Mr Ghulam Nabi Azad’s slogan “Quit India, MBBS Doctors” is gathering momentum. His policy is to make their working conditions impossible so that they will be forced to leave the country. After they have quit India his vision is that we shall all enjoy health under the watchful clinical eye of BSc (Community Health) and Ayush doctors posing as modern medical specialists. The ruling class, including Mr Azad and others of his ilk, however, by some Act, Bill or ordinance, will be treated at national expenditure at Mayo Clinics in USA by the “quitted India” doctors.
MBBS doctors in India today are unemployed, underemployed, poorly paid, exploited by making them work for extended periods without any salary/overtime. In the name of training they are used as bonded labourers. But they are pilloried if they commit an error of judgment after being sleep deprived and on the job for 48-72 hours at a stretch.
Mr Azad claims in Parliament that doctors do not go to villages hence BSc (Community Health), one year compulsory service by all MBBS doctors and allopathic prescription by Ayush doctors are a necessity. We have approximately 120 crore population. At 1 doctor per 1000 population we should have 12 lakh doctors. Around 6-7 lakh allopathic doctors exist in the country today. Even if 50 per cent should be in the government service and 50 per cent in the private sector around 3 lakh doctors should be in the government service. Instead Mr Azad has graciously provided for 31,867 sanctioned posts of MBBS doctors in the Primary Health Centres all over the country. Of these only 2,489 posts are vacant. About 45,000 MBBS doctors pass out every year so where are they to be employed? Any selection of MBBS doctors to serve in the rural areas in the state medical services is applied for by 10-15 times more applicants than the number of available jobs. Punjab Civil Medical Services did not appoint doctors for 6-7 years at a stretch. Same is the position in Delhi and other states.
The basic problem is not that doctors are not willing to work for the nation in the rural areas; it is that Mr Azad wants them to work for FREE. In his budget for the year 2013-14, Mr Azad has kept only Rs 33,000 crore for health. If instead of a measly 2.03 per cent of the budgetary allocation a more reasonable figure of 7.5 per cent were kept the Govt would have funds to hire doctors and post them in the rural areas. By forcing the fresh graduates of MBBS, with no experience, to work in rural areas for one year before they apply for a PG medical course Mr Azad is pulling wool over eyes of the nation. The fact is no benefit accrues to an MBBS doctor unless he works in the government/public service in rural area. Since no post is there in the Government Primary Health Centres where are these fresh MBBS doctors to work? It is simply political vote gathering gimmick with no thought put behind this hare-brained scheme.
Do budgeted development funds ever reach India’s poor at all? Ex Prime Minister Rajeev Gandhi famously estimated that of every rupee spent only 15 paise reached the poor. Administrative inefficiencies, poor targeting, high implementation costs and leakages characterize implementation of almost every scheme. Despite this the Govt year after year rolls out schemes, which are populist, sound grandiose when announced in Parliament but are of no use to the common man. An example is Rs 52,000 crore loan waiver scheme announced in 2009 during pre-election by UPA I.
The Union Budget 2013-14 has Rs 125,000 crore Food Security Act; Rs 33,000 crore Mahatma Gandhi National Rural Employment Guarantee Act (This scheme showed 25% fall in completed works in 2012-2013 compared with 2011-2012. This year in four months only 13 per cent of last year’s work figures have been completed.); Rs 80,194 crore rural development projects; Rs 700,000 crore for agriculture credit schemes; Rs 41,000 crore for scheduled caste welfare; Rs 28,500 crore for tribal welfare.
If the government was to pour this much funds into health and education there would be no need for any of the welfare schemes and doles. The fact is these welfare schemes are not audited. Once the central government sanctions it what happens to the money, how it is utilized, what is the “bang for buck” is never disclosed. These are all avenues of massive and persistent corruption. These funds are siphoned off by the very masters who sanction through their minions.
If instead of Rs 33,000 crore a more substantial sum could be kept for health in the Union Budget more jobs for doctors would be created, more MBBS doctors would be available in the rural areas to serve the poor and through them the overall developmental change can be implemented. But this requires money for health, Mr Azad.
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