Govt. doctors in private sector: More than just a question of ethics?

Atono Tsükrü
Kohima, Sep. 12 (EMN): Medical doctors employed in government departments and hospitals are given an allowance called ‘non practising allowance’ (NPA) by the government to discourage private practice by those doctors.
While NPA is given to doctors to ensure their availability at the hospital, however, it is an open knowledge that many government doctors are also engaged in the private sector – at the cost of the patients.
Doctors are given NPA at the rate of 25% of basic pay inclusive of dearness allowance, travelling allowance and house rent as well as ‘calculation of retirement benefits.’
The state finance department, in a notification issued on March 17, 2010, had made it clear that ‘no doctors getting NPA shall be allowed to do private practice and the Health and Family Welfare department and veterinary department shall strictly enforce this condition.’
Violation of this rule, it had warned, ‘shall invite disciplinary action, which may go to the extent of removal (of the doctors) from service.’
While many doctors have argued that the state government was yet to clearly define ‘private practice’, the department of Health and Family Welfare – in its September 12, 2011 notification – had announced that ‘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.’
Despite the directives issued by the government, many doctors continue to flout the order. When enquired, a doctor told this correspondent – on the condition of anonymity – that doctors are ‘paid a percentage’ for every case they refer to private clinics.
A member of the public, Vechita Khesoh, narrated a very disturbing scenario of this practice by the doctors when he took his aunt for check-up. He said that after the completion check up at the government hospital, the doctor advised his aunt to take ultrasound scan from a private hospital, and then check back with him at his private clinic.
The doctor had given the excuse that the ultrasound unit at the government hospital where he was employed takes a considerable time of 2-3 days to bring out the results. So, he took his aunt to a private hospital instead. He wondered: what happens to those patients who can’t afford private medical treatment?
A pregnant woman was also reported to have been told by a doctor that if she was admitted to the government hospital he was employed at, the doctor would be available only during the ‘working hours’; whereas he would be available ‘anytime’ at his private clinic.
A source from the Nagaland Medical Council (NMC), on condition of anonymity, told Eastern Mirror that NPA has been given to doctors since the 1970s by the government to allow the doctors to ‘give all their time and energy’ towards look after their patients properly, and not to indulge in private practice.
However, the source said that few doctors are indulging in private practices tarnishing the image of the medical fraternity. “All the specialist doctors are concentrated in Dimapur and Kohima without going to their places of posting and practising in their private clinics and also drawing NPA,” the NMC source said.
“This has been going on for too long and the government is not acting on anything. Though directives have been issued time and again, the doctors just don’t seem to care. The problem is that Nagaland is a lawless state.” It was also confirmed that the state vigilance commission is investigating this issue.
Besides the many powers vested upon the NMC, constituted under the Nagaland Medical Act of 2014 as a statutory body under the Medical Council Act of 1956, it has the authority to initiate disciplinary action against doctors found indulging in unethical practices and activities.
However till today, for some mysteries reasons, both the NMC as well as the government choose to remain silent. The state government is reportedly spending nearly Rs 40-50 crore as NPA to doctors.