Is not serving regular pvt clinic, serving teaching & taking evening calls from Jr. Doctors over ‘taxing’
DAYA SAGAR
The then J&K Governor N. N .Vohra was quoted as having said while he was speaking (01-06-2013 ) at 32nd Annual Conference of North Zone Indian Orthopedic Association at SKICC Srinagar that <(i) The frontiers of science are advancing at a fast pace and we can’t stand by and claim that we know ‘adequately’ well what needs to be done. (ii) It seems difficult to accept that all this is possible when we have a system where we expect our doctors, practitioners and surgeons to work 8 to 10 hours a day and then also do private practice and this particular arrangement needs to be reviewed and looked at in all fairness. A day before that on 31st May 2013 the then J&K Cabinet had considered the proposals moved by Taj Mohi ud Din Minister for Medical Education, Youth Services & Sports for banning private practice by faculty members of Government Medical Colleges, Government Dental Colleges and associated hospitals but it was deferred in view of his not getting support of his own cabinet colleagues. Disallowing private practice to government doctors was more in news after Taj Mohi-ud-Din took over the charge of the Medical Education Ministry to improve the patient-care in the government institutions and Charge of department of Health was not with Minister for Medical Education. Those who plead allowing private practice to government doctors ‘claim’ in support shortage of doctors & need for rendering service in odd hours / emergencies and suggest that if relaxation in service conduct rules for government servants as given to Government Doctors for doing private practice against fee Practice is withdrawn there would be more opportunities to private clinics / private practitioners for fleecing the common man. No doubt when the provision might have been created in earlier days it did have some social pressing needs but the way some government doctors have “converted the provision of consultation to almost like a business enterprise” thereby there being the services in government hospitals are being put under question marks ( except institutions like PGI Chandigarh/ AIIMS Delhi) , there is not that pressing shortage of doctors in private sector / many senior retired government doctors are available in the market / doctors even with MD /MS/ DM/MCh Degrees are under employed in private sector / government job advertisements for government jobs get flooded with applicants, government doctors who do private practice refer emergencies to government hospitals/number of government hospitals has grown in much larger proportion than the population /number of medical colleges has grown many folds after 1947 and ultimately only the government hospitals take the serious emergencies the “loss” being incurred to common cause by the provision of Private Practice by Government doctors is much greater than the social advantage that could at all be anticipated in ‘present environment in the health sector’. There may be surely some doctors who still hold to ethics but the ‘commercial’ culture created around discourages them. The institutions where there is no relaxation in conduct rules permitting private practice the service delivery and commitment levels are much better ( say PGI Chandigarh). And above all as even opined by the then J&K Governor about 10 years back there are many government doctors who do private practice from 6 am to 09:30 am at clinic, then work in government hospital/ college from 10 to 4 PM and then again work in private clinic from 5 PM to 11PM. Imagine what justice they can do to teaching, attending to regular duty in hospital and attending to emergency calls from their juniors back on duty in government hospitals. The requirement for doing away with Private Practice by Govt doctors has become even more pressing in 2023 in UTs like J&K and other states. It is no hidden fact that the provision of private practice by government doctors has instead turned into a “malaise,” which in addition to lowering the quality/ quantity of services by government hospitals is also inflicting serious damages to the common cause becoming part of unfair culture of inflated prescription writing in terms of drugs / investigations. Yes the “Public men” may not feel that much pinch since they have many to serve and enough to “buy”. The provision of the private practice by government doctors was created in relaxation of conduct rules ( like Central Civil Services (Conduct) Rules, 1964 Rule- 15 Private trade or employment/ The Jammu and Kashmir Govt Employees (Conduct) Rules, 1971 Rule -10 1 Private Trade or employment / others ) for in in pious / reasonable common cause and not for increasing income but the same is being taken by the community and those who vote for PP provision more for increasing the income . Not only this, many people are found suggesting that under the garb of Private Practice ( for consultation only) , many practicing doctors these days (1) allegedly look for joining with laboratories / investigation centers and even prescribe un necessary tests (2) the doctors feel more interested in the drug manufacturers and defeating the public welfare programmes like Jan Aushadi Campaign where we find negligible prescriptions being written by chemical / generic name even for patent free drugs (3) and at occasions disproportionately high cost of appliances/ supporting accessories too may be prescribed by some doctors even where item could be avoided. Many people see even the very ‘poor’ growth level of Jan Aushadhi Drugs even after 15 years since the ‘prescription ‘ writers even in government hospitals appeared working more for the ‘trade’ ( whatever small growth is there after 2015 it is only due to personal interest taken by PM Narendra Modi). Due to unfair high ‘costs’ MANY suffer loss in health and some even die without taking adequate & timely medicines for treatment of “self”. So private enterprise under the garb of relaxation in conduct rules to Government Doctors must be with drawn. Not only that even no NPA . Employment to government servant can not parttime. If it is assessed that pay scales /wages of government doctors are less and the public exchequer can afford to pay more , let higher salary be paid to doctors, No, doubt government has authority to make / modify service rules but no government in a democratic country is expected to ignore the basic principles and codes that are must for one who has to directly or indirectly handle /manage/ preserve the common resources / provisions of the State. No doubt , in case it is still felt and assessed that in some remote / distant / rural areas still there is need to allow government doctors to privately see patients before / after office hours then there , on case to case basis , a doctor could be permitted to see patients in ‘off duty’ hours outside hospital/ dispensary /PHC and allowed to receive some payment as honorarium and not fee with clear understanding that relaxation in conduct rules ‘has’ been given not for increasing the income. (The author is a social activist and Senior Columnist J&K affairs dayasagr45@yahoo.com).