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Doctor, please don’t leave

- Plum post, pay & promotion carrots fail to retain talent

Ranchi, May 8: They say an MBBS degree-holder is recession-proof. The state, looking to revive its ailing public health machinery with a recruitment system, is now discovering that most MBBS degree-holders are also Jharkhand-proof.

In a recent jolt for the health department, 56 of the 112 selected in the 2012 state medical officer (basic category) recruitment exam haven’t joined, despite gentle reminders and strong notices. It’s an embarrassment that the state mandarins have to learn to live with.

Recruited medical officers are entitled to a salary of Rs 32,000 per month since 2012, up by Rs 2,000 in the first exam conducted in 2009. If they serve for six years, they get a hefty jump of Rs 66,000 a month. Every six years, they are guaranteed a promotion, which means in 25 years they can rise to the rank of a deputy secretary.

But these health department steps to retain talent haven’t worked. Many selected medical officers shun Jharkhand, citing reasons as diverse as remote rural postings, “end of learning opportunity”, professional dissatisfaction due to shoddy or no support infrastructure at hand, low pay compared to private employment and others.

M. Kujur, who worked as a medical officer at a Dumka primary health centre, left in December 2010, worked with an NGO in Ranchi and finally joined a speciality course in All India Institute of Medical Sciences (AIIMS), New Delhi.

Talking to The Telegraph over phone from Delhi, Kujur said: “Rural patients need personal attention. Each needs to be explained about their ailment and how medicines are to be consumed. I enjoyed this aspect. But I was so fed up with clerical work in my tenure as MO such as block-level meetings and silly paperwork, that I quit.”

He added it wasn’t easy. “The state was not giving me a release letter and I had to run around, using personal contacts to obtain it,” he added.

S. Gupta, another appointee, left within a month of joining an East Singhbhum primary healthcare centre when he found out that he would be managing the show alone, without paramedical staff. “Even the sole auxiliary nurse-cum-midwife or ANM was not to be found,” he said.

Admitting doctors either don’t join or leave soon, a senior health official said that the state started its medical officer recruitment exam in 2009 to establish a balance in patient-doctor ratios.

According to WHO, India has a staggering doctor:patient ratio of 1:34,000 instead of the ideal 1:250. Going by trends, Jharkhand’s figures must be lower than this shameful national figure. In a 2009 report released jointly by World Bank, Princeton and Harvard universities, it was found that Jharkhand doctors filled only 30 per cent of sanctioned posts in public healthcare.

“In the 2009 exam, we required 1,500 but 973 medicos were selected of which 447 finally joined and only 375 of them are still posted in various primary health centres,” the senior health officer said.

The picture grew grimmer in 2012. “To reduce the shortfall of doctors, we once again conducted the exam in 2012. Last year, 392 doctors were selected in March, of whom 338 had joined. But only 175 can be found at their workplaces now as 135 have been de-notified and another 28 are undergoing the process,” he added.

To plug the existing gaps, the state called 112 doctors on the waiting list to join. Of them, only half or 56 have shown their interest.

“It is a serious setback,” admitted principal secretary, health, K. Vidyasagar. “It cripples public healthcare in rural areas. But this is endemic across India. These are young doctors with an urban orientation who fail to adjust to village lives,” Vidyasagar, making light of infrastructure spoilers, added.

National Rural Health Mission had floated a cash incentive plan to retain doctors in villages.

“We need to revisit the proposal and realistically seek ways to keep doctors in village primary health centres,” Vidyasagar added. “After all, rural health is the backbone of public health.”