Income on the side over and above NPA
Morung Express News
Kohima | August 11
Non-Practising Allowance (NPA) is a special allowance given to government medical doctors “in lieu of private practice.” This allowance, which is also eligible for government veterinary doctors, comes to approximately Rs 8cr a year, as per a source in the state Finance Department.
To qualify for the NPA, a government doctor has to comply with a compulsory three-year “rural posting.” According to the latest RTI figures, more than half of the medical doctors employed under the state Health & Family Welfare Department (H&FW) are availing the allowance.
The figures, provided by the H&FW, state that 283, out of the total of 548 medical doctors presently employed under the Department, are availing the NPA (See Table). There was no clear cut figure on how much a doctor is entitled but it is normally worked out based on the pay scale or 20 percent of basic pay.
The basic premise of the NPA is to discourage government doctors from engaging in the more lucrative private practice at the cost of their mandated duties at government-run health establishments. But it is not uncommon for government doctors to foray into private practice over and above their official job description.
There is neither official, nor independent data attributing exact numbers to it but it has become an accepted custom, more or less, at the cost of the exchequer. It also brings forth the question of legality, ethics and the quality of medical services at government-run hospitals.
Ethics
A retired state Health official, while admitting to government doctors engaging in private practice, pointed out that it has had an adverse impact on the state health service. Wishing not to be named, he admitted to “a lot of our doctors, especially in Kohima and Dimapur, are into private practice.” Moreover, he disclosed that “some doctors posted in the other districts are working in their private clinics and hospitals in the towns.”
According to him, this practice has had a telling impact on the poorer section of the society, who cannot afford the more expensive health services in the private hospitals. He remarked, “If only our doctors can render their services in their place of postings, we can ease the burden and expenditure of our people, especially those living in the rural areas.”
While that is the observation, he alluded to “divided views” on this among the medical fraternity. “We cannot go on checking all the hospitals. Maybe a third party has to do that. At the end of the day, we leave the matter to the government,” he held.
A citizen in Kohima, who also wished anonymity, commented that government doctors are at the “forefront of running their own private clinics.” From his own experience, he said that government doctors appear to be constantly in a hurry “rush to their own clinics” being paid from the public treasury. “Moreover, most of the doctors often send patients to private centres for diagnostic tests and examinations,” he added.
Statute
A serving H&FW official said, “Indulging in private practice for financial gains by government employees is not permissible unless approved by the government.” According to him, the state government has come out with notifications but has yet to work out a mechanism to check private practice by government doctors.
He termed the practice as “illegal and unethical,” as per the Nagaland Health Care Establishments (NHCE) Act, 1997. The Act states, “No doctors, nurses or any paramedics or any other employees in the employment of the state government shall be employed in such health care establishment.”
As for the state government, it is well aware of the practice. Back in September 2014, the H&FW had issue a notification, noting, “Instances have come to the notice of the government that despite the standing regulations on private practice during working hours by government employed medical doctors, many such doctors continue to indulge in private practice.” It also directed that no medical doctor will be engaged in any private clinic/nursing home for the purpose of private practice for monetary earning from 8:00 am to 2:00 pm.
Private practice by a government doctor, as defined by Health & Family Welfare via a notification dated October 20, 2011 is “any medical practitioner employed under the state government and practicing for his/her profession for personal earning monetarily apart from his/her official duty shall be termed as private practice.”
Meanwhile, the Nagaland Lokayukta is on the case.
This is the conclusion of a two-part series.
