Nursing Personnel Convention, 1977 (No. 149) - Jamaica (Ratification: 1984)

Direct Request (CEACR) - adopted 2021, published 110th ILC session (2022)

Article 2 of the Convention. National policy concerning nursing services and personnel. COVID-19 measures. The Committee notes the Government’s response to its previous comments, initially made in 2013, in which it requested the Government to submit additional information on any difficulties related to the shortage of nursing personnel, the current situation of overseas migration of nurses, as well as any targeted measures, programmes or initiatives intended to address these matters. The Government indicates that nursing personnel (including all categories of registered nurses, enrolled assistant nurses and registered midwives), make up the majority of the technical human resources in the public health system. There are currently 3,890 nurses in the Jamaican nursing workforce, out of a required number of 6,700 that are needed, representing a national nursing workforce shortage of approximately 58 per cent. Moreover, there has been a 20 per cent separation rate among the nursing workforce over the past three years. While this percentage is replaced through nine general training schools in Jamaica, a significant number are also migrating. The Government indicates that the ongoing departure of nursing personnel from the public health sector has placed significant pressures on the healthcare delivery system, leading to challenges such as: staff burn-out; increased absenteeism; junior nurses being placed prematurely in supervisory positions without adequate mentoring and coaching; staff shortages resulting in inadequate nursing coverage; and increased attrition among nursing staff. Recruitment agencies from abroad recruit nurses from Jamaica on an ongoing basis, leading to a significant reduction in the number of experienced nurses trained to offer specialized and critical thinking interventions to patients requiring this level of care. According to information from the Nursing Association of Jamaica, from October 2017 to September 2018, a total of 268 nurses resigned from the public sector, out of which some 95 per cent have migrated. The Committee notes the targeted measures taken by the Ministry of Health (MOH) to address attrition of nursing personnel. In particular, the Committee notes the measures taken by the Government, which include ensuring a positive working environment through supportive supervision and organizational management, offering flexi-shifts (shifts of varying lengths and staggered start times) to give nursing personnel flexibility to help them meet their personal obligations. The Government adds that additional measures have been taken, which include providing personalized orientation periods to meet the needs of new nurses, as well as onsite programmes such as childcare centres or gyms, providing sponsorships to enable nursing personnel to undertake post-basic training, specialization and advanced degrees, enhancement of career development pathways, ensuring the provision of adequate facilities and offering financial and non-financial incentives for excellent work, such as education grants and low-interest house and care loans. The Ministry is also engaged in international cooperation with countries for the training and supply of specialist nurses. For example, Jamaica is recruiting specialist nurses from Cuba and India, while the People’s Republic of China and the United Kingdom are assisting in their training. The Committee requests the Government to provide detailed and updated information on the impact of the targeted measures taken by the Ministry of Health (MOH) to address migration and reduce attrition of nursing personnel. The Government is also requested to provide detailed updated information on the manner in which the COVID-19 pandemic and the measures adopted to mitigate its effects have affected the implementation of the objectives of the Convention, as well as challenges encountered and lessons learned.

Articles 3(1) and 7. Nursing education and training. Occupational safety and health of nursing personnel. The Committee notes the information provided by the Government, which responds fully to its previous comments.

Direct Request (CEACR) - adopted 2018, published 108th ILC session (2019)

The Committee notes that the Government’s report has not been received. It hopes that the next report will contain full information on the matters raised in its previous comments initially made in 2013.

Repetition

Article 2 of the Convention. National policy concerning nursing services and personnel. The Committee notes the National Health Policy 2006–15 prepared by the Ministry of Health, in particular the reference to the continuing migration of human resources which leaves a gap among critical occupational groups, including registered nurses, public health nurses and family nurse practitioners. In this connection, the Committee wishes to recall that the World Health Organization (WHO) adopted in 2010 the Global Code of Practice on the International Recruitment of Health Personnel, which provides, among other guiding principles, that the international recruitment of health personnel should be conducted based on the principles of transparency, fairness and promotion of sustainability of health systems in developing countries. The Committee requests the Government to submit additional information on any difficulties related to the shortage of nursing personnel, the current situation of overseas migration of nurses, as well as any targeted measures, programmes or initiatives intended to address these matters.

Articles 3(1) and 7. Nursing education and training – Occupational safety and health of nursing personnel. Further to its previous comments, the Committee requests the Government to provide up-to-date information concerning: (i) the implementation of the decision of CARICOM Ministers on setting the qualification for entry-level professional nurses at the Bachelor level (BSc) by 2011; and (ii) the adoption of a national workplace policy on HIV/AIDS, which appears to have been submitted to the Senate for examination in early 2013. The Committee also requests the Government to provide a copy of the regional curriculum for education and training of nurses adopted in 2007 by the CARICOM Council for Human and Social Development, as well as a copy of the draft policy of the Ministry of Health offering guidance to health care employees as to how to prevent HIV/AIDS at the workplace and how to cope with persons infected with HIV/AIDS.

Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

Article 2 of the Convention. National policy concerning nursing services and personnel. The Committee notes the National Health Policy 2006–15 prepared by the Ministry of Health, in particular the reference to the continuing migration of human resources which leaves a gap among critical occupational groups, including registered nurses, public health nurses and family nurse practitioners. In this connection, the Committee wishes to recall that the World Health Organization (WHO) adopted in 2010 the Global Code of Practice on the International Recruitment of Health Personnel, which provides, among other guiding principles, that the international recruitment of health personnel should be conducted based on the principles of transparency, fairness and promotion of sustainability of health systems in developing countries. The Committee requests the Government to submit additional information on any difficulties related to the shortage of nursing personnel, the current situation of overseas migration of nurses, as well as any targeted measures, programmes or initiatives intended to address these matters.

Articles 3(1) and 7. Nursing education and training – Occupational safety and health of nursing personnel. Further to its previous comments, the Committee requests the Government to provide up-to-date information concerning: (i) the implementation of the decision of CARICOM Ministers on setting the qualification for entry-level professional nurses at the Bachelor level (BSc) by 2011; and (ii) the adoption of a national workplace policy on HIV/AIDS, which appears to have been submitted to the Senate for examination in early 2013. The Committee also requests the Government to provide a copy of the regional curriculum for education and training of nurses adopted in 2007 by the CARICOM Council for Human and Social Development, as well as a copy of the draft policy of the Ministry of Health offering guidance to health care employees as to how to prevent HIV/AIDS at the workplace and how to cope with persons infected with HIV/AIDS.

Observation (CEACR) - adopted 2010, published 100th ILC session (2011)

Article 5(3) of the Convention. Settlement of disputes. The Committee notes the comments of the Nurses Association of Jamaica (NAJ), dated 25 February 2010 and transmitted to the Government on 6 April 2010, concerning the application of the Convention. The NAJ refers to the decision of the Industrial Disputes Tribunal of 15 January 2010, which has called upon the Government to immediately fix a date for the implementation of the reclassification exercise for the health sector, and alleges that the Government has failed to comply with that ruling and remains unresponsive to industrial action undertaken by its members.

The Committee understands that the dispute concerning the Government’s alleged failure to implement the reclassification exercise relates to the retroactive payment of pay increase which had been agreed upon in December 2009. It also understands that the protest of NAJ members has so far taken different forms of civil disobedience, such as wearing black armbands or engaging in sickout action, and the Supreme Court has issued an injunction to prevent further industrial action that might result in severe disruptions in public hospitals.

In view of the apparent escalation of the dispute, the Committee wishes to recall that the Convention requires that the settlement of disputes arising in connection with the determination of terms and conditions of employment of nursing personnel be sought through negotiations between the parties or, in such a manner as to ensure the confidence of the parties involved, through independent and impartial machinery such as mediation, conciliation and voluntary arbitration. This provision reflects the special nature of health care services and seeks to make it unnecessary for the organizations representing nursing personnel to have recourse to such other steps as are normally open to other workers’ organizations in defence of their interests. Moreover, the Committee recalls its previous comment in which it had noted the Government’s indication that despite the Memorandum of Understanding 2006–08 concluded between the NAJ and the Ministry of Health, there had been insufficient negotiations with respect to working conditions, and as a result, hospitals were faced with serious inconvenience, including critical staff shortage in some cases. The Committee requests the Government to transmit any comments it may wish to make in response to the observations of the NAJ. It also asks the Government to provide information on the measures taken or envisaged in order to reach a negotiated solution to the ongoing dispute in a manner consistent with the requirements of the Convention, and to keep the Office informed of any progress made in this respect.

Direct Request (CEACR) - adopted 2009, published 99th ILC session (2010)

Article 2, paragraph 2(b), of the Convention. Employment and working conditions of nursing personnel. Further to its previous comment, the Committee notes the information provided by the Government concerning the difficulties encountered in completing and implementing the reclassification exercise of registered nurses which has been undertaken since March 1999. The Committee requests the Government to give a detailed account of the ongoing reclassification process and its expected impact on the quality of nursing care and the employment conditions of nursing personnel.

In addition, the Committee wishes to refer to the problem of migration of nursing personnel, which is recognized to be a recurrent problem in the Caribbean region, as indicated in the 2005 report of the Caribbean Commission on Health and Development established under the Caribbean Community (CARICOM). The Committee understands that the Caribbean Ministers of Health have endorsed a programme of “managed migration” to ameliorate some of the factors contributory to migration that their countries can control or influence. It requests the Government to supply more detailed information on the shortage of nursing staff and any measures taken or envisaged in order to secure a sustainable domestic nursing workforce while not limiting the workers’ freedom of movement. In this respect, the Committee draws the Government’s attention to the draft WHO code of practice on the international recruitment of health personnel, currently under preparation, which urges member States to enter into bilateral and multilateral arrangements to promote cooperation and coordination on migrant health personnel recruitment processes in order to maximize the benefits and mitigate the potential negative impact of international recruitment of health personnel, and also calls for measures in order to retain and sustain a skilled domestic health workforce by improving their social and economic status, their living and working conditions, their opportunities for employment and their career prospects.

Article 3, paragraph 1. Nursing education and training. The Committee notes the information provided by the Government concerning the decision taken by CARICOM Ministers on the restructuring of nursing training programmes, so that by 2011 the qualification for entry-level professional nurses be at the Bachelor level (BSc). The Committee requests the Government to keep the Office informed of any further developments and to transmit a copy of the regional curriculum for education and training of nurses adopted in 2007 by the CARICOM Council for Human and Social Development.

Article 5, paragraph 2, and Article 6. Collective bargaining concerning employment and working conditions of nursing personnel. The Committee notes the Government’s indication that despite the Memorandum of Understanding 2006–08, which was concluded between the Nurses Association of Jamaica and the Ministry of Health, there have not been sufficient negotiations with respect to working conditions and as a result, hospitals are faced with serious inconveniences, including critical staff shortage in some cases. It requests the Government to provide copies of all collective agreements or other relevant texts currently regulating the conditions of service of nursing staff.

Article 7. Occupational safety and health of nursing personnel. The Committee notes the Government’s indication that a tripartite working group is leading the process to draft and implement a national workplace policy on HIV/AIDS while the Ministry of Health has drafted a policy to guide its employees as to how to prevent HIV/AIDS at the workplace and how to cope with persons infected with and affected by HIV/AIDS. The Committee would appreciate receiving copies of any relevant documents which may have been adopted in this respect. In this connection, the Committee draws the Government’s attention to the Joint ILO/WHO guidelines on health services and HIV/AIDS, published in 2005, with a view to assisting health services in building their capacities to provide their workers with a safe, healthy and decent working environment as the most effective way to both reduce transmission of HIV and to improve the delivery of care to patients. The Committee also wishes to refer to the International Labour Conference discussion held in June 2009 on “HIV/AIDS and the world of work” with a view to adopting an international labour Recommendation, and in particular to paragraph 37 of the proposed conclusions (see ILC, 98th Session, 2009, Report IV(2), page 310) which provides that public health systems should be strengthened, where appropriate, in order to ensure greater access to prevention, treatment, care and support, and to reduce the additional strain on public services, particularly on health workers, caused by HIV/AIDS. The Committee requests the Government to keep the Office informed of any measures that might be taken or envisaged with a view to improving the protection of nursing personnel from infectious diseases, including HIV/AIDS.

Part V of the report form. Application in practice. The Committee notes the statistical information provided by the Government concerning the number of registered nurses and midwives. It would be grateful if the Government would continue supplying up to date information concerning the application of the Convention in practice, including, for instance, the annual number of students attending or graduating from nursing schools, the number of practising nurses registered with the Nursing Council of Jamaica, the nurse-to-population ratio, copies of official reports or studies addressing nursing-related issues, etc.

Direct Request (CEACR) - adopted 2004, published 93rd ILC session (2005)

The Committee notes the latest report submitted by the Government which essentially reproduces the information contained in its previous report.

Articles 2, paragraph 2(b), 3, paragraph 1, and 4 of the Convention. With reference to the reclassification exercise undertaken several years ago which proposed the establishment of nine levels of registered nurses instead of the previous six grades and the repositioning of staff nurses with post-basic courses at a higher level in the salary scale, the Committee requests the Government to supply detailed information on the final outcome of the discussions held between the Health Review Board and the professional associations concerned. The Committee would be particularly interested in receiving copies of all relevant laws or regulations currently in force establishing the requirements for the practice of nursing and also laying down the basic requirements regarding nursing education and training.

Article 5, paragraph 2. The Committee recalls its previous comments in which it observed that the various collective agreements concluded with nurses’ and midwives’ representative organizations dealt only with pay increases and the readjustment of other fringe benefits and allowances for nursing staff, and requested the Government to indicate whether working conditions, other than remuneration levels, are determined by negotiation. In the absence of any clear reply on this point, the Committee is obliged to reiterate its request for up-to-date and documented information regarding any negotiated agreements regulating non-wage-related employment and working conditions of nursing personnel. While noting that negotiations are usually carried out in a biyearly basis, and that copies of collective agreements were last forwarded in 1993, the Committee asks the Government to transmit together with its next report copies of all collective agreements currently in effect applicable to nursing personnel in the public and private sectors.

Article 6. Further to its previous comments on this point, the Committee once again asks the Government to specify and transmit copies of collective agreements or other relevant instruments regulating each of the subjects covered by this Article of the Convention for nursing personnel employed in the private sector.

Article 7. Further to its previous comments concerning the need to take measures to adapt the legislation on health and safety at work to the particular risk of accidental exposure to HIV/AIDS, the Committee requests the Government to report on any new developments or initiatives on these matters.

Part V of the report form. The Committee notes that no statistical information regarding the number of registered nurses and midwives has been communicated in the last ten years. It requests therefore the Government to supply full particulars on the number of nurses currently employed in both the public and private sectors, the nurse-to-population ratio, the number of students attending nursing schools and the number of nurses leaving or joining the profession. It would also appreciate receiving all other information relating to the practical application of the Convention, such as copies of official reports examining the employment and working conditions of nursing personnel (for instance, annual reports of the Nursing Council, activity reports of the chief nurse, etc.), as well as any practical difficulties encountered in the implementation of the Convention. Finally, with regard to the Government’s earlier statement that the Nurses and Midwives Act, 1964 is undergoing revision, the Committee would be grateful if the Government would keep it informed of any progress made in this respect.

Direct Request (CEACR) - adopted 2002, published 91st ILC session (2003)

The Committee notes with regret that the Government’s report contains no reply to previous comments. It hopes that the next report will include full information on the matters raised in its previous direct request, which read as follows:

Article 2, paragraph 2(b), of the Convention. Further to its information concerning the first exercise of reclassification of staff nurses, the Government states that other categories of nurses have been reclassified and that reviewed and rewritten job descriptions have been submitted to a Health Review Board, whose deliberations were now being discussed by the associations and unions. The Committee would appreciate receiving information on the outcome of these discussions.

Article 5, paragraph 2. The Committee notes from the collective agreements supplied together with the Government’s report [agreement concluded between the Ministry of the Public Service (MPS) and the Midwives’ Association of 26 March 1992; between MPS and the Nurses’ Association of Jamaica (NAJ) on 14 September 1992; between MPS and the Jamaica Enrolled Nurses’ Association (JENA), the Jamaica Union of Public Officers and Public Employees (JUPOPE), the National Workers’ Union (NWU) and the Bustamante Industrial Trade Union (BITU) on 5 February 1991] that these agreements are applicable only to financial benefits for nursing staff. Under these agreements, questions such as training (sections 5.0 to 5.6 of the MPS-NAJ agreement), posts (sections 6.0 to 6.4) and improvement of workplace facilities (section 11) are to be dealt with by the Ministry of Health, and professional appointments and post-basic courses (section 3 of the agreement between MPS and JENA, JUPOPE, NWU and BITU) are again to be examined at the local level by the Ministry of Health, as well as the implementation of post-basic courses (section 5) and the reopening of additional training schools (section 6). The Government states in its report that these conditions of employment and work are determined by negotiation for nursing personnel within the public sector and subsequently by private sector nurses. The Committee asks the Government to indicate where the results of these negotiations are laid down, and to provide a copy of such documents.

Article 6(a) and (b). The Committee notes the information concerning this provision of the Convention, as far as nursing staff in the public sector is concerned. It requests the Government to provide copies of collective agreements, if available, regulating each of the subjects covered by this Article in the private sector.

The Committee further notes that because of the shortage of nursing personnel, voluntary additional hours are worked by nurses, and that remuneration for overtime is based on a formula agreed upon during negotiations. It requests the Government to provide the formula in question, and also indicate up to how many hours overtime may be worked and to what extent weekly rest may be forgone.

Article 7. The Committee requests the Government to indicate the measures which have been taken or are envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and of the environment in which it is carried out. Furthermore, with reference to its general observation of 1990, which was reiterated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, in consultation with the employers’ and workers’ organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, by the arrangement of working conditions, confidentiality of test results, recognition that the cause of infection was occupational, etc.

Part V of the report form. The Committee notes the information supplied and hopes that the availability of nursing services will improve with the graduation of the latest nursing class. It asks the Government to continue to supply the information requested under this point regarding the manner in which effect is given to the Convention in practice. The Committee would also appreciate receiving a copy of the Nurses and Midwives Act, which according to the Government is still under revision, upon its adoption.

Direct Request (CEACR) - adopted 2001, published 90th ILC session (2002)

The Committee notes with regret that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

        Article 2, paragraph 2(b), of the Convention. Further to its information concerning the first exercise of reclassification of staff nurses, the Government states that other categories of nurses have been reclassified and that reviewed and rewritten job descriptions have been submitted to a Health Review Board, whose deliberations were now being discussed by the associations and unions. The Committee would appreciate receiving information on the outcome of these discussions.

        Article 5, paragraph 2. The Committee notes from the collective agreements supplied together with the Government’s report [agreement concluded between the Ministry of the Public Service (MPS) and the Midwives’ Association of 26 March 1992; between MPS and the Nurses’ Association of Jamaica (NAJ) on 14 September 1992; between MPS and the Jamaica Enrolled Nurses’ Association (JENA), the Jamaica Union of Public Officers and Public Employees (JUPOPE), the National Workers' Union (NWU) and the Bustamante Industrial Trade Union (BITU) on 5 February 1991] that these agreements are applicable only to financial benefits for nursing staff. Under these agreements, questions such as training (sections 5.0 to 5.6 of the MPS-NAJ agreement), posts (sections 6.0 to 6.4) and improvement of workplace facilities (section 11) are to be dealt with by the Ministry of Health, and professional appointments and post-basic courses (section 3 of the agreement between MPS and JENA, JUPOPE, NWU and BITU) are again to be examined at the local level by the Ministry of Health, as well as the implementation of post-basic courses (section 5) and the reopening of additional training schools (section 6). The Government states in its report that these conditions of employment and work are determined by negotiation for nursing personnel within the public sector and subsequently by private sector nurses. The Committee asks the Government to indicate where the results of these negotiations are laid down, and to provide a copy of such documents.

        Article 6(a) and (b). The Committee notes the information concerning this provision of the Convention, as far as nursing staff in the public sector is concerned. It requests the Government to provide copies of collective agreements, if available, regulating each of the subjects covered by this Article in the private sector.

        The Committee further notes that because of the shortage of nursing personnel, voluntary additional hours are worked by nurses, and that remuneration for overtime is based on a formula agreed upon during negotiations. It requests the Government to provide the formula in question, and also indicate up to how many hours overtime may be worked and to what extent weekly rest may be forgone.

        Article 7. The Committee requests the Government to indicate the measures which have been taken or are envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and of the environment in which it is carried out. Furthermore, with reference to its general observation of 1990, which was reiterated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, in consultation with the employers’ and workers’ organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, by the arrangement of working conditions, confidentiality of test results, recognition that the cause of infection was occupational, etc.

        Part V of the report form. The Committee notes the information supplied and hopes that the availability of nursing services will improve with the graduation of the latest nursing class. It asks the Government to continue to supply the information requested under this point regarding the manner in which effect is given to the Convention in practice. The Committee would also appreciate receiving a copy of the Nurses and Midwives Act, which according to the Government is still under revision, upon its adoption.

Direct Request (CEACR) - adopted 2000, published 89th ILC session (2001)

The Committee notes with regret that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which reads as follows:

Article 2, paragraph 2(b), of the Convention.  Further to its information concerning the first exercise of reclassification of staff nurses, the Government states that other categories of nurses have been reclassified and that reviewed and rewritten job descriptions have been submitted to a Health Review Board, whose deliberations were now being discussed by the associations and unions. The Committee would appreciate receiving information on the outcome of these discussions.

Article 5, paragraph 2.  The Committee notes from the collective agreements supplied together with the Government’s report [agreement concluded between the Ministry of the Public Service (MPS) and the Midwives’ Association of 26 March 1992; between MPS and the Nurses’ Association of Jamaica (NAJ) on 14 September 1992; between MPS and the Jamaica Enrolled Nurses’ Association (JENA), the Jamaica Union of Public Officers and Public Employees (JUPOPE), the National Workers' Union (NWU) and the Bustamante Industrial Trade Union (BITU) on 5 February 1991] that these agreements are applicable only to financial benefits for nursing staff. Under these agreements, questions such as training (sections 5.0 to 5.6 of the MPS-NAJ agreement), posts (sections 6.0 to 6.4) and improvement of workplace facilities (section 11) are to be dealt with by the Ministry of Health, and professional appointments and post-basic courses (section 3 of the agreement between MPS and JENA, JUPOPE, NWU and BITU) are again to be examined at the local level by the Ministry of Health, as well as the implementation of post-basic courses (section 5) and the reopening of additional training schools (section 6). The Government states in its report that these conditions of employment and work are determined by negotiation for nursing personnel within the public sector and subsequently by private sector nurses. The Committee asks the Government to indicate where the results of these negotiations are laid down, and to provide a copy of such documents.

Article 6(a) and (b).  The Committee notes the information concerning this provision of the Convention, as far as nursing staff in the public sector is concerned. It requests the Government to provide copies of collective agreements, if available, regulating each of the subjects covered by this Article in the private sector.

The Committee further notes that because of the shortage of nursing personnel, voluntary additional hours are worked by nurses, and that remuneration for overtime is based on a formula agreed upon during negotiations. It requests the Government to provide the formula in question, and also indicate up to how many hours overtime may be worked and to what extent weekly rest may be forgone.

Article 7.  The Committee requests the Government to indicate the measures which have been taken or are envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and of the environment in which it is carried out. Furthermore, with reference to its general observation of 1990, which was reiterated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, in consultation with the employers’ and workers’ organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, by the arrangement of working conditions, confidentiality of test results, recognition that the cause of infection was occupational, etc.

Part V of the report form.  The Committee notes the information supplied and hopes that the availability of nursing services will improve with the graduation of the latest nursing class. It asks the Government to continue to supply the information requested under this point regarding the manner in which effect is given to the Convention in practice. The Committee would also appreciate receiving a copy of the Nurses and Midwives Act, which according to the Government is still under revision, upon its adoption.

Direct Request (CEACR) - adopted 1999, published 88th ILC session (2000)

The Committee notes that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

The Committee notes the information supplied by the Government in reply to its previous comments concerning Article 5, paragraph 3, of the Convention.

Article 2, paragraph 2(b). Further to its information concerning the first exercise of reclassification of staff nurses, the Government states that other categories of nurses have been reclassified and that reviewed and rewritten job descriptions have been submitted to a Health Review Board, whose deliberations were now being discussed by the associations and unions. The Committee would appreciate receiving information on the outcome of these discussions.

Article 5, paragraph 2. The Committee notes from the collective agreements supplied together with the Government's report [agreement concluded between the Ministry of the Public Service (MPS) and the Midwives' Association of 26 March 1992; between MPS and the Nurses' Association of Jamaica (NAJ) on 14 September 1992; between MPS and the Jamaica Enrolled Nurses' Association (JENA), the Jamaica Union of Public Officers and Public Employees (JUPOPE), the National Workers' Union (NWU) and the Bustamante Industrial Trade Union (BITU) on 5 February 1991] that these agreements are applicable only to financial benefits for nursing staff. Under these agreements, questions such as training (sections 5.0 to 5.6 of the MPS-NAJ agreement), posts (sections 6.0 to 6.4) and improvement of workplace facilities (section 11) are to be dealt with by the Ministry of Health, and professional appointments and post-basic courses (section 3 of the agreement between MPS and JENA, JUPOPE, NWU and BITU) are again to be examined at the local level by the Ministry of Health, as well as the implementation of post-basic courses (section 5) and the reopening of additional training schools (section 6). The Government states in its report that these conditions of employment and work are determined by negotiation for nursing personnel within the public sector and subsequently by private sector nurses. The Committee asks the Government to indicate where the results of these negotiations are laid down, and to provide a copy of such documents.

Article 6(a) and (b). The Committee notes the information concerning this provision of the Convention, as far as nursing staff in the public sector is concerned. It requests the Government to provide copies of collective agreements, if available, regulating each of the subjects covered by this Article in the private sector.

The Committee further notes that because of the shortage of nursing personnel, voluntary additional hours are worked by nurses, and that remuneration for overtime is based on a formula agreed upon during negotiations. It requests the Government to provide the formula in question, and also indicate up to how many hours overtime may be worked and to what extent weekly rest may be forgone.

Article 7. The Committee requests the Government to indicate the measures which have been taken or are envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and of the environment in which it is carried out. Furthermore, with reference to its general observation of 1990, which was reiterated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, in consultation with the employers' and workers' organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, by the arrangement of working conditions, confidentiality of test results, recognition that the cause of infection was occupational, etc.

Part V of the report form. The Committee notes the information supplied and hopes that the availability of nursing services will improve with the graduation of the latest nursing class. It asks the Government to continue to supply the information requested under this point regarding the manner in which effect is given to the Convention in practice. The Committee would also appreciate receiving a copy of the Nurses and Midwives Act, which according to the Government is still under revision, upon its adoption.

Direct Request (CEACR) - adopted 1995, published 82nd ILC session (1995)

The Committee notes the information supplied by the Government in reply to its previous comments concerning Article 5, paragraph 3, of the Convention.

Article 2, paragraph 2(b). Further to its information concerning the first exercise of reclassification of staff nurses, the Government states that other categories of nurses have been reclassified and that reviewed and rewritten job descriptions have been submitted to a Health Review Board, whose deliberations were now being discussed by the associations and unions. The Committee would appreciate receiving information on the outcome of these discussions.

Article 5, paragraph 2. The Committee notes from the collective agreements supplied together with the Government's report (agreement concluded between the Ministry of the Public Service (MPS) and the Midwives' Association of 26 March 1992; between MPS and the Nurses' Association of Jamaica (NAJ) on 14 September 1992; between MPS and the Jamaica Enrolled Nurses' Association (JENA), the Jamaica Union of Public Officers and Public Employees (JUPOPE), the National Workers' Union (NWU) and the Bustamante Industrial Trade Union (BITU) on 5 February 1991) that these agreements are applicable only to financial benefits for nursing staff. Under these agreements, questions such as training (sections 5.0 to 5.6 of the MPS-NAJ agreement), posts (sections 6.0 to 6.4) and improvement of workplace facilities (section 11) are to be dealt with by the Ministry of Health, and professional appointments and post-basic courses (section 3 of the agreement between MPS and JENA, JUPOPE, NWU and BITU) are again to be examined at the local level by the Ministry of Health, as well as the implementation of post-basic courses (section 5) and the reopening of additional training schools (section 6). The Government states in its report that these conditions of employment and work are determined by negotiation for nursing personnel within the public sector and subsequently by private sector nurses. The Committee asks the Government to indicate where the results of these negotiations are laid down, and to provide a copy of such documents.

Article 6(a) and (b). The Committee notes the information concerning this provision of the Convention, as far as nursing staff in the public sector is concerned. It requests the Government to provide copies of collective agreements, if available, regulating each of the subjects covered by this Article in the private sector.

The Committee further notes that because of the shortage of nursing personnel, voluntary additional hours are worked by nurses, and that remuneration for overtime is based on a formula agreed upon during negotiations. It requests the Government to provide the formula in question, and also indicate up to how many hours overtime may be worked and to what extent weekly rest may be forgone.

Article 7. The Committee requests the Government to indicate the measures which have been taken or are envisaged to improve existing laws and regulations on occupational health and safety by adapting them to the special nature of nursing work and of the environment in which it is carried out. Furthermore, with reference to its general observation of 1990, which was reiterated in 1994, the Committee requests the Government to indicate the measures which have been taken or are envisaged, in consultation with the employers' and workers' organizations concerned, to take into account the particular risk of accidental exposure to the human immunodeficiency virus (HIV) among nursing personnel: for example, by the arrangement of working conditions, confidentiality of test results, recognition that the cause of infection was occupational, etc.

Point V of the report form. The Committee notes the information supplied and hopes that the availability of nursing services will improve with the graduation of the latest nursing class. It asks the Government to continue to supply the information requested under this point regarding the manner in which effect is given to the Convention in practice. The Committee would also appreciate receiving a copy of the Nurses and Midwives Act, which according to the Government is still under revision, upon its adoption.

Direct Request (CEACR) - adopted 1992, published 79th ILC session (1992)

The Committee notes the information supplied by the Government's report in reply to its previous comments concerning Article 1, paragraphs 1 and 3, Article 2, paragraphs 2, 3 and 4 and Article 5, paragraph 1, of the Convention. It requests the Government to provide additional information on the following points:

Article 2, paragraph 2(b). The Government refers to its first exercise in reclassification of registered nurses which is under way. The Committee would appreciate receiving additional details on this exercise and on any other efforts which have been undertaken or are envisaged in respect of the employment and working conditions of nursing personnel.

Article 5, paragraph 2. The Committee notes from the interim agreement concluded at 21 August 1990 supplied by the Government that this agreement is applicable only to wages. Please indicate whether other conditions of employment and work are also determined by negotiation and whether there is such agreement applicable to nursing personnel in the private and public sectors in these areas, and, if so, supply copies of these collective agreements.

Article 5, paragraph 3. The Committee notes the procedures described by the Government which are related to the settlement of disputes arising in connection with the determination of terms and conditions of employment. The Committee would be grateful if the Government would provide more comprehensive and detailed information on the settlement machinery to which it refers and on the role of the organisations representing nursing personnel in this process.

Article 6. The Government indicates in its report that nursing personnel in the public sector enjoy the same working conditions as other public servants. Please supply the copies of the provisions which apply in respect of (a) hours of work; (b) weekly rest; (c) paid annual holidays; (d) educational leave; (e) maternity leave; (f) sick leave; (g) social security. Please provide also copies of collective agreements, if available, regulating each of the subjects covered by this Article in the private sector.

Article 7. The Committee notes the efforts undertaken by the Government to give effect to this requirement of the Convention. Please indicate whether any special measures have been taken or are envisaged to improve laws and regulations on other aspects of occupational health and safety by adapting them to the special nature of nursing work.

Point V of the report form. Please continue to supply the information requested under this point of the report form regarding the manner in which effect is given to the Convention in practice. The Committee would also appreciate receiving a copy of the Nurses and Midwives Act, 1964 which appears to be under revision, upon its adoption.

Direct Request (CEACR) - adopted 1990, published 77th ILC session (1990)

The Committee has taken note of the detailed information supplied by the Government in its first report and would be grateful if it would communicate additional information on the following points:

Article 1, paragraph 2, of the Convention. The Government refers in its report to nursing personnel in the public sector. Bearing in mind that the Convention applies to "all nursing personnel wherever they work", please indicate in what manner and under what legal or conventional provisions the Convention is also applied to nursing personnel in the private sector. (Please supply a copy of these provisions and the text of the Nurses and Midwives Act, 1964.)

Article 1, paragraph 3. The Government states in its report that the general policy on voluntary services adopted by the Ministry of Health also covers persons who provide nursing care and services on that basis. Please give more detailed information on this policy and indicate if special provisions have been adopted to cover the persons in question, and, if so, please communicate the text.

Article 2, paragraph 1. The Committee takes note of the information on the policy concerning nursing services and personnel formulated by the Ministry of Health and the Nursing Associations. Please supply details on the implementation of this policy and on the guiding principles in the matter of administration, training and research established by the Regional Nursing Body and the International Council of Nurses for the countries of the region. The Committee would appreciate more comprehensive information: (a) on the implementation of the draft classification of patients mentioned by the Government, which should provide a scientific basis for planning nursing personnel; and (b) on the role and composition of the Nursing Council.

Article 2, paragraph 2(b). The Government refers in its report to certain measures taken following negotiations with the trade union organisations representing nursing personnel, on the subject of remuneration and career prospects for this personnel but it indicates that these measures are not sufficient to retain members of this personnel in the profession. The Committee notes in fact that, according to the statistical data communicated with the report, the number of persons who have left the profession is very high in relation to the total membership of the profession (1,253 out of a total of 3,152). The Committee hopes that the Government will not fail to take the necessary measures to remedy the situation and to provide nursing personnel with employment and working conditions (including career prospects and remuneration) which are likely to attract persons to the profession and retain them in it, and are comparable to those applying to other categories of workers who perform work of equal value although of a different nature. The Committee would be grateful if the Government would indicate all progress made in this respect.

Article 2, paragraphs 3 and 4. In its report the Government mentions consultations which had taken place between the Ministry of Health and the Nursing Associations when the policy concerning nursing personnel was being formulated and also refers to the co-ordination between the Ministry and the above-mentioned Associations. Please supply more comprehensive information on these consultations and indicate the manner in which the policy concerning nursing services and nursing personnel is being co-ordinated with policies relating to other aspects of health care and to other workers in the field of health. Are the employers' and workers' organisations concerned consulted in this matter?

Article 5, paragraphs 1 and 2. Please indicate in what way nursing personnel are encouraged to participate in the planning of nursing services and if they are consulted on decisions which concern them both at national level and at the level of the hospital establishments where they work. Please state also whether there are collective agreements which determine working and employment conditions for nursing personnel in the public and private sectors and if so please communicate a copy.

Article 5, paragraph 3. The Committee has taken note of the information provided by the Government on procedures for the settlement of disputes arising in connection with the determination of employment conditions of nursing personnel. It has however noted that, according to the first schedule to Act No. 14 of 1975 on industrial relations and industrial disputes that health services, hospital services and sanitary services are considered as being "essential services" and that, for this reason, industrial disputes concerning them may be submitted to compulsory arbitration under the terms of article 9 of this law. The Committee would be grateful if the Government would indicate the manner in which this arbitration system ensures safeguards contained in the above provision of the Convention, according to which the settlement of disputes shall be sought through negotiation between the parties or in such a manner as to ensure the confidence of the parties involved through independent and impartial machinery such as mediation, conciliation and voluntary arbitration.

Article 6, paragraphs (a) to (g). The Government indicates in its report that conditions of employment for nursing personnel are based on those contained in the regulations on public servants and are established by means of negotiation with the professional organisations concerned or by the Ministry of Health in collaboration with the nursing personnel. Please provide the text of the legal, statutory or conventional provisions governing conditions of employment of nursing personnel in the public and private sectors in the fields covered in paragraphs (a) to (g) of the above-mentioned provision of the Convention and specify also whether these conditions are at least equivalent to those enjoyed by the other workers in the country. Please state also whether nursing personnel is covered by the national insurance law.

Article 7. The Government states in its report that health and safety at the workplace is one of the Ministry of Health's priority programmes. It adds that existing legislation in this matter is not designed specifically for nursing personnel but that it could be partially modified and adapted to the needs of this personnel. The Committee takes note of this statement and hopes that the Government will endeavour to improve legislation on occupational health and safety so as to take into account the special nature of nursing work and of the environment in which it is carried out.

Point V of the report form. The Committee has taken note of the statistical data and the other practical information communicated by the Government and hopes that the latter will continue to provide such information in its future reports.