Page 44 - Tehelka Issue 15 August 2018

countries employ a large number of in private colleges, their students can- With six new AIIMS reeling under
doctors from South Asia region. An esti- not afford rural postings with low sala- acute faculty shortage, the Centre is
mated 20,000 doctors from South Asia, ries and limited opportunities. On top trying out ways to address their human
with a majority being from India, are of that, the limitation of resources adds resource challenges. With only about
present in the Gulf. Indian government a lot of burden on government doctors. 31 per cent of the vacancies filled, the
figures indicate that 90,000 doctors Who would opt for so much mental government may come out with new
trained in India were working outside stress for so little compensation?” recruitment guidelines, with contrac-
the country in 2014. This constituted The recently announced Ayush- tual appointments, increased stipend
around 13 per cent of the active doctors mann Bharat Health scheme is a solu- for visiting faculty, easing off some
in the country in 2014. tion that is too little, too late. Speaking norms, etc. In some cases, state and
Moreover, most doctors who remain at the event for Amartya Sen’s book central governments are opting for
in India are more inclined to work in launch, development economist and questionable short-term solutions to
major cities. Currently, a public doctor activist Jean Dreze termed the soon-to- address the overall shortage of medi-
posted in a Maharashtra village earns be-launched scheme a “hoax” as it was cal practitioners. The ministry of health
about 20000 — 25000 a month, actually not big as it was being claimed and family welfare has introduced a
meanwhile facing excess workloads, to be. “The budget (for the scheme) for controversial amendment in the draft
National Medical Commission (NMC)
Bill, a wide-ranging legislation for re-
form in medicine, to allow nurses, ho-
meopaths, Ayush practitioners and
others trained in alternative medicine
to practice conventional medicine after
taking a bridge course, which doctors
fear might promote quackery. Gujarat
has employed an eccentric new tactic
in response to mass shortages of medi-
cal staff across the state. The state is us-
ing children, some as young as eleven,
as stand-in Bal Doctors within schools,
who are only allowed to practice Ayush.
To tide over the acute dearth of doctors
in remote areas, Andhra Pradesh in
southern India has launched a mobile
health programme. Vans equipped with
basic medical tools and skilled para-
medics visit rural parts of the state to
provide instant relief to patients.
To achieve the modest prescribed
doctor-population ratio of 1:1000, India
erratic working hours and poor living • Health trips Last year, the density of doctors will need 2.07 million more doctors by
conditions. They can make more than at national level was 79.7 per 100,000 people 2030, according to a report in Indian
double that by opening up a private Journal of Public Health. The National
clinic in the city with half the stress. Health Policy (2017) has pledged to raise
While the skewed distribution of doc- this year is 2,000 crore. Even if it is the public health expenditure from
tors in rural regions is often attributed spent, it’s less than 20 rupees per per- the current level of 1.1 per cent of the
to the unwillingness of doctors to work son. It is projected as health insurance GDP to 2.5 per cent of the GDP by 2025.
in difficult areas, others say not enough for 50 crore people, but it is virtually The prosperity of a nation can only be
is being done to incentivise such post- nothing”, said Dreze, who helped draft measured by the well-being of its sub-
ings. A resident of PGI, Lucknow shared, the first version of the Mahatma Gandhi jects. If necessary measures are not
on condition of anonymity, “While doc- National Rural Employment Guarantee taken soon to remedy the Indian health
tors in government hospitals might Scheme (MGNREGA). According to him, delivery system, an ever-growing un-
have compulsory rural stints, a medical “There are issues of management, cor- healthy population will be a huge deter-
graduate from a private college only ruption, accountability, and ethics and rent to the growth of our country.
come to government hospitals for pres- so on. The main problem is healthcare
tige. With the exorbitant fee structures is way down the political agenda.” letters@tehelka.com

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