Imkong Walling
It seems fair, the demand by doctors or, collectively, the Nagaland In-service Doctors’ Association (NIDA) calling for increasing the retirement age of government doctors serving in the state Health & Family Welfare Department.
An inferred scarcity of practicing medical professionals in Nagaland was the justification, backed up by a 2016 Central government pronouncement to enhance the age of superannuation to make up for shortage of doctors in the country.
The Nagaland state government is yet to respond to the call even as NIDA members have started a symbolic black armband protest from January 25.
The ground reality is visible, supplemented by statistical indicators pointing to Nagaland faring poorly in terms of doctor-population ratio. The ratio works out to roughly 1 doctor for 2000 people against the WHO recommended 1:1000, while the state averages less than the country’s 1.34 doctors per thousand population.
The total requirement for the state is tipped at 2,073 doctors, while the Nagaland Medical Council has 1,118 doctors in its registry. Out of the existing total, 528 are said to be in the “public sector,” which can be construed as those under the payroll of the government.
As on April 2020, the number of posts for allopathic doctors in the department was 391 against a total sanctioned strength of 424.
The demand for service extension seems justified given the figures and a clearly under-strength doctor cadre in the H&FW Department. However, there is the question of how increasing retirement age correlates with improving state sponsored health service.
As a norm, government doctors eventually get absorbed in the Directorate, by virtue of seniority, after serving/practicing a certain period of time in the field hospitals/PHC/CHCs. This implies losing years of medical experience to desk-jobs or administrative positions.
It is indisputable that a department relating to health must be run by medical professionals. However, considering the primarily white-collar work in the senior years, increasing service length would not have as much an impact on the ground. It would, at best, only translate into spending an increased number of years in the Directorate.
Disgruntlement in the junior and mid-level cadre is also evident-- a sentiment arising from apprehension relating to delayed promotion prospects of juniors and delayed employment for fresh medical graduates.
According to this narrative, enhancing retirement age would only benefit senior doctors holding administrative posts.
Given the apparent discontent, extension of service would only foster distrust and animosity, which would ultimately affect service delivery.
It demands approaching the issue with tact and the practical implications in view, while exploring options to augment the doctor to population ratio and improving the overall public health care.
There is the option of filling up the sanctioned number of posts, while creating more doctors' posts in the government health facilities.
Further, there is another option i.e. joining the NHM in ‘care-giving’ roles post-retirement. It is not uncommon for retired government doctors to rejoin the medical field either as consultants, private practitioners or under the National Health Mission.
Instead of service extension, transforming the state medical sector into a more lucrative and trustworthy entity, besides improving road connectivity, would only serve to attract the 40 odd medical students, who graduate every year, to join the government health sector.
The writer is a Principal Correspondent at The Morung Express. Comments can be sent to imkongwalls@gmail.com
