On the afternoon of Monday 17 December 2018, a fire broke out at the Employee State Insurance Corporation Kamgar Hospital in Andheri, Mumbai. The ESIC aimed at providing workers healthcare facilities consumed the lives of 7 workers and a 6-month old baby and injured over 176 more, 3 of whom are firefighters. 25 patients including 5 babies are reported to be in a critical condition. It took several hours to douse the fire despite the dedicated efforts of the Mumbai Fire Brigade. The fire was caused by an electrical short circuit on the ground floor where rubber rolls were stored. The fire entered the electrical ducts and spread through the building.
This ESIC Hospital was established in 1977 as a 600 bed hospital which was downgraded to 325 beds in 2007. The very next year the ESIC decided to transform it into a ‘model hospital’ for which over Rs. 260 crores were allocated. A decade later this task is still incomplete.
Self-certification vs Workers’ Safety
According to the ESIC Employees Union, over half the flooring in the building remains unlaid, leakages and water logging are rampant throughout the facilities and the ground floor has been converted into a dump yard for construction material. The hospital has completely disregarded the standard fire safety protocol. Officials in the Fire Department report that while passive fire-fighting systems like emergency exits and dedicated stairwells exist, the active fire-fighting systems like fire extinguishers, sprinklers, etc. are non-functioning. The Hospital did not even have a no-objection certificate (NOC) from the Mumbai Industrial Development Corporation and the fire department. The hospital had made an application for a Fire NOC for the expanded facilities but this was rejected due to irregularities noted in installations and dearth of requisite fire equipment. No applications were made subsequently.
While this may be attributed to lax management, at the base of this lies the shift in the government policy for enforcing safety. In 2017, the Maharashtra government like other BJP ruled states mooted self-certification procedures for fire safety citing a lack of resources, human and financial, available with concerned departments. As per these new procedures, buildings including hospitals were to obtain a “Certificate of Compliance with Provisional Fire Approval submitted by License Agency appointed by the company.” The only role the MIDC and fire department had in this process was to check for outstanding dues and to issue certificates. All regular inspection procedures were discarded. Self-certification has become the cornerstone of industrial policy of the BJP led governments at the centre and in the states.
Is Health important to Government?
Alongside the government has been running down ESIC hospitals by diverting resources to projects such as building medical colleges and of course seeking to merge the ESIC into the Social Security Code which guarantees no rights for workers. There has also been a decline in government spending as a proportion of GDP on healthcare, which is now down to 1.3% of GDP. As the BJP government seeks to push the entire population, including workers, towards private insurance companies for their healthcare needs under Ayushman Bharat, Prime Minister Narendra Modi has lately been claiming that spending on healthcare will go up to 2.5% of GDP by 2025!
Official probes into the fire, like that ordered by Maharashtra Chief Minister Devendra Fadnavis will have little impact unless they probe into the disastrous fall-out of self-certification on the lives and work conditions of working people, the systematic running down of ESI and other government healthcare facilities and the reduction of both state and central government expenditure on healthcare.
The NTUI demands:
- Withdrawal of ‘self-certification’ rules and the institutionalising of exhaustive machinery of inspection including under ILO Convention 81,
- Review of all ESIC hospitals with a clear timetable for revival of all hospitals,
- Withdrawal of Social Security Code to be followed by active and open engagement between government and trade unions on both workers health and all other issues of social security including pension.