------------------------------------------------------------------------------ Documented by Goa Desc Resource Centre Ph:2252660 Website: www.goadesc.org Email: [EMAIL PROTECTED] Press Clippings on the web: http://www.goadesc.org/mem/ ------------------------------------------------------------------------------ --------------------------- Absence of Doctors --------------------------- EDITORIAL
Medical treatment and health care are no more the exclusive domain of state governments; the market economy is throwing up an increasing number of enterprises in the sector. Private entrepreneurship was there in the health sector from a long time, but over past several years, it has had enormous rate of growth. All of it cannot be explained by the failure of the state governments, but they cannot surely shrug off a certain part of the blame.
Medicare and medical education have been state subjects and any proposal,
either for privatisation of the state medical sector or for hiring of the services
of private medical practitioners for improving the health network in the villages,
is an admission of the fact that the state has failed to keep its commitment
to the people, to re-orient the medicare system and most important, to
exercise effective control on its cadre of doctors.
This is of course not only the case of Goa. Almost all states are afflicted with this malaise. Government doctors are reluctant to abide by the instructions of the government and join rural primary health centres. Even those who are attached to hospitals in urban areas prefer to devote much of their prime time in conducting private practice. The problem in fact has acquired much bigger dimension in the northern states where some of the state governments even tried in vain to ban private practice by government doctors.
Ironically, the coercive lobbying of the doctors has proved to be much more effective than the government powers. It is really a shame for a government to give up its social responsibility and succumb to the pressures of powerful doctors.
The Goa government has come out with a proposal for hiring 20 doctors on part-time basis for the medical sub-centres of talukas of Valpoi, Sanguem, Pernem and islands of Chorao and Divar. Obviously it is the reluctance of the government doctors to move to the rural areas that has forced the government to take this decision.
The moot questions are: how can government doctors go against the terms of their employment and what action has the government initiated against the rural job-evading doctors? Do these doctors think that the people living in the remote rural areas are not human beings and do not need basic health care? Or, is it the lust for more money that prevents them from going to the rural areas?
A section of doctors accept that the rural health centres in peripheral talukas have failed; and these have failed due to the absence of the doctors. It would be necessary for the public to know why these centres failed and what steps the government took to revive them.
Undoubtedly Goa can boast of having one of the best health care infrastructures with 150 hospitals with a total bed strength of 5211 beds. In Goa the doctor:population ratio is 1:865 as against 1:2148 for rest of the country. There are 5 community health centres, 19 primary health centres, 172 sub-centres, 29 rural medical dispensaries, 2 specialised and 3 general hospitals. Besides, there are dental clinics and other special clinics for implementation of various national health programmes.
In this background, the move of the government to bring in private doctors, instead of reorienting its medical cadre, raises apprehensions. By and large hospital-oriented medical relief was available to the people in the urban areas and the rural areas were very much neglected.
In a welfare state, the government is committed to ensure basic facilities to its people and the Goa government is under constitutional obligation to fulfill its commitment to the people. But at the same time, it must ensure that the doctors do not abandon their responsibility.
Of course there is no disagreement on the issue that super-specialities set- up, especially in cardiac treatment, needs to be established as a state-of-the-art centre, managed by the private organisations.
There are many who believe that with the annual outgo on mediclaim the state government could have created such a centre on its own, but this does not take into account many ifs and buts, like the lack of modern hospital management, huge financial resources and competitive sophistication of equipment, which would not been possible for the state government to handle.
However, the state government certainly did not lack the managerial capability, financial resources or the required equipment to run primary health centres. It lacked only the will. ----------------------------------------------------- The Navhind Times 6/11/03 page 10 -----------------------------------------------------
======================================= GOA DESC RESOURCE CENTRE Documentation + Education + Solidarity 11 Liberty Apts., Feira Alta, Mapusa, Goa 403 507 Tel: 2252660 mailto:[EMAIL PROTECTED] website: www.goadesc.org ---------------------------------------------------------------------- Working On Issues Of Development & Democracy =======================================
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