A need for grievance cell in health sector

What is it?

Grievance in industrial relations is a technical term. Any one may feel "aggrieved" about the way management has behaved without having cause to raise a grievance. Technically, a grievance is a complaint that the employer has failed to comply with an existing agreement or well-established custom and practice. Grievances are taken by one individual or group of individuals against management about one issue. The grievance will be heard by a panel in a formal hearing according to the agreed upon procedure unless resolved through more informal negotiation first. A member who is dissatisfied with any aspect of his position shall be entitled to utilise the grievance process. A member who feels aggrieved should first discuss his grievance informally with his supervisor. If the member remains dissatisfied, the grievance procedure should be followed.

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In the days of Mughal rule, there was a system of public appearance in a regular interval at Dewan-e-Aam to listen to the people for narrowing down the gap with the ruling class. Nowadays, the regular appearance of the top boss to the subordinates helps in maintaining a congenial working environment. In Bangladesh, the new concept may be introduced as a test case by establishing a grievance cell in the Ministry of Health and Family Welfare for dealing with archaic problems in the sector.

Why?

The tree Ps -- politics, paisa (money) and porichoy (acquaintance) -- prevails in all strata of our society, and has pushed out many honest and hard working officials from the deserved level in their respective careers. Almost everyone believes that the normal official system does not work without tadbir (persuasion and manipulation). "I have passed 25 years of my service life including 15 years as an UHFPO without getting any promotion. Few years left for my retirement and still I didn't get any chance to ventilate my grievances regarding anomalies in my professional career," a disgruntled UHFPO of a remote upazila of a southern district told me. A highly centralised system regulates all posting, transfer, promotions, training etc. which hardly follows the system and encourages tadbir for individual gains.

"After completing my studies in the US, I came back home to join my government job at IEDCR. But the authorities asked me to join at the ministry instead of at my job place. How can I enter into the fortified Secretariat for my joining where normal entrance is simply impossible? I could somehow manage to take my file directly to the Secretary which may not be possible for many others," an official told me, preferring anonymity.

Speaking on managing grievances, Dr. Enamul Karim, Team Leader of UK based health sector development organization HLSP, said a grievance procedure can be followed which will explain the policy on handling grievances and the approach to dealing with them.

Timely management of grievances would help improve the performance of staff, said Dr. Karim and informed that India has introduced grievance management system for last 10 years where Director level officials usually attend the aggrieved staff once a week in lots of institutions.

How it may start?

Two cells -- one in the Ministry of Health and Family Welfare (MoHFW) with Joint Secretary and Joint Secretary (Admin) and another one in the DGHS with DG and Director (Admin) may be set up to listen to the grievances of health officials. The top brass can earmark one or two hour's time in every week to listen to the sufferers on appointment. The system will be very easy and does not have any procedural bottlenecks to get access to the top bosses. A set of grievance procedure report forms may be used to quicken the action.

Benefits

* Deprived/aggrieved officials will have access to the top management.

* Increase management efficiency. Reduce adhocism.

* Act as motivation among all staff.

Not only personal but institutional grievance to be managed through this system. For example, the fuel scarcity for ambulance despite persuasion through official procedure may be solved instantly.

Reduce inordinate delay in some urgent issues which may not occur in the normal file-system.

End words

The system of grievance management is now one of the priority issues which needs to be introduced throughout the public health sector. It will make easier the human resource management function and bring positive changes to the individual staff and the organisation as a whole. However as has been said many times, whatever the management formula you apply, the 'person behind the gun' is as important as the system. We need open and transparent process also to deal with the grievances. What the system will bring is access to someone would not have access otherwise.