Quit India Doctors!

Thursday, November 21, 2013

by Dr Neeraj Nagpal

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.

Dr Neeraj Nagpal

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.

Dr Neeraj Nagpal
Convenor, Medicos Legal Action Group
Ex-President, IMA Chandigarh
9316517176

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36 Comments »

Comment by Quitting India Doctor
2013-11-21 13:48:26

I’m one of these MBBSes (pre-PG) who has made up his mind to quit. I’m looking at my options now and will take a call soon. Azad can run his show any which way he likes, but I am sure that I cannot survive his experiments. Any suggestions (non-Gulf) for a suitable country is welcome.

 
Comment by Dr Pradeep Arora
2013-11-21 22:26:33

It’s ‘quit profession ,doctors ‘ dictate for practitioners of modern medicine, if you are not in a position to quit India. The status and sanctity of medical qualifications is sought to be diluted by introducing courses that are alibi for licensed quackery. Although such farcical political decisions frequently boomerang , and govt is set to regret it in long run, but not before it is too late to undo the damage caused by such slapstick measures.
It rubs salt into the wounds of a profession who is already hounded by wily patients ( more correctly their avaricious relatives) who are out to make windfall fortunes or hogging lime light on telly shows by hysterical narratives and sob stories.

 
Comment by Santosh
2013-11-22 04:36:25

We should also pity the plight of those students who would innocently join this course and face a dead end of their career at a very early stage in life without any opportunities for further studies or career development. At the end of my MBBS from a premiere govt medical college in India, I could confidently diagnose rare conditions like Lateral Medullary Syndrome but felt jittery in approaching common conditions like fever and hypertension. While my class mates at school who took to Engineering stream had a decent job and a wide range of career choices.These BSc graduates are likely to be worse off as they will face the same neglected work environment and will not even have an opportunity to “Quit India”

 
Comment by Dr Bijayraj R
2013-11-22 09:58:43

Half of the 45000 medical seats are for those who can afford it.
Out of the remaining half, half are for those who were born in some “low” caste. (Most of their parents are doctors)
Merit is merely less than 1/4th, and Mr Ghulam Nabi Azad wants these meritorious students only to serve their sentences in the rural areas- under the guise of “they should realise the problems of the rural people”. Why? What about the other 75% who bought their seats and didn’t deserve to be doctors (some have IQs and attitudes worse than sweepers). Aren’t the doctors who were affluent enough to buy seats more deserving to be in rural areas- they are more ignorant of the common peoples’ problems!

Mr Azad co are not hare brained. They are simply playing to their rich and powerful puppeteers. Keep out the merit, keep harassing the merit. Those who can buy seats get extra time to set up thier careers in the meantime. Mr. Azad and co., as you said sir, can always get treated by those whom he pushed out to UK, USA etc.

 
Comment by shashi
2013-11-22 11:26:07

Yeah very truely said…n nw moreover the situation is 2 grave..even if by chance out of all adversities, u r selected,then where u ll b thrown and wat branch u ll b allotted,ll b again decided either by these ppl or by the system…wow!!!the form of a national xm is approx.4000rs…wow again!!!trust me guys in d next 10 yrs the Indian health system z going 2 b rummage either in d nam of reservation or money or workload or in short due 2 dirty n filthy politics

 
Comment by Dr naresh krishnani
2013-11-22 12:58:52

Very nice article indeed. The fact is our policy makers have no vision, they want to run country only on populist and welfare schemes keeping in view the mindset of their voters for short term gain of winning the elections at any cost. The real problem is of low funding, absent infrastructure in villages, widespread corruption and swindling of funds, lack of willpower at every level, no protection to doctors security or financialwise, excess interference by chutbhaiyya netas etc. In chhattisgarh we have health welfare scheme called Sanjivini kosh under which a patient can get a benefit of about 2.5 lac rupees for treatment of various enlisted diseases, a lot of money goes in this fund especially for cardiac diseases which is good from patients and private hospitals point of view but the fact is there is no cardiothoracic department in any of the medical college hospital in chhattisgarh which explains apathy on part of government and policy makers. A proper running CTVS deptt can save a lot of money of sanjeevni kosh which can be utilised in betterment of government hospitals but who cares?

 
Comment by Maj Pankaj Rai (Retd)
2013-11-22 14:08:05

It would have been appropriate if the Hon’ble Union Health Minister had sought the views of doctors ~ both Government and private practice before announcing a policy which has far reaching implications not only for doctors but for patient rights also. To what extent patients are going to feel comfortable with BSc (Community Health) and Ayush doctors is something which does not appear to have been thought through.

 
Comment by Dr Goodboy
2013-11-22 18:30:05

The idea, that a medical student needs to be a “good boy” or a “good girl” and devote their lives to quasi-communist ideas of “free treatment” has made this profession a field of “exploitation by default.” Fresh graduates are fleeced physically, mentally and financially by both private and public institutions till such time that they “become senior” and can stand-up to to the hypocrisy. Even the shopkeepers won’t feed you for free. Underpayment is no different.

And the government keeps forcing medical graduates into areas with zero usable infrastructure claiming to have “paid for their education.” On one hand you keep the seats artificially low. That causes private college fees to be high to the point of being unaffordable. Then coming to claim your “pound of flesh” is deplorable.

Quit medicine or quit India or quit life – only three options left.

 
Comment by Dr. Prakash Mehta
2013-11-22 20:10:20

Unfortunately our politicians and high public servants are not accountable, even if they cause tremendous damage to people.

 
Comment by Vijay Kumar
2013-11-22 20:39:22

Very nice written and summarized. The govt has always ignored the health sector and doctors, but keep spending on populist, non fruitful schemes just to garner votes in elections

 
Comment by Dr.Pillai
2013-11-23 00:02:44

Tell this uneducated farce of a minister to do some proper research.
The only shortage that exists in India is a shortage of specialist doctors, and not of fresh MBBS grads.

Doing whatever he is intending to do is going to screw the whole system badly with dire consequences.

I hope he reads this well researched perspective published in IJMR (Indian Journal of Medical Research) recently, or someone who knows him get him to read this, if he can read properly, ie.

http://www.icmr.nic.in/ijmr/2013/april/perspective.pdf

 
Comment by dipak
2013-11-23 10:31:40

and now the fuss created by NBE under the title “NEET ” …paper toughness level has been increased to such a high level that even if every student is allowed to keep Google search with them…still its difficult to crack exams…….my question is anybody kows whether students are getting standard education or not ?different sessions with different paper toughness level are matched by some statistics…is it authentic to decide future of hard working pg aspirants.in this country nobody thinks about reform in medical education and exam system which should be clinically oriented …now we knows only medical mcq instead of clinical skills …indirectly forcing us buy paid ssea.ts. in private.cvinstitutes

 
Comment by ashwin
2013-11-23 19:32:39

The difference in the pay scale for doctors in India and abroad is too stark for doctors or for anyone to ignore. If this continues for some more time, India stands to loose a generation of good quality Indian doctors.

 
Comment by DR.P.UPENDER GOWD
2013-11-23 22:16:12

Dear sir
What you said is absolutely true and we are so unfortunate to have been ruled by Idiots who don’t have a basic knowledge that all Human beings are to be treated by Qualified people when Animals are being treated by qualified Vets.I came to know that the psyche of Politicians that the Money spent on Health and Education is a waste, as they cannot show this as their Achievement like Dams and Projects to Public.This expenditure will not Fetch votes for them.Hence I feel that there should be an Autonomous body appointed by the President to dictate the Health Policies and Requirements and no politician should be allowed to finger.I also feel that all the Medical Colleges should be under one Umbrella and no Private managament except few seats for them( Management quota may be 1-2% )

 
Comment by Dr.RAJARAM.P.C.
2013-11-24 00:51:27

Dr.NEERAJ NAGPAL has driven the nail on the head by his superb analysis of facts,falacies of non-professional (?planners),and insufficient fund allocation for health care,failure on the part of the non-professional and political (administrators) to understand the needs and grievances of members of a noble profession. Should people in rural areas be contented with treatment by trainees and young doctors who might be compulsarily posted to rural health centres as a part of their training as interns just to become eligible to receive the mdical degree?Medical doctors–(particularly young budding medical graduates) CAN NOT AND SHOULD NOT be looked upon ,treated and utilized as free-be cmmododities for political milage.Let us recognize and accept that human life taken care of by our noble profession is equally valuable-be it in rural,urban or anywhere in our motherland.If anybody is pronouncing QUIT INDIA to M.B.B.S .doctors,it is not only unfair but illegal,derrogatory and arrogant in the superlative. and deserves condemnation in the strongest terms by one and all. Dr.RAJARAM.P.C.

 
Comment by sourab mittal
2013-11-24 15:24:23

Sir ji, everyone knows and even great psychologists like Sir Maslow and Mr. Herzberg had said that social security is the key for making stability. Why our respected leaders are not able to learn this? Every aam aadmi (supposedly for which UPA is made) and even maoists are fighting for the same common (aam) thing in one way or other even 10 years down the line of UPA rule. I hope the time should not come when medical professionals will also be treated like naxalites .

 
Comment by drsanket
2013-11-24 17:11:44

situations are becoming worse for doctors…………

 
Comment by PP
2013-11-24 23:15:08

I agree with Dr Nagpal
India does not want doctors( rather the government), people will die and spend all savings on health
Poverty persists so government schemes persists.
No priority for health or education

 
Comment by Dr Pradip Abraham
2013-11-24 23:38:27

Well said sir..

 
Comment by kalyan dutta
2013-11-25 00:45:44

I think the comments are absolutely true. I did my DM Cardiology and fellowship in electrophysiology-all on merit and did not have a job as an electrophysiologist because there is no money.Now i serve a middle eastern country and am amazed to find that everybody can afford health here because of insursnce cover. Though the heart long to be in india the pocket says no. Quit india or quit the profession. And yes gulf is good, docs are financially happy and have fixed hours.Please do consider this option also.

 
Comment by Urmila Deshmukh
2013-11-25 12:44:25

Thanks Dr Nagpal for the write up.
In addition, what is the assurance that those who take this new course (BSc Comm Health) would serve rural populations only, and not flee to urban sectors?

 
Comment by dr sumit
2013-11-25 13:55:24

this is true . .
but who is bothered, these very politicians are not going to get treated in India, forget about some village hospital. Only thing they need is more irrelevant plans & schemes to grab the money. In India, who is accountable, only the honest man. It is shame we are the best but only in books, we are the most corrupt nation. Law implementation is very weak & poor.

 
Comment by Prathap kumar
2013-11-25 18:37:20

First, make a rule that no politician or public servant should go abroad for medical treatment.
Let them get treated in Government hospitals, whether it is a common cold or cancer.

Then they will make better rules.

 
Comment by Drs.k.singhal
2013-11-25 22:27:44

this is not truth as doctors are not going to villages
1. in actuality governments are not providing permanent jobs timely. instead most of the time they are providing temporary/adhoc jobs where after working on temporary post if doctors are not able to confirm by public commission then they are not able to get jobs in private hospitals in cities
2. see the in Public commission recruitments lots of applications of doctors are coming and out them lots of are joining.
3. Salary are less then their counter part of other services eg. teachers are working in academic colleges. why?
4. Work on PHC/rural clinics as/on post of
Medical officers are not counted as experience for appointment in Medical colleges as Faculty? why?

 
Comment by Drs.k.singhal
2013-11-25 22:30:58

point2 ………..avoid the before in and in point 3…….. than instead of then

 
Comment by Drs.k.singhal
2013-11-25 22:39:05

different type of courses and increase in MBBS seats are good for private medical colleges for increasing their profit in business of education ……but not good for doctors and patients…….. shortage of doctors may be a false reason for increasing MBBS seats and starting new courses for increasing business of private medical colleges

 
Comment by ajay
2013-11-25 22:39:44

i fully agree with u. someone has to set the things right. bureaucrats and politician will get treated in US & UK. science , research & health will go in drain. every one in india is after money.
we have to uproot these idiotic villains who just work for self & votes and not for country or ts people.
we should have honest & effective leadership in our profession who can lead us and also the community. they also have to set our profession in order.
ultimately we all have to wage a fight other we all will be ruined.

 
Comment by Dr Us
2013-11-26 02:45:25

The babus and netas would always go abroad for treatment. Who wouldn’t? Treatment that they provide to Indians is merely “cattle class” – strictly for the peasants. They will use public money to fly out on paid leave on all-expenses-paid-foreign-trips (with side trips to Swiss banks) to get the best treatment in the world. All this while the public has to fend for themselves after buying onions for Rs.100 a kilo. Very reminiscent of “Animal Farm” (milk and apples for the pigs and ever-shrinking dry rations for the masses.) Such are the Orwellian times we live in. God save the Indian poor patients.

 
Comment by Dr Neeraj Nagpal
2013-11-27 09:39:17

There is no such assurance. Infact it is guaranteed that in the country where a BAMS can conduct renal transplant and before and after follow up, the BSc CH will be the replacement doctors for jobs which are not done by law abiding qualified doctors.

 
Comment by Dr Neeraj Nagpal
2013-11-27 09:43:32

Whims and fancies of our Health Minister will determine the health of our nation. This is nothing but a political gimmick. When you announce grandly in parliament that doctors do not go to villages hence 1 yr compulsory rural service will be made mandatory it is simply playing to gallery. The immediate passouts after internship (which they have spent studying for PG exam) are in the phase of their career where they require supervised training on the job. Instead they will be let loose on the gullible rural voters to enable the minister to say that “We have provided doctors”

 
Comment by sonal
2013-11-30 17:05:35

i m a dentist , right now in kuwait, while in india salry offered in 30- 40 K per month ,, they earn 2-3 lakh per month abroad ,,,, why will they work in india , forget about rural…

 
Comment by kr chandan
2013-12-01 01:23:25

Pls start Bsc com health instantly.

 
Comment by Dr. Trials
2013-12-06 02:47:53

It’s not money that keeps doctors from going to rural areas. It’s the lack of infrastructure. You cannot just go a sit there and not do anything. You are likely to be beaten (as happens every single day – literally) or murdered (as has happened several times before) by the mobs that gather around each and every patient. And if you are a lady doctor being posted in these conditions, there always looms the added threat of molestation (as has happened on several occasions). No amount of money or government brutality (coercion) can make unwilling doctors go to the hinterlands.

But there are locals who become doctors too. They do go back to their native places. The current vacancy is only for specialists and not MBBS doctors. The only reason that Azad is forcing MBBS doctors to go to rural areas is a poll gimmick – the last refuge of the corruption-ridden congress party.

 
Comment by vivaa
2013-12-14 15:29:28

I fully agree with your views. Thanks for your article. Request more action from your side against exploiting young MBBS doctors.

 
Comment by Kusuma kumari G
2014-08-19 09:23:12

I feel BSc community health in will improve the health of rural India in abig way. A good moove by health ministry DOnt criticize them rather appreciate it.

 
Comment by Dr. Ramesh Vardhan
2017-08-03 10:52:06

Silly politicians come out with stupid ideas, being busy through out their political carrier being psychopaths / Chamchas, they have acquired all sorts of idiotic, impulsive ideas of making easy money or impressing their boss /bosses. Or pleasing their Chamchas. The Government Medical College which got L O P / letter of permission from the MCI in the year 2006, to start a New Medical college on a condition to set up a Functional 650 bedded Teaching Hospital, with an existing old and shabby 300 bedded District Hospital. With out required Infrastructure, EQUIPMENTS, Faculty Members and supporting staff is still managing in the same old district hospital of bed strength of 300 with 100 admissions for MBBS continuing for last 10 years. This is clearly cheating the poor public, students who do not have enough clinical material for developing clinical skills. Such Ill trained doctors are like misguided missiles. It is a misfortune for the patients to be treated by such doctors. That is why the patients and the public is losing faith and are resorting to physical assault against the doctors. Enemies within the country are more dangerous than those outside who are the ones spoiling our country. First and foremost are the corrupt politicians who for the sake of amassing wealth will go to all extents and still think they are above the law. While in power they freak out with ill earned money by giving permission to all nasty colleges, when not in power they come screaming and shouting in the well of the Speaker to protect crooked leaders involved in corruption. Like the recent raids by the IT Department on Karnataka Minister’s many abodes.

 
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