Recently the honourable
minister for health came up with another genius plan to overhaul the health
department. A three tier roster for the doctors
working in the health department was proposed.
The doctors working in the department reacted sharply questioning the
very basis of the plan. The doctor
bodies even threatened industrial action if the plan was forced on them. I am still to hear from anyone if the
proposal is workable and it seems that even the common sense has been kept at a
distance. I am not advocating that
doctors should not work, or work less or run way from on call and night
duties. But it would be interesting to
know who came up with this idea. Was it the health ministers himself or his clever
advisors? Surely whosoever it was does not seem to understand the basic
problems or does not care to know.
One must be either naïve
or idiotic to conceive the idea of starting a shift at twelve in the midnight where
by a new doctor is supposed to come in and relieve the doctor on duty. What about the prevailing situation in Jammu
and Kashmir, conflict, insecurity, poor roads, lack of resources to mention a few?
Would the authorities be kind enough to explain where a lady doctor will go if
she has to leave the hospital at twelve midnight? Who would be responsible if any doctor is
harmed in the process? Is there a proposal of constructing staff quarters at every
hospital? Are there plans to provide transport and security to doctors when
they go home?
What is the current
staffing level and doctor patient ratio in the state? Can the current number of doctors cope with
this kind of rota? If a doctor has to work whole week without any break or
rest, how safe is it for the patients being treated? There are only questions
and no solution. This has caused further unrest in already overburdened doctor
fraternity. It seems that such orders or
rhetoric is deliberate to mislead common people from the basic issue of lack of
appropriate health service in the state.
There are so many other
examples of such orders since this government took charge. Humiliating doctors seems part of the plan,
should it be the senior most doctors working as Principal Medical College Srinagar
or a female psychiatrist in Jammu. Sadly
the honourable health minister was seen physically pulling a doctor’s collar
recently. I wonder does law of the land permit anyone to
behave like this. In another example, it
was ordered to arrest a doctor and other staff members of a hospital who had
been on a picnic, probably to please the local headman. Also hefty fines are being imposed on the
staff for not doing their job, which not only speaks about lack of vision but
also regressive approach to improve any system.
Is there no legal framework in that state? Surely there must be some rules and
regulations. If someone is not attending
duties properly, action needs to be taken after proper fact finding than
following an appeasement policy. As an
elected representative, how can one think and behave like a dictator is
amusing.
Similarly an order was
passed making prescribing by generic names mandatory for doctors without
thinking about how that will work on ground. When there are no regulated pharmacies
in the state, anyone can sell and buy medication, how was the policy supposed
to make any positive impact and not do more harm? If this is about fooling people, surely there
are other ways to do that. But let’s not
forget health is a serious issue and how long can one fool the voters by
polarising and rhetoric. The issue of
private practice by doctors is another favourite past time brought up often to
cover the failings of the system without any proper alternative whatsoever. Huge
threats are made in media without any action or a plan of action.
In another bizarre
statement the health minister came up with the impractical idea of mandatory
five year service for doctors.
Apparently he wants to pass an order to prevent any doctor leaving the
state to curb the shortage of staff. Let
us not forget that Jammu and Kashmir is the only place where doctors are
jobless and if he actually wants to improve the staffing levels, why not
recruit? He actually reduced the number
of posts in the department by recruiting allied professionals on the assistant
surgeon posts. None of the announcements
or policies made so far seems practicable and every time there is a U-turn for
obvious reasons. So apart from making
some news, nothing changes in practice.
There has been too much
centralisation of power and posts like Principal GMC have lost its worth and
effectiveness. There are no significant decisions which can be taken locally
and everything is managed from the secretariat, making sure that one has to be
either a yes-man or corrupt to remain on any post. This has a significant
negative effect on the delivery of health care and morale of doctors. There is
no room for whistle blowers and people who strive to improve the service. Is
this the fault of our ministers and bureaucrats or top doctors in the
department is open to debate?
There are often
allegations that the senior doctors are hand in glove with the administration
when it comes to corruption and current miserable state of health care delivery
in the state. Whenever there is a question
of improving services, queries about lack of facilities, lack of manpower, the
in-charge bosses always take one stand of ‘nothing
being wrong’. It is confirmed in
writing that everything is hanky dory and there is no room for any error
whatsoever. They presumably do all this to keep their bosses happy in the
secretariat, either to acquire a position, remain in the chair or get further
undue extensions. Are they doing so in
compulsion or not, I leave you to judge that.
The selection of
doctors for various administrative posts from BMO to Director Health has always
been a contentious issue. There are no set guidelines and even if there are
any, surely none is followed. Posts are
allocated by a process better known to the health secretariat and the minister. One does not have to be a genius to know how
it works. There are rampant examples of partiality
and corruption. Same people who are
initially attached to department on corruption charges are later awarded higher
posts. How on earth are these officers
going to be effective and upright when they are toothless and only in-charge
till the ministers are happy with them?
Doesn’t it look like an
organised mafia which actually does not care what happens to poor people? If
there were any real intensions to help people and alleviate their suffering,
surely something meaningful would have been said and done by now. The doctors involved
in corruption and malpractice get away with it, so does the administrators and
ministers who benefit. Common man and an
average doctor are made out as scapegoats in the process.
In a civilised set up,
any representative tries to understand the shortcomings of the department first
and then resolve the same. It is prudent that few expert committees are framed
to review the current health infrastructure and failings to come up with
appropriate recommendations which can be acted upon. Nothing will improve by mere tactics of
threats, bullying, humiliation and corruption to name a few. But as the African
proverb goes, ‘a wise man never knows all, only fools know everything’.
Should the Chief
Minister think about changing the health minister or keep a check on his rhetoric
to save further embarrassment? Should
the civil society respond and demand some actual change? Question remains who
will bell the cat?
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