Henceforth, the State Governments can shell out pay packages at par with the private sectors, that can go beyond the Rs1 lakh mark, for calling on private doctors to treat patients at Community Health Centres (CHCs), first referral points, sub-district hospitals and district hospitals.
In a move aimed to make the public health services lucerative as that of private sector to meet the shortage of specialists, the Modi Government has allowed flexibility in its flagship National Health Mission (NHM), to the States to source specialists from the private sector and those retired from Government services.
They can be sourced on contract basis or fixed days or hours or surgical sessions, ie as per need.
Presently, just 18 per cent of the required specialists are posted at the CHCs CK Mishra, Additional Secretary and Mission Director in Union Health Ministry told The Pioneer recently that a detailed guidance note on ‘strengthening specialists in public health facilities’ has been shared with the State Governments in this regard.
The Government has already increased the retirement age of its doctors to 65 years.
As per plan, the State Governments can engage doctors especially for fixed day in CHCs, sub-district hospitals and district hospitals which are grappling with acute shortage of doctors particularly specialists such as gynecologists and anesthetists, said Mishra. The States have been asked to seek lump sum funds to hire specialists services on part-time basis too.
The suggested pool from which the specialists could be drawn from includes those retired from the Government service but continue to be mentally and physically fit, employed in Government medical colleges but who could come on fixed days, from charitable or NGO-run hospitals or those in the private sector working in the surrounding areas, as per the note.
These specialists should be deployed at the post for which there are no specialists or where the number is insufficient to meet current caseloads and HR augmentation is required or where periodic shortage occur, the note suggests.
The plan also allows annual contract at competitive market rate for specialists whose services are required on a daily basis, fixed number of hours/working days, fixed day/date/week, fixed number of hours/week, fixed surgical sessions/week according to need/disease condition and also case by case basis, on call.
The plans aims to improve the efficiency of available specialist resources who at times render non-functional, for instance irrational deployment such as surgeons and obstetrician posted at a facility with no anesthetist, lack of appropriate equipment/infrastructure, inadequate support staff, absenteeism and vested interest such as diverting Government patients towards personal practice and using specialists for general duties.
As per the World Health Organisation, there is only one doctor per 1,700 citizens in India against the WHO stipulated 1:1,000 ratio.
As per the Health Ministry data, as of March 31, 2015, more than 8 per cent of 25,300 primary health centres in the country are without a doctor, 38 per cent without a laboratory technician, and 22 per cent had no pharmacist. Nearly 50 per cent of posts for female health assistants and 61 per cent for male health assistants remain vacant.
In community health centres, the vacancy figure is grimmer surgeons (83 per cent), obstetricians and gynaecologists (76 per cent), physicians (83 per cent), and paediatricians (82 per cent).
While the Ministry figures claim that there are about 6-6.5 lakh doctors available, India would need about four lakh more by 2020 - 50,000 for PHCs; 0.8 lakh for community health centres (CHC); 1.1 lakh for 5,642 sub-centres and another 0.5 lakh for medical college hospitals.