Identifying pay rates as the rationale behind medicos choosing private practice over work in the public sectors, the Madras High Court is calling for a pay increase for government doctors.
The issue of comparatively lower pay in the public sector was raised during a High Court hearing of a petition concerning strike action by doctors over violence against them. The petition was filed in 2017 by a Royapettah resident who sought that the doctors who went on strike be penalised for dereliction of duty and medical negligence. The petitioner claimed that, as a consequence of the strike, three deaths were reported because of a lack of medical attention – a claim which was disputed by the state government.
In responding to the petition, the High Court actually offered praise for government doctors. “Doctors’ profession is one which cannot be equated to any other service,” stated the two-judge bench, consisting of Justices N. Kirubakaran and V. Parthiban. “They work round the clock without any security in their workplace, often facing attack from [the] public.” The justices observed that “an assistant surgeon is paid only Rs 45,000 whereas other government servants in the same grade get a much higher pay.”
As previously reported by Health Issues India, government doctors sometimes work up to 120 hours a week owing to staffing shortages. Such overburdening has led to some states raising the retirement age for doctors whilst, across India, doctors’ shortages have prompted a number of unorthodox proposals to plug the gap, including bringing dentists, ayurvedic practitioners and homoeopaths, and even unqualified quacks into the fold.
Highlighting long hours and inadequate pay is to say nothing of the issue of violence against doctors, which made headlines earlier this year after an attack on a junior doctor in a West Bengal government hospital prompted a national stir. Violence against India’s healthcare workforce is commonplace: “for government hospitals and primary health centres across the country…violence by patients’ relatives, local goons, political leaders and even by police has been reported,” noted a study published last year. The same paper flagged numerous challenges which complicate addressing the issue: “[The] majority of the hospitals in India do not have good grievance addressal [systems] in place. Legal procedure in India also takes [an] inordinately long time.”
The combination of these factors make it unsurprising that many doctors opt for private practice as opposed to manning government-run facilities. The overwhelming majority of qualified medical professionals in India are employed by the private sector, including eighty percent of doctors and seventy percent of midwives and nurses. While raising pay rates could incentivise some to staff government hospitals, it is clear that the issues beleaguering India’s healthcare workforce are manifold, from violence at work to overlong hours. These problems require a cohesive response if doctor dissatisfaction and staffing levels in the corridors of public hospitals are to be raised to the level where quality healthcare is delivered.