A robust public healthcare system is considered the hallmark of any progressive democracy. Even those governments which were apathetic to spending on healthcare had been scrambling to get their act together in the last two years of Covid-19 pandemic.
Yet, here in the national capital, none seems to have learned from the past. The public healthcare system of Delhi could withstand the storm of three successive waves of the deadly pandemic not because it was inherently strong but of the hundreds of healthcare workers who sacrificed their blood and sweat in the altar of service. As thankless and thoughtless a system can be, once the coronavirus started signs of ebbing, a large number of contractual healthcare workers in the city started facing the axe.
This comes at a time when government-run hospitals are struggling with staff shortage. The ripple effect of firing of contract workers and lack of hiring permanent staff has put the patients at a disadvantage. Thousands of patients from Delhi and neighbouring states, most of them from socially and economically disadvantaged sections, visit the hospitals in the national capital. With government healthcare facilities grappling with shortage of surgeons and physicians, the hapless patients often get their surgeries and treatments delayed.
The perils of cheap labour
Contract labour and outsourcing are the new mantra of governments and private companies alike. The contract system is often flayed by rights activists for being one-sided and putting the workers at risk. AICCTU state secretary Surya Prakash said the government uses a private company to hire employees on contract basis so that it can keep its hands off from any responsibility. “This entire system of contracts ensures that corruption happens easily between the ministry concerned and the contractor,” he alleged.
“Are the sanitation workers and security guards less important? Is their job not essential and permanent? Why are they being hired on contractual basis?” he asked, stating that most of the sanitation and security guard jobs are also on hire-and-fire mode.
Meanwhile, a writ petition has been moved in the Delhi High Court by the All India General Kamgar Union. Sources claimed that some contractual workers still manage to stay in their job by paying bribe to the outsourcing firm.
Plight of contract staff
When it comes to firing contractual employees, all major government-run hospitals in the city have fared similarly. Hundreds of nurses, dietitians, paramedical staff, lab technicians and cooks have been terminated by Ram Manohar Lohia (RML) Hospital, Lady Hardinge Medical College (LHMC), Kalawati Saran Hospital, Raj Kumari Amrit Kaur College of Nursing.
Forty-three-year-old Nanak Chand is a specially abled person. Employed in the prosthetic department of RML Hospital since 2010, Nanak used to make prostheses for the premier hospital. Nanak said it was a shocker when the hospital slapped him with a termination notice.
Nanak claimed he was not a contractual employee but was appointed by the hospital after interviews and medical test. Nanak, who lives in Lal Kuan (Badarpur) with his polio-stricken wife, mother and two daughters, lamented that on one hand the government keep on telling that ‘Divyang’ have divine power but on the other hand takes away their jobs. Nanak said that while he was working, around 150-200 patients used to visit the Physical Medicine and Rehabilitation Department of the RML Hospital on a daily basis.
Nanak is among the 200 odd healthcare workers – most of them were in the roll for more than a decade -- sacked from their jobs in the RML.
The situation was not different at LHMC where more than 400 contractual workers were terminated. The fired staff included 80 multi-tasking staff (MTS) who operated vital life-saving machines like ventilators and biPAP machines during the pandemic. Most of these workers were hired during the pandemic period through an outsourcing company which had told them that their job contract job will be only for 100 days. The fired staff said since they were in dire need of a job, they accepted the condition. The job remained with them for next 11 months during which performed essential activities including operation of critical life-saving equipment such as ventilators, bipap machines, oxygen concentrators, ABG machines, intubation trolleys, etc. These services were of utmost importance to LHMC functioning during the pandemic period.
When contacted, the officials of these hospitals had no concrete response on the issue and this reporter was asked to speak with some other officials who again dodged the questions by referring to another set of officials. The Delhi government-run hospitals also terminated a number of healthcare workers after the Covid-19 figures started falling. In March alone, Lok Nayak Hospital terminated the services of around 95 nurses who were recruited 11 months back to handle Covid-19 duties.
The Delhi government also shut more than half of its vaccination centres that were operational in schools and other non-health facilities due to which services of around 1,900 contractual vaccinators, nurses and data entry operators were terminated. The workers had protested for several days in front of Delhi Secretariat demanding reinstatement of their jobs but to no avail.
Officials in the Delhi health department, however, said the contract workers had been told beforehand that theirs was a contractual job and they would be terminated once the demand ends, and yet they are protesting.
Doctors too not spared
Hiring and firing of healthcare workers was not restricted to paramedical staff. Around 30 junior resident doctors were disengaged less than two weeks after they were brought on board to staff the 500-ICU bed facility linked to Guru Teg Bahadur Hospital at Ramlila ground in May last year.
According to Dr Arun Gupta, president of Delhi Medical Council, the government hires doctors and healthcare workers on contractual basis to save expenses and put a lid on trade unions. Contract workers often get only a fraction of what permanent staff receives. Also, compared to permanent staff, these employees need not be paid any perks.
“Also, the government fears permanent workers forming trade unions among themselves. If kept on contractual basis, the government can fire them at will,” Dr Gupta said. He, however, said there are examples of permanent doctors and workers not doing their job well due to the job security, and this tempts the government to hire contract staff.
Dentists rued that there were hardly any vacancies for dentists in Central government-run hospitals in Delhi on a permanent basis. “Those hired on contract basis are being paid less than Rs 15,000. A labourer can earn this much in a month. What’s the point of being a dentist then,” said Dentist Dr Bhawani Satawan.
Vacancies not filled yet
Even as healthcare workers are being terminated from various Central and Delhi government-run hospitals, around 2,000 vacancies are still unfilled at the All India Institute of Medical Sciences, Delhi. Also, more than one-third of faculty posts are lying vacant in one of the most sought-after healthcare facility in the national capital. The institute has 1,131 posts sanctioned for different faculty positions and out of these, 400 (36%) posts are vacant, said the data shared by the Union Health Ministry in the Lok Sabha.
Similarly, in Delhi government-run hospitals, over 2,500 posts are lying vacant, including 487 posts of doctors. Out of the total vacant posts, 1,200 are for nursing staff and 834 for paramedical staff.
A status report submitted before the Delhi Legislative Assembly stated that there are 2,583 sanctioned posts for doctors in all the government hospitals functioning under the Delhi government, of which 487 are vacant.
Strike impact
Staff at North and East MCD-run hospitals have gone on strike several times in the past over delayed salaries. East Delhi Municipal Corporation-run Swami Dayanand Hospital doctors said they have not received their salaries since last December. In February, after the doctors went on a strike to demand their pending salaries, around 100 senior and junior resident doctors were fired. All other contractual doctors and DNB residents (junior doctors who work as residents while studying for their specialisation) were marked absent for the three days that the hospital was on a complete shutdown.
Also, the salaries of resident doctors from the Central government-run Lady Hardinge Medical College (LHMC) and two associated hospitals were deducted for the period when they were on strike in December to expedite NEET PG counselling. Even though resident doctors from the medical college have written to Union Health Minister Mansukh Mandaviya to ensure that the deductions are reversed, the issue hasn’t been resolved.
Adding to the woes of doctors, another issue which has been discouraging aspiring doctors from moving ahead in the profession is the delay in NEET PG exams and counselling.
Row on NEET PG counselling?
The timing of examination and counselling for NEET-PG and Diplomate of National Board has time and again been a burning issue making the young MBBS graduates go through a traumatic time in a bid to complete their medical education.
On May 13, the Supreme Court dismissed a petition to delay the National Eligibility Entrance Test Postgraduate (NEET-PG) examination for 2022. NEET-PG aspirants have said that the verdict is unfavourable to the demands of various doctors’ associations, which had moved the court after the Union health ministry refused to heed their demands of postponing the exam for two more months.
The NEET-PG examination for 2022 is scheduled to be held on May 21. Over 1.74 lakh (1,74,886) candidates have so far applied for the National Eligibility cum Entrance Test (NEET) for PG exam, the application process was shut on March 30.
The number of students appearing for the exam each year is nearly three to four times the 42,000 seats available across the country. Hence, many end up taking multiple shots at the test. Around 50,000 doctors will reappear for the exam and are currently doing their requisite internship with different hospitals across the country. They aspire to reappear in exams for the purpose of choosing their career option as per their ranking, choice, and available options under different branches of medical science.
Many of them are participants in the ongoing counselling process which is still underway after starting late this year, considering the roller-coaster ride which they have been subjected to since July 2021. Many were deprived of even filling up forms for the NEET-PG 2022, as the last date for it was closed on March 25.
Hospitals and number of contract staff terminated
400 Lady Hardinge Medical College (LHMC) and Associated Shrimati Sucheta Kriplani (SSK)& Kalawati Saran Children’s hospital
200 Ram Manohar Lohia Hospital
200 Safdarjung Hospital
100 Raj Kumari Amrit Kaur College of Nursing
95 nurses Lok Nayak Hospital
More than 1K Delhi government’s vaccination centres
Approximate figures
Healthcare workers at government-run hospitals in Delhi raise a slew of concerns such as long working hours, irregular payments, outsourcing of staff and unfilled vacancies. Many of their woes have intensified after the pandemic started ebbing. A report by Ankita Upadhyay