Doctors in Haryana are taking flight and healthcare itself is on the ventilator in the state hospitals nowadays.
While there is an acute shortage of manpower in all state-run hospitals, the tedious process of the state government for the healthcare staff recruitment too is contributing to it in a big way. It has emerged as a big factor for the shortage of doctors as it takes two to three years for recruitment due to formalities and procedural failures in the system.
The large rural population of the state is at the receiving end as more and more doctors are leaving government hospitals in search of greener pastures, thus depriving the rural population of sufficient healthcare services. A recent district-level households and facility survey-4 (DLHS-4) in Haryana has pointed out that the acute shortage of doctors is there in all the district and sub-divisional hospitals, primary health centres, community health centres and sub health centres in the state.
The DLHS-4 survey, conducted in 708 villages of the state covering 673 sub-health centres, 246 PHCs, 106 CHCs including block PHC, 21 SDHs and 21 district hospitals, has made some startling revelations:
Only 19.1 per cent PHCs have AYUSH doctors .
Only 34.2 per cent PHCs have lady medical officers.
Only 13.2 per cent Community Health Centres (CHCs) have Obstetricians/ Gynaecologists out of 106 CHC surveyed.
Only 8.5 per cent CHCs have Anaesthetists.
Only 46.2 percent CHCs have functional operation theatres.
Only about 28 per cent Sub Divisional Hospitals (SDHs) have a Paediatrician.
Only 9.5 per cent SDHs have a regular radiographer.
Only 4.7 per cent SDHs have 2D Echo facility, 14.3 per cent have ultrasound facility and 42.8 per cent have critical care areas.
Only 38.1 per cent district hospitals have regular radiographer, 38.1 per cent have 2D Echo facility, while 76.2 per cent have critical care area.
None other than the state government and its faulty policies are to be blamed for the crisis. Such is the level of government's ineptitude that even in Narnaul -- the home district of the state's health minister Rao Narender, there is an acute shortage of doctors and other nursing staff at its General Hospital (GH), community health centres (CHCs) and primary health centres (PHCs). Here over 47 per cent of sanctioned posts of doctors are yet to be filled.
Doctors flee in search of better options largely owing to heavy work load because of paucity of medical staff because of the inordinate delays in filling up the vacancies, low salaries and lack of incentives, and poor facilities in the government-run hospitals. Many specialists and general physicians in Haryana are even opting for a more lucrative deputation as faculty members in government medical colleges than continuing work in a public healthcare facility as the state government has set the retirement age in medical colleges at 65 as against 58 for its doctors in PHCs.
The medical college faculty also has better amenities as compared to Medical Officers. Indeed state government policies are responsible for the high attrition rate in the field of public health care in the state.
Consider these points:
The doctors do not get any promotion or salary hike even after serving for 15 years in Haryana.
The scope of work for doctors too is not defined.
It is only after serving for five, ten and fifteen years that doctors are appraised in the state. As in the Central government or neighbouring Punjab doctors are appraised after four, nine, 13 and 20 years of service, many doctors from Haryana are shifting to Punjab.
A 2013 union health ministry of health report points out that the state hadn't yet established or created a separate public health cadre on the lines suggested by high level expert group set up by the Planning Commission of India to improve the functioning of the system by enhancing the efficacy, efficiency and effectiveness of health care delivery. The Rajasthan government is working out ways to woo the doctors from private hospitals. A similar strategy, besides amending its faulty healthcare policies, is the need of the hour for Haryana too.