Despite warning of stern action by Health Minister Chandra Mohan Rai, the doctors owing allegiance to the Bihar State Health Services Association (BSHSA) remained adamant on their 'work to rule' agitation and decided on Sunday to press with their move to seek voluntary retirement en masse if their demands were not fulfilled within a time-frame. The ongoing agitation has hit health services across the state hard.
The Association has so far procured the VRS application from 1,175 doctors and is likely to intensify this move after June 7. The doctors went on 'work to rule' agitation on June 1 in support of their demands, including Central pay scale, dynamic ACP and fixed working hours.
The Health Minister had appealed to the doctors to suspend their agitation or the government would be forced to accept their VRS applications without a second thought. The Minister had said that the government was sensitive to the demands of the doctors and aware of the need to improve infrastructure and service conditions. "We are considering Central scale for the doctors. But a way has to be evolved so that it does not have a ripple effect on other cadres," the Minister said.
Health Secretary Deepak Kumar said that the government would initiate departmental inquiry against the doctors found defying the government ruling in the wake of their asgitation. He said all the civil surgeons have been asked to closely monitor the performance of the doctors.
Convenor of the BSHSA, Dr Ajay Kumar, said that 'work to rule' was not something against the government. "The Minister asked us to work for eight hours a day. We are already doing that in compliance of his instruction. But our move to collect applications of VRS from doctors would continue. We have so far procured the VRS applications from 1,175 doctors and the drive to procure the same would be intensified after June 7. We will also apprise the doctors of the actual intent of the 'work to rule' agitation," he said.
He said that the working conditions of the doctors in Bihar were not as per the health manual, which said that nobody who had acquired a specialist's degree at his own cost would give free specialised services unless he was posted in specific cadre or given some allowance for specific work. But the government has posted specialist doctors in some places in disregard of their degrees.
As regards other demands, he said that the Fitment Committee or Fitment Appellant Committee strongly recommended providing annual allowance, specialist allowance, conveyance allowance as paid to Central Government doctors from January 1, 1996. "The state government, however, has not implemented it even after the lapse of 10 years," Dr Ajay Kumar rued. The National Rural Health Mission itself has recommended Indian Public Health Standard for community health centres, which provides for the posting of seven specialist doctors along with requisite paramedical staff and other instruments to run it round the clock. It is the minimum requirement for community health centres to have the services of one anaesthetist.
As per the requirement of NRHM, about 11,000 doctors have to be available to run primary health centres (PHCs), community health centres (CHCs) and district hospitals, out of which 6,000 doctors must be specialists. The state government had got 6,500 posts in the Bihar health service and 3,000 contractual posts have been created but the actual number of doctors working with the state health service is not more than 3,200 (regular and contractual). They are working against the requirement of 11,000.
Media in-charge of the Association Dr Ranjit Kumar and Dr Sunil Kumar alleged that the state government had made a mockery of the norms and guidelines of the NRHM. The doctors quoted a Supreme Court judgment which said that only surgical specialists and MBBS doctors with five years' experience could perform family planning operations in the presence of an anaesthetist. "But in actual practice, the state government has not notified or made arrangements as asked for by the apex court," they complained, adding that "Rule of Executive Business is not being followed in health services. They are inspected or administered by anybody and even the BDOs have been made their in-charge in blocks."