases are still persisting as major health problems but the Non- communicable diseases are doubling its incidence & prevalence. Coronary Artery Disease, Diabetes, Renal failures, Stroke, Cancer are on a rise as a result of Hypertension, metabolic syndrome & stress.

Employment Trends in Healthcare

Between June and September 2011, the Healthcare sector has added 60,400 jobsand is expected to add another 58,700 jobs between October and December 2011.The Healthcare Industry has witnessed a paradigm shift in the last five years and has grow from a unorganized to organized sector. The contributing factors for this shift are growing Indian economy resulting in increasing disposable income level of people, increased penetration of health insurance sector, demographic shift, expanding medical tourism increased prevalence of lifestyle related diseases and enhanced healthcare awareness, at least among the urban population..The Indian Healthcare Industry is currently estimated at US$ 40 Billion. The industry is expected to grow to US$ 79 Billion by 2012 and ~ US$280 Billion by 2020 according to a KPMG report on the sector.The hospital sector is experiencing rapid increase in investments from Corporates. Most of the existing players have announced expansion plans and many of large companies with no or very little healthcare presence have announced huge investment plans in Healthcare Delivery. There is also a boom in the diagnostic industries along with the growth in hospital infrastructure in the country. New investors including the MNCs are playing a key role in increasing the employment base in the sector, through expanding their presence in Tier I and Tier II cities. There have been a number of noteworthy initiatives taken up by the Indian government to boost the Healthcare sector in the country like 100% FDI under automatic route and National Rural Health Mission.Expansion is also taking place in the number of medical colleges and their intake capacity. Six new AIIMS category medical institutions are coming up along with upgradation of many existing colleges. This sector, however, suffers from bottlenecks in manpower supply, as

the current number of seats in medical and nursing colleges is woefully short of requirement, as reflected in the low doctor to population ratio. This is expected to limit growth potential in the shorter term. An ASSOCHAM study has estimated the current worth of Indianmedical tourism industry at around Rs.4.5 billion with about 0.85 million foreign patients annually getting treated here. These numbers are expected to grow to Rs. 10.8 billion with 3.2 million foreign patients expected to visit India by 2015. However, with the currentglobal economic downturn, the inflow of foreign patients in the June- September ’11 period has been lower than the trend. The increase in the price of pharmaceutical products has led to the review of brown field FDI policy in the sector. The Healthcare Industry has witnessed a paradigm shift in the last five years.

Various laws applicable to hospital

Law related to governing the commissioning of hospital :

Society registration Act 1960

Companies Act 1956

Urban land Act 1976

National building code 2005

Building permit from municipality

Delhi Fire Service Act, 2007

Delhi Fire Prevention and Fire Safety Act, 1986

Fire safety rules 1987

Electricity rules 1956

Delhi electricity regulatory commission ( Grant of consent for captive power plants ) regulations 2002

Delhi lift Act 1942

Bombay Lifts Act,1939

Delhi nursing home registration Act 1953

Bombay Nursing Homes Registration (Amendment) Act, 2005

Bombay Nursing Homes Registration (Extension and Amendment) Act, 1959

Bombay Nursing Homes Registration Act,1949

Radiation protection certificate for radiology dept from BARC

Atomic energy regulatory body approval for radiology / nuclear medicine services under the atomic energy Act 1962

Atomic energy ( safe disposal of radioactive waste) rules 1987

Indian telegraph Act 1885.

Clinical Establishments Bill, 2010

BUILDING AND OTHER CONSTRUCTION WORKERS (REGULATION OF EMPLOYMENT AND CONDITIONS OF SERVICE) ACT, 1996 (27 of 1996).

The Registration Act, 1908

THE NATIONAL CAPITAL TERRITORY OF DELHI LAWS (SPECIAL PROVISIONS) SECOND BILL, 2007

Government Buildings Act, 1899

Karnataka Medical Registration (Amendment) Act, 2003

Karnataka Private Nursing Homes (Regulation) Act, 1976

Red Cross Society (Allocation of Property) Act, 1936

St. John Ambulance Association (India) Transfer of Funds Act, 1956

Laws governing the qualifications / practice and conduct of professionals

Indian medical council Act 1956

Indian medical council (professional conduct, etiquette and ethics) regulations, 2002.

Indian medical degrees Act

Registration of medical practitioners with state medical councils

Indian nursing council Act 1947

Delhi nursing council Act 1997

The ICN Code of ethics for nurses

The Dentists Act 1948

The Dentists ( code of ethics regulation) 1976

Dental council of India regulations 2006

AICTE rules of physiotherapy rules

All India council for Technical Education ACT, 1987

The Apprenticeship Act 1961

Rehabilitation Council of India Act, 1992

Rehabilitation Council of India (Amendment) Act, 2000

Kerala Anatomy Act, 1957

Kerala Co-operative Hospital Complex and the Academy of Medical Sciences (Taking over the Management) Act, 1997

Kerala Professional Colleges or Institutions (Prohibition of Capitation Fee, Regulation of Admission, Fixation of Non-exploitative Fee and Other Measures to Ensure Equity and Excellence in Professional Education) Amendment Act, 2007

Karnataka Anatomy Act, 1957

Law governing the safety of patients, public and staff within the hospital premises

No objection certificate from the chief fire officer

Periodic fitness certification for operation of lifts

Indian Boilers Act , 1923

Explosive Act 1884 ( for diesel storage)

Petroleum Act + storage Rules 2002

Gas cylinder Rules, 2004

Rules for provision of safe drinking water

Rules for provision of uninterrupted power supply

Prevention of food adulteration Act 1954

The radiation surveillance procedures for the medical application of radiation 1989

Radiation protection Rules 1971

AERB safety code no . AERB/SC/Med -2 ( REV -1) 2001

Insecticide Act 1968

Arms Act, 1950

IPC Sec 336 ( act endangering life and personal safety of others)

IPC Sec 337 (causing hurt by act endangering life and personal safety of others)

IPC Sec 338 ( causing grievous hurt by act endangering the life and personal safety of others )

The Indian fatal accidents Act , 1955

The cigarettes and other Tobacco products ( prohibition of advertisement and Regulation of trade and commerce , production , supply and distribution ) bill 2003

Prohibition of smoking in public places Rules 2008

The Indian fatal accidents Act 1855

The Tamil nadu Medicare service persons and Medicare service institutions ( prevention of violence and damage or loss to property ) Act 2008.

Vaccination Act, 1880

Vaccination (Repeal) Act, 2001

Disaster Management Act, 2005

Protection of Human Rights Act, 1993

Laws governing the employment of manpower

Child labour Act

Citizenship Act 1955

Employees provident fund and misc provision Act 1952

ESI Act 1948

ESI ( central ) Rules 1950

Employment exchange ( compulsory notification of vacancies ) act 1959

Equal remuneration Act 1976

Minimum Wedge Act 1948

Payment of bonus Act 1965

Payment of Gratuity Act 1972

Payment of wages Act, 1963

PPF Act 1968

TDS Act

Maternity Benefit (Amendment) Act, 2008

Workmen’s Compensation Act, 1923

Workmen's Compensation (Amendment) Act, 2009

Indian Trade Union Act 1926

Industrial Disputes Act, 1947

Shops and factories Act (for national holidays)

Negotiable instrument Act , 1881

Persons with Disabilities Act 1995

SC and ST Act 1989

Weekly Holidays Act, 1942

Official Secrets Act, 1923

Persons With Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995

Karnataka Prohibition of Violence against Medicare Service Personnel and Damage to Property in Medicare Service Institutions Act, 2009

Information Technology (Amendment) Act, 2008

Information Technology Act, 2000

Regulations governing the business aspects of hospital

Charitable and religious trust Act 1920

Contract Act, 1982

Income Tax ACT 1961

Customs Act 1962

Foreign Exchange management Act 1999

Insurance Act 1938

Rules for display of Red Cross Insignia

Sales of good Act 1930

Vehicle registration certificate

Wireless operation certificate from post and telegraphs

Cable television network ACT 1995

Gift Tax Act 1958

Copyright Act 1982

The Public Liability Insurance Act, 1991, amended 1992

The Public Liability Insurance Rules, 1991, amended 1993

Various licenses / certificate required with sanctioning authority

Incorporation of hospital as Company (Registrar of Companies )

Allotment of land ( State DI/SIDC/Infrastructure Corporation /SSIDC)

NOC and consent under Water and Air Pollution Control Acts State Pollution Control Board

Approval of construction activity and building plan ( a. Town and country planning , b. Municipal and local authorities ,c. Chief Inspector of Factories d. Pollution Control Board e. Electricity Board )

Sanction of Power (State Electricity Board )

Boiler Inspection Certificate( Chief Inspector of Boilers )

Registration under States Sales Tax Act, and Central and State Excise Act ( i. Sales Tax Department ii. Central and State Excise Depts.)

General permission of RBI under FEMA

Form FC-IL - COMPOSITE FORM FOR FOREIGN COLLABORATION AND INDUSTRIAL LICENCE

Land, Water, Electricity, Registrations ( Ministry of Environment and Forests )

Environmental Clearance (EC) Process in India

NANAVATI HOSPITAL

The foundation stone at Dr. Balabhai Nanavati Hospital was laid by the Late Prime Minister Mr. Jawaharlal Nehru in November 1950, and the hospital opened its doors to its first patient in May 1951.

The hospital has since completed over 60 years of dedicated service and prides themselves on offering world class quality medical care.

Presently, it is managed by a team comprising of Shri Suresh R. Nanavati as the Chairman and Shri Priyam S. Jhaveri as the Vice Chairman.

Well-equipped hospital rooms, state-of-the-art Infrastructure and technologically advanced equipment and systems are all backed by the expertise and reputation of the Hospital’s consultants, resident doctors, nurses and paramedics.

Dr. Balabhai Nanavati Hospital prides itself on its attention to maintaining a high standard of quality and hygiene. The hospital serves 100% vegetarian meals, and offers patients the facility of selecting from different cuisines, ranging from Indian to Chinese.

Mission and Vision

Our vision is to improve the health and well being of our country by providing an innovative, proactive, professional, and high-quality service that promotes partnerships with our community and a supportive, nurturing environment. Our mission is to improve the health and wellbeing of the people in our country.

Values and Principles

The staff of Dr. Balabhai Nanavati Hospital value respect, responsibility, and accountability, the development of talents and a sense of accomplishment. Our underlying principles are teamwork and cooperation, honesty, leadership, and the development of a customer service culture.

We believe that it is important to provide a high-quality service, to promote a learning environment, to be supportive to each other, and to behave in a professional manner at all times.

We recognise our strengths and talents as being good communicators, being reliable, conscientious, and innovative. In the future we will strive to be a team that is recognized by being; high performing; proactive, and committed to work.

Departments

Various dpartments includes Department of Audiology and Speech Therapy; Department of Bariatric Surgery; Department of Cosmetology; Department of Neurology and Neurosurgery; Department of Radiology and Imaging; Department of Nephrology; Department of Oncology; Department of Orthopaedics; Arthroscopy; Reconstructive and Plastic Surgery; Department of Physiotherapy and Rehabilitation Center; Pediatric Center; and Telemedicine Center.

Facilities

Patient care, emergency services (casualty, admission, billing, blood bank, corporate cell, ambulance, operation theaters), corporate services (corporate tie ups, TPAs, DGCA), and international services (currently not into medical tourism).

Infrastructure

Dr. Balabhai Nanavati Hospital

Buildings: 5Total number of beds: 375Critical care: 74 bedsDay care (chemotherapy): 4 bedsOperation theaters: 10Cath lab: 1Full time employees : 1,200Eminent consultants: 200Skilled, resident doctors: 100Trained nurses :406Nanavati Hospital Heart Institute (NHHI)Cath lab: 1Operation theaters: 2Post-operative recovery rooms: 34

Accrediations

ISO 9001: 2008 Certified Organisation - achieved NABH in process

HR Practices at Nanavati Hospital: Primary Research

As a part of primary research, we took an interview of the VP-HR at Nanavati hospital which is given in Annexure 1 in the report.

The major HR functions performed at Nanavati Hospital are Recruitment, Induction, Disciplinary actions/Awards, Appraisal/promotion/transfers, Policy making and implementation, Compliance to statutory requirements, Maintenance of personal files and confidential records of employees.

The recruitment policy of the hospital follows Employee Exchange (compulsory notification of vacancy) Act. We have two different flows for recruitment, one for managerial posts and other for non-managerial posts.

For Managerial posts:

Openings in the newspaper Applications Interviews ShortlistRecruitment and confirmation.

For Non managerial posts:

Openings on Hospital Notice Board Applications Interviews ShortlistRecruitment and confirmation.

If suitable candidates are not found then:

Openings in the newspaper Applications Interviews ShortlistRecruitment and confirmation.

There are 1200 employees at the organization. There are 34 contract labor of liftman category and security. Payment of Provident fund and gratuity (social security) is taken care as per Employee Provident Fund Act, with Scheme and Payment Of Gratuity Act, with Rules.

Compliance to statutory requirements and maintenance of personal files is made compulsory under Bombay Shops And Establishments Act. Record for each and every employee has to be maintained and kept with the employer so as to present at the time of verification or inspection.

The grievance handling procedure at Nanavati hospital follows a step wise procedure. For any employee, facing any trouble, the employee should tell his/her problems to immediate supervisor. If the dispute is not resolved, the employee can raise the issue to the HOD of the department. The issues are usually resolved at this level. If it still goes unresolved HR department should intervene and try to settle things up. If not resolved, it goes to the grievance handling commission and then to union managing committee and Vice Chairman of the trust, their decision is the final decision.

The disciplinary proceedings at Nanavati hospital for the terminated employee involves the following steps:

1. Charge sheet cum enquiry letter is issued, which has the details Detailed record of employee Misconduct concern under Standing Orders Enquiry date and timing

While ‘Suspension cum pending enquiry’ period First 90 days - 50% of gross salary After 90 days - 75% of gross salary is paid to the employee.

2. Enquiry officer submits reports after enquiry.3. Explanation is asked from the employee4. If explanation is not received/is unsatisfactory then the employee is terminated.

Resignation: Employee should give one month notice or/else one month salary deduction.

Salary is paid on 7th of every month to all the employees as per Payment of Wages Act, 1936. Complete injury compensation as per Workman Compensation Act, 1923 is given to all the employees of the organization. This includes

Free treatment to employee/free medical supply to all employees Injury in hospital premises complete treatment and leaves.

Maharashtra Tax on Proffesional/trades, calling and employement act, 1975

Salary Deduction<5000 Nil5000-10000 175>10000 2500 per anum (200 per month+ 300 in

February)

Maharashtra Labour Welfare fund paid half yearly in month of December and June

Salary Deduction<3000 Employee contribution(EEC)=6

Employer contribution(ERC)=18<3000 Employee contribution(EEC)=12

Employer contribution(ERC)=36

There are approximately 30-40 incidents of suspension (usually menial staff) due to absenteeism. No case of termination of employees as it involves Mumbai labor union. The hospital believes in using threatening tactic like suspension, warning letters rather than terminating them.

The major problem faced by hospital right now is manpower problem. It is difficult to get menial staff work properly, high rate of absenteeism due to daily wage payments outside as compared to monthly wage payments in the hospital. Another issue is the Nursing problem. Its getting difficult to find and retain nurses. Previously there was 1.5 years bond period which included 6000 as bond money and originals were kept with the hospital. Due to some suicide case this bond period is scrapped by nursing council. Now the hospital is facing difficulties in retain nurses.

The hospital underwent an agreement with Mumbai Labour Union, comprising of 1280 members on May 20, 2008 to raise the wages/incentives for employees to various effect. The move was basically to retain the man power. The agreement is in effect till date and will continue to remain in effect till it is terminated by any of the parties as per ID act. The major highlights of the agreement are:

50% hike in salary Additional service increments

Years completed in service as on 1.4.2007

Number of increments

Less than 2 Nil

Between 2 and 5 2

Between 5 and 9 3

Between 9 and 13 4

Between 13 and 16 5

Greater than 16 6

Special Allowances : 250 per month 20 to 25 years in serviceo 500 per month greater than 25 years

Increase in LTA, Outdoor lunch allowance, Ex-gratia to different extent No change sin acting allowances, Cash allowances, attendance bonus, welfare fund,

festive advance Duration of agreement: 4 years(1.4.2007- 31.3.2011) and will remain in force until

terminated by any party under ID Act.

KAMLA NEHRU MEMORIAL HOSPITAL, ALLAHABAD

The Kamala Nehru Memorial Hospital has been registered under the Indian Foreign Contribution (Regulation) Act, 1976. By virtue of this notification, the Hospital is eligible to receive contributions from India & abroad. Donations to the Kamala Nehru Memorial Hospital are exempted from levy of income tax in the hands of donor, under section 80G of the Indian Income Tax Act, 1961. Donations under section 80G are meant for general purpose and are exempted upto 50% of the amount donated.

Kamala Nehru Memorial Hospital traces its roots to the Freedom Struggle, when in the year 1931, Smt. Kamala Nehru converted some rooms in her ancestral house, Swaraj Bhawan into a Congress Dispensary. After her sad demise, Mahatma Gandhi and other national leaders like Pt. Madan Mohan Malviya, Pt. Jawahar Lal Nehru, Dr. B.C. Roy, Shri Uma Shankar Dikshit and others took it upon themselves to “see that the work for which she made herself responsible was carried on even after her death” (Mahatma Gandhi). To start with, it was a fledgling unit with just 40 beds of Obstetrics & Gynaecology, out of which 28 were free. The first Medical Superintendent of the Hospital was Dr.(Mrs) Satyapriya Mazumdar.

The first trustees of the Hospital were :

Pandit Jawaharlal NehruMiss Khursheed A.D. Naoroji

Dr. Jivraj N. MehtaPandit Madan Mohan Malviya

Dr. Kailas Nath Katju Dr. Bidhan Chandra Roy

Smt. Vijayalakshmi Pandit

Shri Jamnalal Bajaj

Dr.Syed Mahmud Shri. Jal A.D.Naoroji

The year 1949 marked the beginning of cancer treatment at the Hospital with the installation of Maximar Deep X-ray therapy unit for cancer therapy. The Cancer wing of the Hospital was further expanded and formally inaugurated by the then Vice President of India Dr. S. Radhakrishnan on April 8, 1959 with three Deep X-ray units, one Cobalt Unit and 200 mg Radium for Brachytherapy. This made KNMH the third centre in the country for comprehensive cancer treatment in the early fifties, the other two being Tata Memorial Hospital, Mumbai and Chittaranjan National Cancer Hospital, Kolkata.

A modernization program of the Cancer Wing was initiated in 1986. It has now evolved into an upgraded cancer treatment Centre with modern facilities and infrastructure. It has proved a boon for the people of the region who earlier had to go to far off places like Mumbai and New Delhi for cancer treatment.

Some of the salient features of the development are - installation of stationery head Janus Cobalt Unit in 1984, re-establishment of cancer wards in 1984 and commissioning of rotational head Isocentric Teletherapy Unit, Theratron 780 C, Selectron LDR (remote control after loading) unit with Caesium –137 source and RT 3000 Ultrasonography Unit. In 1987, the imaging section was further strengthened by addition of a Whole Body CT Scan – CTW 700, under the Indo Japanese Aid Programme for Cancer control in India. 

The Hospital initiated a Rural Health program in 1986. Sri. Rajiv Gandhi, the then Prime Minister of India and President of Kamala Nehru Memorial Hospital Society, laid the foundation stone of Kamala Nehru Memorial Rural Hospital in 1987 at Village Newada Samogarh, Naini, Allahabad. The Rural Hospital was inaugurated in 1988. The Hospital serves as a base centre for preventive oncology and cancer detection at the grass root level in the surrounding villages. A Community Oncology wing was established in the Rural Hospital in 2003.

The Hospital completed fifty years of distinguished service to humanity in 1991. The commemoration of the Golden Jubilee Year (1991) of the Hospital began on 28th February 1990 with the hosting of the 17th National Conference of Indian Association for Radiation Protection and Annual Conference of Radiation Oncologists of India (U.P Chapter). 

In 1992 the Hospital was recognized as Regional Institute of Mother & Child Health by Government of India. The National AIDS Control Organization recognized the Hospital as an AIDS Surveillance Centre in 1993, and made it a state level Voluntary Counseling & Testing Centre in 1998.

In 1993, the Department of Atomic Energy co-opted this Hospital as a Centre for Research in Radiation Oncology, Medical Physics and Nuclear Medicine.

On the strength of the services rendered by the Hospital, Government of India recognized KNMH as a Regional Cancer Centre in 1994 covering Uttar Pradesh and the neighboring region.

The Hospital also has a Post Graduate Teaching facility. Since 1964, the Hospital is affiliated to M.L.N. Medical College, Allahabad to provide teaching & clinical facilities in Obstetrics & Gynaecology to undergraduate and postgraduate students. It is recognized by the National Board of Examinations for Diplomat of National Board (DNB) in Obstetrics & Gynaecology, Radiotherapy, Pathology and Radio diagnosis. The Hospital also offers PG Diploma in Obstetrics & Gynaecology and Paediatrics & Child Health from Indian College of Maternal & Child Health.

The Hospital has earned public recognition for its services in this part of the country and has been at the forefront for bringing cutting edge technology in Medical Care for public cause as a charitable non-profit making voluntary organization.

Board of Trustees

President

Pt. Jawahar Lal Nehru May 1936 - May 1964

Smt. Indira Gandhi May 1964 - Oct 1984

Shri Rajiv Gandhi Nov 1984 - May 1991

Smt. Sonia GandhiMay 1991 - April 2006 and Aug 2007 onwards

Honorary Secretary & Treasurer

Shri Uma Shanker Dixit & Shri P.A.Narielwala

May 1936 - Nov 1949

Shri P.A.Narielwala Nov 1949 - Aug 1980

Shri B.K. Nehru Sept 1980 - Sept 1985

Shri Ajitabh Bachchan Sept 1985 - May 1987

Shri Inder K. Khosla May 1987 onwards

Board of Trustees

Smt. Sonia Gandhi Trustee & President

Chief Justice Ravi S Dhawan (Retd.) Trustee

Dr. (Mrs.) Sneh Bhargava Trustee

Air Com Vivek Y. Nehru (Retd.) Trustee

Smt. Priyanka Gandhi Vadra Trustee

Shri R.P. Goenka Trustee

Dr. K.P.Mathur Trustee

Shri Rahul Gandhi Trustee

Shri Murli S. Deora Trustee

Shri Inder K. Khosla Trustee & Hony. Secretary & Treasurer

Kamla Nehru Memorial Hospital v/s Presiding Officer, Labour Court on 26 July, 2005

This writ petition is directed against an award of the labour court dated 2nd. January, 1997 whereby the cessation of the services of the respondent employee have been held to be illegal and he has been directed to be reinstated with full backwages. The respondent No. 2 was appointed as a Security Incharge for a fixed period from 8.3.1988 to 8.3.1989. This period was extended uptil 31.3.1990, however, he stood disengaged w.e.f. 1.4.1990 and as such he approached the Conciliation Officer claiming violation of the provisions of U.P. Industrial Disputes Act, 1947 (hereinafter referred to as the State Act). Upon submission of a failure report, the State Government made a reference to the Labour Court, Allahabad which registered it as Adjudication Case No. 77 of 1994.

The workman admitted the nature of his appointment but claimed that it was retrenchment and violation of Section 6-N of the State Act entitling him to reinstatement with back wages. The petitioner raised a preliminary objection that the employee was not a workman within the meaning of the State Act. It was further contended that as the appointment of the employee was for a fixed term, there was no question of any retrenchment or violation of Section 6-N of the Act. The Labour Court vide its order dated 22.11.1995 decided the preliminary issue in favour of the respondent employee which was subjected to challenged in Writ Petition No. 6365 of 1996 but no interim order was granted and the petition remained pending after exchange of pleadings. Since no interim order in the aforesaid petition was granted, the Labour Court proceeded with the adjudication and rendered the impugned award which was published on 3.10.1997.

Learned counsel for the petitioner has firstly urged that the labour court erred in law by holding that the respondent employee was a workman without allowing the petitioner to lead evidence on this issue. However, the learned counsel for the respondents contends that this issue is subject matter of another Writ Petition No. 6365 of 1996 and it cannot be raised again in this petition.

In my view this argument of the respondent cannot be countenanced. The preliminary order dated 22.11.1995 holding that the respondent employee was a workman has merged in the final award which is being challenged in the present writ petition, therefore, for all purposes Writ Petition No. 6365 of 1996 has become infructuous and thus the petitioner can canvass its illegalities in this writ petition. In any case, the order dated 22.11.1995 has been specifically challenged through amendment.

 H.R. Adhiyanthaya Etc. v. Sandoz (India) Ltd. Etc. [ 1995 (1) L.LJ. 303]  was considered to define ‘workman’ for this case.

 Shanker Chakravarti v. Britannia Biscuit Co. Ltd. [ 1979 (39) F.L.R. 70] was referred to, to specify the nature of work performed by the respondent.

Thus, after much deliberation, it was established that the employee was appointed as a security incharge for a fixed term with certain conditions and his extension was granted on those very conditions for another fixed term. He joined and continued to work on the strength of these letters and after the complelton of the term of his appointment, he could not be heard to say that he was not bound by the conditions mentioned therein. It is not a case of an illiterate labour but of a security incharge of a big hospital looking after its security through about 30 security

guards. It is not his case that he did not understand the import of the conditions mentioned in the appointment letter, in fact, there is not even a whisper either in the pleadings before the labour court or in the counter affidavit before this court that he did not comprehend the conditions mentioned in the appointment letter. The finding of the labour court that the alleged disengagement without notice was violative of Section 6-N of the Act, is erroneous. The proviso to Section 6-N (a) clearly stipulates that no notice before termination is required if it is under an agreement which specifies a date of disengagement.

f U.P. State Sugar Corporation Ltd. v. Om Prakash Upadhya [2003 S.C.C (Labour and Services) 77 was referred to, to establish grounds for automatic reinstatement.

FINAL JUDGEMENT : With the aforesaid observations and directions, this petition succeeds and is allowed. The impugned award dated 2nd January, 1997 is hereby quashed. No order as to costs.

Sri Ramakrishna Hospital

Sri Ramakrishna Hospital was established by S.N.R. Sons Charitable Trust. The trust was founded in 1970 by the sons of Sri S.N.Rangasamy Naidu.Free medical treatment is provided to the needy poor and with charges for those who cannot afford the full cost of treatment. Free medical camps are conducted in the surrounding villages in association with Non Governmental Agencies.

* This hospital has also been recognised to treat patients who obtain Chief Minister's Public Relief Fund and Prime Ministers National Relief Fund for Kidney Transplantation & Heart Surgery etc.

* Recognized by Govt. of Tamilnadu to perform Family Planning Operations.

* The Chief Commissioner of Income Tax has recognized this hospital under section 17 of the IT act 1961 .

* The Governement of Tamilnadu and The Government of India have also accredited this hospital for treating State Government employees for the following specialties.(a) Cardiology (B) Nephrology (C) Neurology (D) Orthopedics (E) Simple Ophthalmology (Simple Surgery). (F) Oncology.

Staff DetailsFully qualified and experienced consultants/ Super speciality Doctors : 46Junior Doctors : 49Staff Nurses, ANM’s, Technicians, Pharamacists and other hospital menial staffs : 580

Hospital StatisticsBed strength : 400Bed Occupation : 90-110%

Out Patient attendance : over 450/dayLab Investigation : Around 50000 investigations for OP & IP Patients / yearOperations : Around 5000 major and 4000 minor / yearKidney Transplantation : 300 till 2005Heart surgeries : 362 Open Heart Surgeries (including 316 CABG) & 180 Closed Heart Surgery done so far in 2005.

The hospital has its own Pharmacy that serves round the clock and well stocked. An ambulance with Mobile Ventilator, Defibrillator, Oxygen supply, emergency drugs along with trained personnel is available on call for 24 hours service. Also attached to the hospital is a canteen for the use of patients and other visitors. Senior doctors resided in the campus and one instantly available for emergencies.

* This hospital is recognized by the medical council of India for trainin of C.R.R.I's in the department of General Medicine , General Surgery and Obstetrics & Gynaecology.

* This hospital is medical courses are conducted B.Pharm , Nursing, B.P.T., (Including Post Graduate Courses ) & B.D.S.

* Recognized by National Board of Examination for DNB course in General Medicine, Obstetrics & Gynaecology, Anesthesia, Radiotherapy , Radio diagnosis and Family Medicine.Board Of Trustees: Dr.R.Venkatesalu, Managing TrusteeSri. R. Doraiswami,Managing TrusteeSri.C.Soundara Raj TrusteeSri R.Vijayakumhar, Trustee

S.N.R. Sons Charitable Trust v/s The Commissioner, Coimbatore on 25 August, 1992

This writ appeal at the instance of S.N.R. Sons Charitable Trust, Coimbatore, has -been preferred against the dismissal of Petition No. 9701 of 1983, praying for the issue of a writ of certiorari (A decision by the Supreme Court to hear an appeal from a lower court.) Or other appropriate writ calling for the records of the respondent relating to the notice of demand in Assessment No. 60511, dated 30.9.1983 and quash the said notice of demand relating to Sri Ramakrishna Hospital, Coimbatore, run by the Appellant trust.

In the affidavit filed by the appellant in support of the writ petition, it was stated that after the formation of the trust on 9.2.1970 and in accordance with the terms of the Deed of Trust, the appellant has been running Sri Ramakrishna Hospital, Sri Ramakrishna Children's School, etc., and that the hospital was started in 1974. It was also stated that prior to the coming into force of Coimbatore City Municipal Corporation Act (hereinafter referred to as 'the Act'), the appellant sought exemption from payment of property tax from the then Coimbatore Municipality and the appellant, by proceedings dated 20.9 1977, was exempted from payment of property tax under Section 83(1)(e) of the Tamil Nadu District Municipalities Act, 1920 with effect from 1 .4.1977,

excluding the office canteen doctors' residential quarters and nurses' quarters, in respect of which a separate assessment for property tax was made.

This according to the appellant, had continued till 30.9,1980, when a special notice dated 31.3.1981 was issued to the appellant proposing to revise the earlier assessment with effect from the half year commencing from 1.10.1980 by revising the annual value and on representations by the appellant, the appellant was granted exemption from payment of property tax under Section 123(e) of the Act for the period from 1.10.1980 to 31.3.1982, by an order passed on 8.8.1981.

The appellant also referred to the grant of exemption under Section 80(g) of the Income Tax Act, 1961, as well as exemption from payment of urban land tax and the certificate of the Collector of Coimbatore to the effect that the hospital run by the appellant was doing charitable and relief work and 40% of the out-patient cases were treated completely free of charges and even in-patients whose income was less than Rs. 300 were given free accommodation, bed and linen, medical and nursing care including investigations, medicines, operations and diet, to establish that the hospital run by the appellant was a charitable one which justified an exemption from payment of property tax.On 25.2.1982, according to the appellant, it applied for a renewal of the exemption from payment of properly tax from 1.4.1982, but no reply was received. Instead, a notice was served on the appellant demanding property tax for the half year commencing from 1.4.1982 and this led to the appellant making further representations on 13.8.1982 and 30.8.82 praying for the renewal of the exemption granted upto 31.3.1982.

Thereupon, the respondent, by a communication dated 30.9.1983, not only refused to grant exemption, but demanded payment of arrears of property tax for three half years commencing from 1.4.1982 and called upon the appellant to pay the same within seven days from the date of receipt of that notice. Thereafter, the appellant approached this Court under Article 226 of the Constitution of India, praying for the relief set out earlier.

DEFENCE:

In the counter filed by the respondent, it was stated that during the first half-year 1975-76, three assessments were made in respect of the hospital building, the first two covering the hospital buildings and the third comprising of the doctors' quarters, nurses' quarters, canteen and office room and that the appellant had paid the tax upto 1977.

Referring to the claim for exemption made by the appellant by letter dated 26.7.1977, the respondent stated that objections were raised by the Audit Department on the ground that the hospital was not entitled to the benefit of such exemption, as charges were paid by the patients for the use and occupation of the rooms and that would disentitle them to the benefit of exemption.

Pursuant to that according to the respondent, on the orders of the commissioner dated 10.10.1980, the hospital, was assessed to property tax on the basis of the annual rental value with effect from 1.10.1980, by the issue of a special notice. When the notice of demand was served on the appellant, it was brought to the notice of the respondent that the appellant had presented a

revision petition before the commissioner on 7.4.1981 and after the Coimbatore Municipality became a Municipal Corporation from 1.5.1981, the Commissioner inspected the property on 6.8.1981 and after perusing the relevant records produced by the appellant, exemption from payment of property tax had been granted for the period from 1.10.1980 to 31.3.1982 and that no exemption was granted for the subsequent period.

Relying on the proviso to Section 123 of the Act, the respondent maintained that the appellant was not entitled to the exemption, as it had collected rents from persons who used to occupy the hospital rooms and charges had also been collected from out-patients and, therefore, the appellant cannot be permitted to take advantage of Section 123(e) of the Act. An objection that the appellant had an effective alternative remedy was also put forward.

REFERENCES

Reference in this connection was also made to the decision of the Supreme Court in  State of Punjab v. British India Corporation Ltd. and New Delhi Holy Family Hospital Society v. Delhi : FOR use of the word 'rent' contemplated letting out and the relationship of landlord and tenant being brought into existence and the occupation of a bed by a patient was only permissive and did not confer any exclusive possession or enjoyment and the word 'rent' cannot be given a comprehensive or wide meaning as to include any payment, irrespective of the character of the payment and also ignoring the circumstances leading to such payment.

Municipality A.I.R. 1984 Del. 84.. On the other hand, learned Counsel for the respondent submitted that though it may be that the appellant had received amounts from the patients, who had come to the hospital, either as bed and linen charges, nursing and para-medical services, charges for tests, etc., the payments were really for the use of the premises and regarded as consideration for such use, the payments were only 'rent' as contemplated in the proviso and therefore, the exemption was rightly refused.

Counsel for the appellant relied upon the decision reported in New Delhi Holy Family Hospital Society v. Delhi Municipality , we find that it does not assist the appellant in any manner. Reference, however, in this connection may be made to the decision of the Supreme Court reported in State of Punjab v. British India Corporation Ltd. , strongly relied upon by learned Counsel for the appellant. Amongst others, the Supreme Court had occasion to consider the meaning of the word 'rent' in Clause (ii) of Rule 18(4) of Punjab Urban Immovable Property Tax Rules, 1941 for purposes of availing the benefit of exemption

FINAL JUDGEMENT

 Though the attention of the learned Judge, had been drawn to this decision of the Supreme Court in State of Punjab v. British India Corporation Ltd. , we find that apart from referring to it, as a decision which can be seen with advantage, the learned Judge has not otherwise dealt with it. In

view of the aforesaid decision of the Supreme Court, on a consideration of the relevant provisions of the Act referred to earlier, we are clearly of the view that the payments made by the patients to the hospital by way of hospital charges, or stoppages or even service charges, cannot be equated to "rent" as contemplated under the provisions of the Act and the denial of the benefit of exemption to the appellant; on that score cannot be sustained. We may also observe in this connection that when it was not disputed that the hospital run by the appellant was entitled to the benefit, of exemption under Section 123(e) of the Act, unaffected by the proviso, till 31.3.1982, it is not known how the appellant could be denied the benefit of such exemption from 1.4.1982. We have carefully perused the order passed by the respondent and we do not see any reason whatever for denying the benefit of exemption prayed for by the appellant. In the impugned order, it has also not been stated as to why the appellant is not entitled to the benefit of exemption from 1.4.1982, when it had enjoyed such a benefit till 31.3.1982. There is also no indication therein whether the character of the payments made by the patients taking treatment in the hospital underwent a change between 31.3.1982 and 1.4.1982 and in this view also, the refusal of exemption prayed for by the appellant cannot be upheld. We, therefore, allow the writ appeal with costs, setting aside the dismissal of W.P. No. 9701 of 1983 and that writ petition will stand allowed, as prayed for by the appellant. Counsel's fee Rs. 2,000.

Annexure 1

The following section focuses on the interview with Mr. Rajendra Vartak(VP-HR and Admin) and Mr. Rajan Chauvan.

What are the various HR functions performed at the hospital by HR department?

The major HR functions include:

Recruitment Induction Disciplinary actions/Awards Appraisal/promotion/transfers Policy making and implementation Compliance to statutory requirements Maintenance of personal files and confidential records of employees

What are various Job designations at the hospital?

The hospital staff mainly consist of Doctors, administrative posts, nurses, nursing supridant, security, ward incharge, nurses in special areas, nurse tutors, student nurses, patient relation officer, ward assistant, dieticians, food service supervisors, kitchen/purchase/store staff, sweepers, ahyas, pathology technicians, ward boys and receptionist.

How many employees are there in the organization?

There are about 1200 employees.

Are there any contract workers?

Yes. A total of 34 employees.

Liftman category employees- 13

Security employees- 21

What are the recruitment practices followed in the hospital?

The recruitment policy of the hospital follows Employee Exchange (compulsory notification of vacancy) Act. We have two different flows for recruitment, one for managerial posts and other for non-managerial posts.

For Managerial posts:

Openings in the newspaper Applications Interviews ShortlistRecruitment and confirmation.

For Non managerial posts:

Openings on Hospital Notice Board Applications Interviews ShortlistRecruitment and confirmation.

If suitable candidates are not found then:

Openings in the newspaper Applications Interviews ShortlistRecruitment and confirmation.

What are promotion related policy in the hospital?

Promotion is based on seniority. Every 12 years the employee is promoted to next class. Yearly increments are given to each employee.

What is the procedure followed in the hospital for grievance handling?

For grievance handling we follow a step wise procedure

The employee should tell his/her problems to immediate supervisor if the dispute is not resolvedHODHR department grievance handling commissionunion managing committee + Vice Chairman of the trust their decision is the final decision.

What are various disciplinary procedures followed at Nanavati hospital?

For termination the following steps are followed:

5. Charge sheet cum enquiry letter is issued, which has the details Detailed record of employee Misconduct concern under Standing Orders Enquiry date and timing

While ‘Suspension cum pending enquiry’ period

First 90 days - 50% of gross salary

After 90 days - 75% of gross salary is paid to the employee.

6. Enquiry officer submits reports after enquiry.7. Explanation is asked from the employee8. If explanation is not received/is unsatisfactory then the employee is terminated.

Resignation: Employee should give one month notice or/else one month salary deduction.

What is the salary structure and when is the salary paid to the employees?

The salary structure consists of basic and various allowances. DA is calculated as per index received from labor commissioner office. It is per point 2.75 as per the agreement.

Salary is paid on 7th of every month. Ex-gratia is paid 10days prior to Diwali.

What is the leave policy in the hospital?

There are a total of 29 leaves per year consisting of 14 casual and 15 sick leaves.

Privilege leaves and maternity leaves are also applicable. Maternity leave is of 12 weeks as per Maternity Benefit Act, 1961

What other benefits are provided to the employees?

Complete injury compensation as per Workman Compensation Act, 1923.

Free treatment to employee/free medical supply to all employees Injury in hospital premises complete treatment and leaves.

Maharashtra Tax on Proffesional/trades, calling and employement act, 1975

Salary Deduction<5000 Nil

5000-10000 175>10000 2500 per anum (200 per month+ 300 in

February)

Maharashtra Labour Welfare fund paid half yearly in month of December and June

Salary Deduction<3000 Employee contribution(EEC)=6

Employer contribution(ERC)=18<3000 Employee contribution(EEC)=12

Employer contribution(ERC)=36

What are labor laws applicable to Charitable hospitals and are followed here at Nanavati?

The various acts applicable are:

Apprentice Act With Rules Bombay Labour Welfare Act, With Rules Bombay Industrial Relations Act Bombay Shops And Establishments Act Contract Labour Act, With Maharashtra Rules Employee Compensation Act, With Rules Employee Provident Fund Act, With Scheme Employee Exchange ( Compulsory Notification Of Vacancy) Act Equal Remuneration Act Industrial Disputes Act, With Maharashtra / Central Rules Industrial Employment ( Standing Orders) Act Maharashtra Workman Minimum HRA Act And Rules Maternity Benefits Act, With Rules Minimum Wages Act, With Rules MRTU And PULP Payment Of Bonus Act, With Rules Payment Of Gratuity Act, With Rules Payment Of Wages, With Maharashtra Rules Trade Unions Act, With Maharashtra Rules

Is there any trade union eisting?

Yes. Mumbai labor union.

1280 members

Is there any incidence of strikes in the past?

No strikes at all.

Any incident of suspension or termination of employee?

30-40 incidents of suspension(usually manual staff) due to absenteeism. No case of termination of employees as it involves Mumbai labor union.

What are the major problems/Challenges faced ?

1. Manpower problem: difficult to get menial staff work properly, high rate of absenteeism due to daily wage payments outside as compared to monthly wage payments in the hospital.

2. Nursing problem: Difficult to find nurses. Previously there was 1.5 years bond period which included 6000 as bond money and originals were kept with the hospital. Due to some suicide case this bond period is scrapped by nursing council. Now it becomes difficult to retain nurses.

What are the steps taken by hospital to tackle these challenges?

An agreement is signed between the hospital and Mumbai labor union, to raise the wages. The major highlights of the acts are as follows:

Bipartite agreement between Dr. Balabhai Nanavati Hospital and Mumbai Labor Union on May 20, 2008.

Applicable to :1. Permanent employee on roll as on 31st March 20072. No benefits to who resigned /dismissed/discharged 3. Arere will be given to retired/expired employee (1.4.2007- 28.5.2008) to the effect

Effects1. 50% hike in salary2. Additional service increments

Years completed in service as on 1.4.2007

Number of increments

Less than 2 NilBetween 2 and 5 2Between 5 and 9 3Between 9 and 13 4Between 13 and 16 5Greater than 16 6

3. Special Allowances : 250 per month 20 to 25 years in service 500 per month greater than 25 years

4. Increase in LTA, Outdoor lunch allowance, Ex-gratia to different extent5. No change sin acting allowances, Cash allowances, attendance bonus, welfare fund,

festive advance

6. Duration of agreement : 4 years(1.4.2007- 31.3.2011) and will remain in force until terminated by any party under ID Act.