Promising Trend

Source: The Hitavada      Date: 26 Aug 2018 11:05:57


 

 

 

 

 

 

 

 

 

 

 

It is really a precedent to find doctors engaged in private practice dedicating their time in Government hospital. It is hardly a trend in India and doctors making hefty money in private practice are mostly reluctant to serve in Government facilities.

 

Malegaon is a very encouraging experience for both patients and society because it can set up a new trend in society. India is gravely short of doctors and hundreds of posts are vacant in Government hospitals.


THE Bombay High Court has recently asked the Maharashtra Government to encourage private doctors to assist in civil hospitals across the State by way of charity so that poor patients can be benefited.
The Government’s exercise of getting such doctors to serve at the Malegaon civil hospital (in Nashik district) should be followed as a ‘model’ in other districts, it said. A division bench of Justices N H Patil and G S Kulkarni was hearing a PIL filed by a resident of Malegaon town, alleging inaction on part of the public health department and the local civic body in filling vacancies for doctors and assistant medical staff at the Malegaon civic hospital for years.


Petitioner Rakesh Bhamare cited replies to his Right to Information (RTI) queries to inform the court that authorities had failed to sanction and fill such vacancies since 2012. Advocate General Ashutosh Kumbhakoni submitted a report to the court showing work carried out by medical experts attached to the Malegaon civil hospital and doctors practising privately in June this year.


As per the report, apart from three gynaecologists working with the Malegaon civil hospital, 12 gynaecologists and as many anaesthetists working with private hospitals have also contributed there. “The report is encouraging. It has informed that private doctors have shown their willingness to extend co-operation as and when required by the administration,” the court said.


“We appreciate the gesture. We further expect the administration to encourage private doctors to get them involved in such an exercise, which would be a step in the larger public interest,” the bench said. “We expect the administration would continue the work in the same manner so that poor patients are benefited and this could be a model exercise to be followed in the rest of Maharashtra,” the court said.


The Government should take necessary steps to protect all civil hospitals’ premises in Maharashtra by erecting boundary walls, necessary fencing and by appointing appropriate agencies to safeguard them, it said.
It is really a precedent to find doctors engaged in private practice dedicating their time in Government hospital. It is hardly a trend in India and doctors making hefty money in private practice are mostly reluctant to serve in Government facilities.


The paraphernalia of Government medical centres and hospitals are also not often conducive for many medical professionals which is why they avoid coming to them. Malegaon is a very encouraging experience for both patients and society because it can set up a new trend in society. India is gravely short of doctors and hundreds of posts are vacant in Government hospitals.


This not only puts immense pressure on those working but the lack of Government doctors also puts undue pressure on the private sector. This gap also allows the private hospitals to fleece poor patients by adding multiple overhead costs in the name of treatment. Quacks flourish.
If the Government hospitals have adequate medical professionals engaged in service, much of the woes of poor patients can be alleviated. Engaging young doctors in rural Government facilities mandatorily has long been considered and even tried to be enforced but such a system has not been implemented yet for any practical purpose. In a lopsided development model, all the best doctors are huddled in the bigger cities while the poor in the villages and small towns suffer.


However, it is difficult to predict if a State injunction or a legal order on doctors can really be effective. It is always better to convince and attract someone to a job rather than coaxing him to do something he/she doesn’t like to do.
Force cannot sustain a project or effort for long. The cracks are bound to appear. There should be a willingness and a participatory feeling in professionals. Only then they can give their best. Attracting talent is a difficult proposition because of the ecosystem that is extant in our society.


As has also been indicated by the court, the facilities in the hospitals need to be enhanced if we want better hands to be engaged in them. The security of doctors is a concern. So is the availability of electricity, ambulance, necessary appliances, proper infrastructure and connectivity. These things are often lacking in Government hospitals, especially in smaller towns and villages, which is a big put-off for doctors. Doctors are highly skilled and specialised professionals who spend immense, energy, time and money to reach where they are. No one wants to squander away all that in poor working conditions and an unsupportive ancillary cushioning. Forcing them to do so will only lead to a greater exodus out of the country.


In foreign shores, doctors get much more respect, money and more importantly, a supportive ecosystem that ensures their professional growth and personal security. As long as these things go amiss in India, it will be hard to get many good hands in the system.


The Government may be targeting opening more medical colleges and spread medical education to increase the number of doctors but unless doctors are equally distributed in society, the purpose is somewhat defeated. We don’t want doctors clustered at one place but we need them more in underserved areas.


To have more doctors in underserved areas, we simply need to have the right facilities in place. The Government must also aggressively target improving the existing facilities so that doctors actually get attracted to work in them. If we have a rickety and fragile framework to work with, we tend to lose interest and fail to deliver to our full potential. Ultimately, this leads to loss of productivity and futility of the exercise.


By the way, if the grassroots coordinates are strong and the system from the bottom up is spruced, things will change. But till then, examples like the Malegaon hospital will remain stray examples only.


Emulation of such a template in the large-scale application will not take place in a vacuum, where the support system to sustain such change is not existing. We need to work towards them and tweak the smaller cogs and
screws of governance and officialdom to change the larger picture.