Nurses’ levy increments: Implications for the Ghanaian nurse

Preceding events and matters arising from the national delegates conference of the Ghana Registered Nurses and Midwives Association (GRNMA) held from 22nd to 24th November, 2017 in Cape Coast leaves much to be desired for many well-meaning nurses in Ghana and in the diaspora.

Perhaps, this is an opportunity to take a closer look at the administration of the GRNMA and the way forward for the nursing profession which we purport to love. It is indeed a sad turnout of events, waking up to reports from the 16th Biennial National Delegates Conference, which inter alia have suggested upward revisions in association dues from 1.5% to 2% of basic salary (25% increment); Building Levy from GHS 10.00 to GHS 20.00 (100% increment); and Nurses Fund from GHS 20.00 to GHS 50.00 (150% increment).

It must be stressed that the move to carry out these increments appears to be insensitive to the working conditions of the common Ghanaian nurse. Not only are the increments overly ambitious, the timing is nothing short of mischievous and does not foment good faith with the Ghanaian nurse.

There is no doubt whatsoever that the modern day association runs on funding; however, hiking levies are not the only way to go. In fact, if the association had been more responsive to the needs and interests of its members by negotiating for better conditions of service in the first place, revenue generation would have been easier and less onerous to members. The GRNMA by far remains the largest association of healthcare professionals in Ghana.

This by default suggests that the association wields the highest leverage at the negotiation table in terms of salaries and conditions of service. By failing to recognize this leverage and not exercising it in the interest of its members, the association also fails in championing its primary mandate, which is to protect the interests of the Ghanaian nurse.

Now, in the light of the many sentiments emanating from the upward adjustments in the various levies, it is only proper that the move be suspended abruptly until such a time that it is economically feasible for members. There are many members with various monthly financial commitments, including servicing of loan facilities. Increasing association levies without a substantially commensurate increase in the salaries of members further reduces the revenue base for such members.

To this extent, suffice it to say that until such a time that salaries of nurses are reviewed substantially upward, it would be malicious to attempt to upwardly review association dues. Perhaps, this is also an opportunity to go back to the negotiation table to set right what have been done amiss over the years as far as salaries and conditions of service are concerned.

Having mentioned the above, there are other critical issues that the GRNMA must actively pursue, beside creating avenues to amass membership dues ---issues that are directly enshrined as constitutional obligations of the association. For the avoidance of controversy, the GRNMA per the constitution inter alia must seek to “Promote…the dignity of the profession; Maintain the honour and independence of the profession…; Promote nursing education and research; and Promote and support law reforms on matters affecting the nursing profession.”

In pursuance of these objectives, it is only proper that the appropriate foundation is laid. Nursing in Ghana and the GRNMA have come a long way, for which reason it is proper to render credit to the forerunners. That notwithstanding, it is not far-fetched to observe that the fundamental training and socialisation system over the years underpin the fiscal and socio-political challenges that bedevil the profession. Today, medical doctors are accessing sponsorships to pursue relevant programmes such as Law, Economics, Finance, Political Science, Human Resource Management, etc in order to offset similar challenges.

Eventually, curricula for nursing education must even be revised to address these concerns. Today, nurses practicing in private facilities are exposed to various forms of financial malfeasance, and those in public facilities have not been spared professional subjugation. Nurses have limited access to and information about the Nurses Fund which is administered by Axis Pension Trust, and offices of the trust seem non-existent.

These are the issues that the GRNMA must actively seek to pursue with strategic advocacy and commitment in order to achieve the objectives of the association. It may be argued that undertaking these commitments require funding, which is undoubtedly so; but if the nurse is shown the least gesture toward these ends, she may be inclined to pay more to see it through.

Finally, transparency and accountability on the part of the GRNMA have not been satisfactory over the years, and these are fundamental motivation factors for revenue contribution. Like the common Ghanaian, nurses are increasingly becoming discerning and interested in issues affecting their wellbeing; and social media has become a viable platform for the influx and reflux of information.

Until such a time that the nurse in the CHIPS compound at ‘Brahabebome’ is aware of how the association spent her 20 pesewas, tension and dissentions will continue to brew whenever similar motions to raise levies are adopted. The GRNMA under the leadership of Mr. Asante Krobea must take advantage of the social transition, engage its members in accordance with the dictates of the constitution and bury this melee for good.