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Cash bait for doctors: go rural, earn more
Azad in Delhi on Wednesday. (PTI)

New Delhi, July 1: The health ministry will use financial incentives to lure doctors into some of India’s most remote and inaccessible primary health centres in rural, tribal and hilly areas, health minister Ghulam Nabi Azad said today.

The ministry will work with states in the next three months to identify these areas, particularly in hilly states, the Northeast, and in tribal areas of other states for this incentive-driven recruitment, the minister said, laying out his plan of action for the next 100 days.

“We’ll ask states to come up with location-specific incentives,” Azad said. “We’ll make available funds for appointment of doctors on contract and we’ll provide significantly higher monetary incentives based on the location of the posting. In some instances, doctors might be able to earn double the pay.”

Azad said the focus on under-served primary health centres was part of an effort to consolidate the National Rural Health Mission, a programme launched in 2005 to improve basic health services across rural India.

Health ministry officials said about 7,000 of India’s 22,000 primary health centres were located in remote or difficult-to-access terrain. “We’ve had incentives earlier to get doctors in rural areas, but not on the scale planned now,” an official said.

According to the plan, private doctors could be appointed on contract for short periods, officials said. NRHM funds would also be used to add infrastructure, perhaps even new buildings at such primary health centres.

But health experts familiar with the mission say the proposal is impractical. “I don’t think money is the main reason why (government) doctors are unwilling to get posted in remote primary health centres,” Abhay Shukla, the national joint convener of the People’s Health Movement-India, told The Telegraph. “Most states do not have a well-defined transfer policy and doctors are reluctant to accept such postings because they feel they will get stuck there forever.”

Public health experts monitoring the NRHM also point out that some primary health centres don’t have running water, or stand-by generators for electricity, or even essential medicines. “These are things any doctor would want in a clinic,” a doctor said.

Shukla said recruiting private doctors for primary health centres could lead to complications. “Experience shows that doctors who have a good private practice would either not be interested in the first place, or they would begin using the primary health centre as a catchment to refer patients to their own clinics.”

Azad said his ministry would formulate a comprehensive medium- and long-term policy to address human resource deficiencies in the health sector. The ministry would also initiate a process to establish an overarching regulatory body for human resources in health announced by President Pratibha Patil in her address to Parliament in which she had outlined the government’s 100-day agenda.

Azad said his ministry would revamp and revive the public sector vaccine production units that had been shut down last year.

The other health ministry plans unveiled today were about old projects — a bill to create a central drug authority for uniform drug manufacturing standards in all states and an amendment to the 15-year-old organ transplantation law to make transplantation less cumbersome.

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