CHENNAI: A recent Madras High Court order has left the government doctors community furious. Subsequently, services in government hospitals across the State were affected by the doctors’ strike last week. Their main grouse was that the court had cancelled 50% reservation for government doctors in PG admissions.
The order, passed by a single bench consisting of Justice Pushpa Sathyanarayana on April 17, drew the ire of all opposition political parties, who issued statements condemning the ‘abolition’ of the quota.
But a fine reading of the judgement points out that the carefully worded order did point out how the 50% reservation for government doctors was termed illegal by a Supreme Court order.
Yet, it went on to direct the State health department to compute the incentive marks for a candidate, who is the petitioner in the case and had served in a remote/tribal/hilly area for three years, “while preparing the rank list for admission to the postgraduate courses in 50% reservation category for government servants.” So, the order actually granted incentive to a doctor for having served in a remote area.
Problem with method
Detailed conversations with the protesting doctors revealed they were against the method of computation of the incentive marks that the high court upheld. There are about 1,600 seats in postgraduate courses in government colleges and 50% of these — about 800 — are reserved by State government laws for doctors who served in government institutions.
Last year, in a case involving Uttar Pradesh, the Supreme Court ruled that such a reservation for government doctors is illegal and the central government’s Postgraduate Medical Education Regulations, 2000, is the only rule book that should be followed.
Instead of reservations, the central government’s rule gives 10% incentive marks for each year of service in “remote or difficult areas”.
The incentive marks are calculated based on marks obtained by the candidate in the National Eligibility cum Entrance Test. While the high court order indirectly acknowledged 50% reservation for government doctors, where it differed with was the method of calculating the incentive marks from the brochure for PG admissions released by the State government.
As per the brochure, out of the total 100 marks, 90 will be proportionate to the marks obtained by the candidate in NEET and the remaining 10 marks based on service after finishing MBBS.
One mark for each year of experience, one mark per year for service in rural areas, two marks for service in hilly and remote areas and two marks for service in government hospitals in Thiruvarur, Nagapattinam and Ramanathapuram districts.
Mismatched incentives
So what is the real grouse of the protesting government doctors was that the central government’s rule gives much higher incentive to the candidates who work in remote/tribal/hilly areas.
“As per the ruling, 1,000 seats will go to doctors in the remote areas. Again, after non-clinical seats, only a few will be left for others working in (other) rural Primary Health Centres. This is atrocious,” said Dr K Senthil, State president, Tamil Nadu Government Doctors Association.
The main argument was that imposing the central government’s rule will make serving in government hospitals in areas other than those classified as “remote, hilly or difficult” will become unattractive.
“If this system prevails, there will be no specialists in government hospitals, which are facing manpower shortage. If 30% incentive is given to in-service doctors serving in remote areas, then there will be no seats for doctors serving in other areas,” said Dr PC Rupesh, State joint secretary, Tamil Nadu Medical Officers Association.
No entrance exams
Young MBBS graduates who joined government medical services in rural and semi-urban areas are upset since they consider that they are unjustifiably stopped from taking any entrance exams during the first two years of service as per the contract. What makes the government service attractive is the promise of the 50% quota in PG admissions in government colleges. As doctors protest, patients are forgotten.
“The government stopped us from appearing for entrance examination for the past two years. There was a bond only after two years of government service that the doctors can write entrance exam. If they were allowed to write the exam, majority of them would have escaped from these difficulties,” said one of the protesters in Chennai.
When contacted by Express, a senior health official said: “The government has appealed against the Madras High Court order. It will affect hundreds of doctors working in PHCs in rural places and this will affect the public health system in the state.”