Medical College is the highest seat of education when it comes to the training and teaching of future doctors and other allied health professions. Worldwide, most medical colleges are deemed universities and enjoy an independent status which helps them to grow and excel both academically and clinically. Government Medical College, Srinagar has the prestige of being the oldest in the state and once upon a time used to be ranked among the top ten medical colleges in India. But, one does not have to explain the current state of the health system in the state or of the esteemed Medical College, Srinagar. For a long time now, it has been in the news for all the wrong reasons, from the death of infants, administrative cock-ups, violence against doctors, poor academics to almost no research. The very same college and its allied hospitals were the victim of fake drug supply by the very health department which is supposed to run it safely.
From the last few weeks, the issue of the principal medical college (PMC) has become very contentious and one fails to understand who is running the institution? The current PMC (ex-PMC as per some) Dr Rafiq Pampori went on a protest leave few weeks ago alleging bullying and undue interference from the current health minister Lal Singh. Dr Rafiq Pampori is a well-known ENT surgeon of the country and is highly respected by his colleagues and students alike for his integrity, honesty and humility. He has been a role model for many newcomers to the medical profession. But, when it comes to the administrative abilities, many people are sceptical about his role and to what extent he is able to deliver. Going through the social media debates, everyone is united in vouching about his professional capacity and integrity, but there have been many voices questioning his extension as principal Medical College. As it stands now, it has been reported that due to the direct intervention of the Chief Minister, Mufti Muhammad Sayeed, Dr Rafiq Pampori decided to join back as the PMC. Meanwhile, the health minister, Lal Singh has appointed Dr Kaiser Ahmad as the in-charge PMC. It is still unclear who is running the Medical College, as both have the claim of being the official PMCs. This speaks volumes about the disarray and mismanagement of the health sector in the state and it is not rocket science to figure out who is responsible for the mess!
While submitting his protest leave, Dr Rafiq Pampori alleged that the current health minister is interfering constantly into the day to day work of the medical college and the post of PMC has been rendered impotent. It is no secret that Lal Singh has been bullying professionals openly and has been in the news repeatedly since he has taken the charge, from almost man-handling senior doctors to publicly harassing female doctors. He has humiliated Dr Pampori publicly on many occasions, which comes as a surprise in current day and age. Why Lal Singh got the health portfolio again, is a mystery? This is, in fact, his second term as health minister and everyone knows his regressive tactics for allegedly improving the health sector in the state. With the current PDP-BJP coalition, the situation is worse as it is hard to say if there is any coordination between the chief minister’s office and departments headed by BJP ministers.
Like all other departments, the health sector has also been the victim of centralisation of power. Every decision is made in the secretariat with institutions like the Medical College having no powers to run its own affairs. We all know why the powers are centralised and how the mafia for nepotism and corruption makes sure that even a small decision like transfer of a class fourth employee is done by the minister. The hospitals cannot even buy their own medicines and equipment which ultimately led to the fake drug scams with central purchase committees directly under the control of the health minister. The scandal of the postings and transfers in the health department has made sure that people continue to pay a high price for everything and in this process, the institution has been left to the dogs. If a doctor has to go outside country for leisure or academic reasons even for few days, it is mind boggling to know that they have to take permission from the chief minister of the state. Does the government have no better things to do than to micro-manage everything from the secretariat? Is the government for the people or against the people?
Should the medical colleges not be autonomous institutions? Who is responsible for the failings of the Medical College and its allied hospitals? Can we blame the PMC and the faculty for everything? What about the accusations of Dr Rafiq Pampori against the health minister? Why is no one talking about the allegations he has made? In any civilised society, a written note by a person of his standing will be entertained as an official complaint and investigated to get to the facts before taking further action. But as we are talking about a minister, it would be blasphemous to consider such an idea as VVIPs are above the law in the current age. How can elected representatives and more so cabinet ministers be wrong? Whistleblowing is almost unknown in our setup and anyone who speaks the truth is humiliated and punished in various ways may it be forcible retirement to the threat of transfer to far flung areas. With the ongoing conflict in the state, people even fear for their safety and lives. Few months ago when the Doctors Association of Kashmir (DAK) protested against the excesses of the health minister, immediately one of the doctors was transferred hundreds of miles away and the Doctors Association almost disbanded. There is no space for questioning the coercive methods of the people in power.
That said the senior doctors and faculty of the various medical colleges cannot shy away from their responsibility and role in the degradation of the health education in the state. There is a culture of yes-manship for various reasons and highly qualified professors can be seen lining the corridors of the secretariat for petty favours. The medical colleges are in bad state academically, clinically and hardly fulfil the role of a university- as the hub of teaching and research. There are no simple reasons why this has happened. One of the main reasons one can argue is the centralisation of power. The government should have no role into the day to day running and management of medical colleges and they should be allowed to set their own rules and regulations with short and long term goals. The PMC should not just be a caretaker and always under threat of getting sacked for no reason. Of course, there should be checks and balances but not by the government but by an independent body set for the purpose.
There should be regular appraisal and accreditation of the faculty and not merely by the outdated system of annual reviews (APRs). The promotions of the faculty should be based on their performance than automatic. Becoming a professor, for example, should be based on actual contribution to teaching and research and not just time in the job. The entry criteria for the faculty posts should be revised and people with academic or research background should be offered the posts and not any doctor with a postgraduate qualification. Ideally, people need to have a Ph.D. or an additional teaching qualification to qualify for the faculty post, so that they have the drive and passion for training, teaching and engage in fulltime academic work. This would cut the dead wood out and let people chose their paths early on.
Finally, the government should seriously revisit the portfolio of the health minister and who should run the department. I am sure there are many highly qualified MLA’s and even doctors in the current government who can run the department more sensibly in the greater good of the state rather than for their personal obsession of bullying medical professionals. The state has already lost many doctors who are leaving left, right and centre due to unfriendly work culture, bullying, humiliation and lack of job satisfaction. There is still time to save this (once upon a time) prestigious institute from the further debacle and prevent putting further lives at risk. It would also mean saving the careers of many efficient brains who decide to become doctors after toiling for years. The coalition government should rise above the petty politics and appoint someone with experience and qualifications to run the Medical College and not merely the one who is senior on the list. Decentralising the powers and restoring the dignity of the PMC’s chair cannot be excused if the government is serious to improve the state of healthcare.
http://www.risingkashmir.com/news/medical-colleges-should-be-autonomous-institutions/
http://www.risingkashmir.com/news/medical-colleges-should-be-autonomous-institutions/
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