Rural service or big fine for doctors in West Bengal

A doctor refusing to work in a rural health care facility after getting a postgraduate degree from a state-run medical college could be penalised Rs 30 lakh from next year, three times the originally notified amount. There has been a rethink on the penalty since the health department issued a notification stating that all postgraduate medical students other than in-service candidates would need to execute a bond to work in a rural health care unit for at least a year, beginning the 2014-15 academic session.

The bond amount had been fixed at Rs 10 lakh, which the government reviewed and found to be too little to act as a deterrent to opting out of the mandatory service period. “We are planning to increase the bond amount from Rs 10 lakh,” director of medical education Sushanta Banerjee toldBanerjee did not mention the quantum of increase but sources said the plan was to raise the penalty three-fold.

Bengal apparently took the cue from Maharashtra, where the penalty of Rs 10 lakh has failed to keep doctors from opting out of the rural health service. “Our policy has been only partially successful. Many doctors still refuse rural postings, saying they would rather pay compensation,” T.C. Benjamin, additional chief secretary of public health in Maharashtra, said from Mumbai.

Bengal has 736 postgraduate seats, of which 50 per cent are taken by students from outside the state. “We have studied the models in other states and reached the conclusion that the only way to make doctors serve in the rural areas is a high amount of compensation,” said an official at Swastha Bhavan. He said the proposed penalty could help ease the shortage of doctors in rural health care centres. Around 1,800 doctors are required to fill vacancies in district hospitals, block primary health centres and primary health centres. The shortage of medical professionals in the rural belt is one of the reasons why patients flock to the already overcrowded medical colleges in Calcutta.

Some believe that raising the penalty alone wouldn’t be enough to make doctors go to villages, primarily because the national entrance examinations for PG courses allow medical students to apply for a seat anywhere in the country. “A candidate can opt for a state where there is no rural-service obligation,” a source said. A senior health department official said the government “had to start somewhere” and an upward revision of the penalty was the practical thing to do.

The government has also finalised a plan to introduce Diplomate of National Board, postgraduate and diploma courses at six district hospitals in a bid to get junior doctors into these hospitals. It has already announced “10 per cent additional points” in postgraduate entrance examinations for those working in remote areas during their internship period. The six district hospitals where courses could be introduced are Deben Mahato District Hospital in Purulia, Howrah District Hospital, Chinsurah District Hospital, Shaktinagar District Hospital in Krishnagar, Barasat District Hospital and Asansol District Hospital. Diplomate of National Board is a postgraduate degree and diploma awarded by the National Board of Examinations, an autonomous academic body under the Union health ministry. It is equivalent to an MD or MS degree. “We have selected five subjects and each stream will have two postgraduate seats. Six more seats will be created for the two-year diploma courses,” Suman Biswas, a spokesperson for the health and family welfare department, said. Diplomate of National Board courses are taught at two state-run medical colleges — MR Bangur and Shambhunath Pandit, both in Calcutta.

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