Misuse of relaxation in conduct rules allowing Govt Doctors Pvt. Practice is also eating into government efforts
DAYA SAGAR
Often there are debates and discussion regarding the health services available in India and references quality/ quantum of health services available in some developed countries like US/UK /Europe / UAE too are made there in. Any shortfalls that are assessed are mostly reasoned for India having a very large population and India being a ‘developing’ country / economically not that effluent. No doubt others may have better resources but India too has as per some well connected quotes in 2023 atleast 660 Medical Colleges with 1,01,148 MBBS seats and 65335 PG seats.
No one stops those with less resources to use their resources, as far as possible, efficiently. And there exists a lot of scope to increase the efficiency ( quality/ quantity wise) of the government hospitals in India. Even the resources /the amount of finances that have been deployed / are being deployed presently in India can still deliver health services at more reasonable cost and efficiency to a large part of common masses of India worth comparing to many of good economies.
For getting an idea to fix the parameters for conducting a logical study it has to be kept in view that atleast 90%of ailments with which people suffer can be treated by those drugs that are free from any patents , that atleast 95 % of the suffering masses do not need any super specialty attention ( can be served by MBBS/BAMS/BDS/ MS/MD doctors. We may be needing more doctors and what is ideal number shall always remain debatable but it has to be agreed upon that in case the resources and services are adequately programmed, deployed and teamed the quantum of services levels could be reasonably increased over what we are observing in India today.
No doubt we may find even in cities like Jammu people rushing to private clinics of government doctors with MS/ DM degrees even for normal bad cold / regular digestion problems. It is not because people are economically well placed , more of reason is that the level of faith that people hold in government hospitals and commitment doctors while working there in has reasonable declined ( even senior bureaucrats / MP/MLAs/Ministers do not demonstrate that much ‘fascination’ for the ‘systems’ they get installed/manage out of public resources . What to talk of the common man, even superior bureaucrats and the political masters appear having lost faith in the dependability of government health services, why ?
But still it has to be accepted that when comes the question of emergency / serious ailment they run to Government Medical College Jammu since the private clinics / hospitals do not entertain. Government Hospitals In India are still serving a very large population , all most all the preventive health care jobs / services are being rendered by government institutions, still most of the serious ailments, emergencies and interventions are being done / handled /nursed by government hospitals. The people in India are unnecessarily shelling out of their pockets on average a few thousand rupees every year through consultations / treatments/investigations via in private hospitals / private clinics/ private clinic of government doctors who are permitted private practice during off hours in relaxation of conduct rules for government employees ( some government employee associations / unions of engineers / those with professional qualifications has also started demanding relaxation in service conduct rules to allow them do private consultations like is to doctors in government service in J&K) whereas had the Govt Health infrastructure performed even in proportionate the financial inputs the governments have been so far making. In the earlier years for social reasons / public health reasons government doctors were in relaxation of conduct rules for public service were allowed to attend emergencies /local calls during off hours and also accept some ‘fee’ ( honorarium). But over the years the social concept has been lost, under the garb of permission for local clinical consultation people have started using the relaxation like a license for enterprise and which has surely made the public health service system “sick” due to taking undue advantage by them which is also affecting the efficiency / commitment of those who really want to serve. It was reported in media on November 27, 2019 that Medical Superintendent of Govt Medical College Jammu Dr Dara Singh had written a letter to GMC Principal that revenue collection for MRI which was Rs 10,00,000 and Rs 2,79,700 for CT scan in August 2019 was just Rs 5,02,500 for MRI and Rs 1,58,300 for CR Scan in Oct . Som Nath Dabgotra, an RTI activist was quoted as having said ” Recently, three to four private new radio diagnostics centres for MRI and CT Scan have been inaugurated around the GMC complex in Bakshi Nagar. This is why the majority of doctors referring the patients to these private centres
No doubt it is not that bad everywhere in the Government hospitals / Health institutions/ Research institutions in India since we can still quote example institutions in India like PGI Chandigarh , AIIMS Delhi rendering health care to very serious patients / critical cases / even normal ailments / common masses in numbers much more than their installed capacity since the masses believe in the promptness & quality of services rendered by doctors there with lesser cost / effort implications. One of the main reasons for the better delivery of services by institutions like PGI Chandigarh , AIIMS Delhi has been assessed by those who observe/ analyze the affairs has been that Private Practice to Doctors working in these institutions has been ” banned”. Rather in other words the conduct rules have not been relaxed there to allow government doctors to do private practice.
It has to be taken note that private practice had not been allowed for increasing income and hence there should also be no NPA. And in case government considers the opinion of those who support income increasing then NPA should be given to engineers as well.
The menace of unfair practices under the garb of private practice has gone so ‘daring’ in J&K that even some Head of Departments of Jammu Medical College had been doing private practice/ operations openly in private clinics. Fair case for LG to appoint a commission to isolate such cases during 2023-24 only.
(The author is a Sr Journalist and a social activist and can be mailed at dayasagr45@yahoo.com).