Doctors attend to a patient at a government hospital in Patna. Picture by Ranjeet Kumar Dey

‘Hike healthcare budget’

What, according to you, are the biggest problems in the health sector in the state?

Various schemes under National Rural Health Mission (NRHM) are being implemented in 18 states of the country. But the scenario in Bihar is poor compared to other states. Ever since the NDA came to power in Bihar six years ago, it has improvised on a number of health indicators. But much is yet to be done. Our state still lacks grossly on proper health management, health administration and health policies. I know for sure that chief minister Nitish Kumar wants the state to do well in the sector. But because of bureaucratic interference, right things do not reach him. As a result, the direction is lost somehow. For the state to do well in benefiting people in terms of providing quality healthcare facilities, budgetary allocation needs to be increased by about 10 times. Expenses incurred towards healthcare system have been 1- 1.5 per cent of the total budget in the state for the last 20 years. It needs to be taken up to 10 per cent if there has to be qualitative improvement in health delivery system.

Doctors in the government state services have been agitating for long seeking various benefits. How far your organisation has reached yet?

There are problems aplenty for the doctors who are there in the government service and also those who want to join these services. The government’s policies are unfriendly and in many a cases even discouraging.

The poor working conditions, coupled with increasing interference by bureaucrats, have made it difficult for us to continue with our services. We are grossly suffering in the hands of high-handed bureaucrats who, on many occasions, treat us badly and misbehave with many of our colleagues. We have also been seeking benefits of promotions, recruitment of doctors in specialist cadre with additional advantage, same salary structure as that of central government doctors, ban on private practice by government doctors with non-practice allowance, constitution of special security force for doctors at work, fixation of scheduled duty hours in accordance with NRHM recommendations, more powers for health directorate and regularisation of doctors working on a contractual basis. Recently, the government extended retirement of doctors to 65 years, which was 62 earlier.

This should have been done six years ago. Some of our demands have been met with. But our fight will continue till we realise our rights and dignity.

‘Ineffectivedirectorate’

The state government has recently begun the process of recruiting regular doctors.

They have, but it will not benefit young doctors who are fresh out of college. It will only benefit those who are already working in the state on a contractual basis because two years of experience in rural area is a must. On one hand, contractual doctors are made to work on disrespectful terms and conditions that are totally absurd and unacceptable. On the other hand, there is absolutely no encouragement and effort to bring in fresh blood in the system. The situation is gloomy. Besides, the bureaucrats who formulate the policies and plans are mostly self-righteous and do not understand the nuances of running the health delivery system effectively. The health directorate has been made totally ineffective and doctors do not have a say in policy making for the department. Otherwise, how else do you explain that doctors who have MD degrees in subjects other than gynaecology, surgery, paediatrics and anaesthesia are made to work as general doctors with lesser salaries just because the state health society believes their qualifications are not required at block-level hospitals while NRHM envisages specialised healthcare at even primary health centres (PHCs)?

‘Few can avail govt schemes’

Do you think various schemes by the Centre and state government in health sector are reaching the people on ground?

It will be wrong to say that they are not reaching the beneficiaries, but they have not been very helpful for the poor and downtrodden people. There are a number of reasons for that. For example, the health card guarantee scheme, which was launched by the government, has not been very beneficial for the children in the state yet. Not many can avail of the facilities that the state government claims to provide through the scheme. While the idea behind the scheme is absolutely wonderful, there are no infrastructure and resources to support the programme and many others like this. So if there is a problem on the implementation and execution level, the purpose stands defeated.

Comrade of the past

Tell us something about yourself.

I was born in a village in Samastipur district on June 15, 1950. My father was a district education officer and there was much emphasis on education in our family. I did my higher secondary from a block-level inter college and was selected for MBBS course in Patna Medical College in 1969. Three years later, as I got interested in Leftist movement, I dropped out of college and devoted full-time to the movement. However, later I realised that I could do more as a doctor by serving the needy. I rejoined the course in 1976. After completing the course, I came into government service in 1979 and later took a special leave to complete my postgraduation degree in medicine. All through my tenure so far, I have mostly preferred to work in rural areas. I could have even gone in medical teaching, but I preferred to stay in villages and serve the downtrodden people. I have been actively involved in BHSA for several years, struggling for the rights of doctors in the state.

What have you been if not a doctor?

We are five brothers. Since very early, my father had planned what he wanted us to be. He wanted two of his sons, including me, to be doctors and I was motivated like that. Given my gift of gab and interest in fighting for the rights of people, I would have chosen law as a career. I have always been interested in rea-ding and oratory and they have helped me being what I am today.

‘No competition’

The situation in private sector either is not impressive.

For the private sector to improve, things have to be good in the government sector first because private hospitals compete with government hospitals. It’s a classic case of figure among ciphers. If there is an institution like AIIMS in the state, private players will want to provide better facilities and options to draw patients. But healthcare facilities provided by the state government — right from PHCs to tertiary care centres such as Indira Gandhi Institute of Medical Sciences and Patna Medical College and Hospital — are so low in quality that patients throng private clinics and hospitals even if they are not good enough. The state needs to develop super specialty wings in medical colleges so that they serve two purposes - benefiting the needy and training the doctors in the making.