In what seems to be a face-off between the junior doctors and the government of Telangana, lies a larger debate about the path the country is treading in both healthcare and employment.
The junior doctors in the state of Telangana have been on strike since September 29 on the issue of mandatory rural service on completion of education. They demand the scrapping of G.O. MS. No. 107, and that students who have to do compulsory service in rural areas after passing out be offered permanent employment and salaries at par with assistant professors and civil assistant surgeons. The government on the other hand was planning to send the passed out students only for a period of one year and that too on a contractual basis with low pay.
Governments implemented mandatory service as part of tackling the lack of skilled professionals in the government owned primary health centres and to increase the doctor patient ratio in the semi-urban and rural areas of the country. The doctors have been urging the government to make permanent posts to achieve the goals mentioned in G.O. MS. No. 107 and solve the issues of high infant mortality and maternal mortality, thereby achieving the target of IMR at 18 per 1000 live births and MMR at 54 per 1 lakh live births.
The junior doctors under the banner of the Telangana Junior Doctors’ Association (TJUDA) have been the voice of the graduate and postgraduate medical students of the state over past decades. The Telangana Junior Doctors’ Association has its strength in the government medical colleges with limited presence in the private sector medical colleges. The same junior doctors were at the forefront of the struggle for statehood and are known for the spirit of struggle on issues pertaining to the society, along with issues bothering medical students.
In the last one month the postgraduate students lay siege to the office of the Directorate of Medical Education (DME), protested outside the state secretariat and have been carrying on various non-violent protests like dharna, rallies and meetings all over the state. The demand of the junior doctors is clear at the present stage where they are not against compulsory rural service, but demand that the pay be sufficient and that job security be provided by making the postings permanent. It is argued that the main motive of the government to increase the number of doctors in primary health care centres would be solved if it would recruit the doctors on a permanent basis rather than sending them on a one year basis. The evidence for it was that the past year’s recruitment saw an excess of applicants where thousands applied for the 1324 civil surgeon posts and the 350 specialist posts, however the recruitment was cancelled by the government due to unknown reasons.
The government on the other side has been accused of playing a mute spectator, criticized for the way the protests have been dealt where the students and the tents under which they were fasting were removed in police action post-midnight, at around 3:30 a.m. in the premises of Osmania medical college. The striking doctors have come under fire for boycotting their duties and participating in the strike .The government and some sections of the society have been blaming the medicos for not attending to health services and failing to serve the poor in the rural population, to which the medicos have replied again and again that protesting against injustice is their right and that they are not against serving in the countryside.
If we see the whole issue we would understand that the government seems to be very keen on sending the medicals students on a contractual basis as part of decreasing its spending on the health sector. This trend of the government is a phenomenon all over the country where the state governments have notoriously been cutting down their expenditure on healthcare services, healthcare providers and their recruitment. This trend of low expenditure on health and lack of permanent jobs can be attributed to the neo-liberal economic policies that are being followed in the country.
The present central and state governments should also understand that the country’s healthcare needs more funding than what is being allocated in the present budget. The answer to the problem would be nothing less than permanent recruitment of young doctors which would solve the lack of skilled professionals and healthcare providers on a long term basis.