In the state of Gujarat, recruiting doctors to fill positions in government hospitals remains a challenge – with rural Gujarat bearing the brunt.
In 2018 and 2019, the state government recruited 2,228 graduates of Bachelor of Medicine, Bachelor of Surgery (MBBS) courses. However, a mere fourteen percent of them – translating to just 321 medicos – took up their appointments according to Nitin Patel, the state’s Deputy Chief Minister who also holds the portfolios of Health and Family Welfare and Medical Education in the state cabinet.
Addressing Members of the Legislative Assembly (MLAs), Patel pledged that the state government would collect fines from doctors who were in arrears for failing to fill their posts. The state government mandates that MBBS graduates from government-assisted colleges serve postings in government-run hospitals in rural Gujarat or be liable to pay Rs 20 lakh should they decline to do so. The mandatory term of service for graduates in rural Gujarat is two years.
Gujarat, as with many states, contends with a shortage of medical professionals in the public sector which, in turn, impacts patients poorly. As Health Issues India reported in 2018, Gujarat is one of the hardest-hit states and union territories in India when it comes to human resources in the field of healthcare, reporting “mass shortages in local health centres, with limited numbers of physicians and general practitioners.” Rural areas typically bear the brunt of doctor shortages.
At present, Patel said that Rs 7.21 crore has been recovered in penalties from medicos that did not take up the required positions. However, this is dwarfed by the Rs 62.07 crore still owed. The state government, Patel told MLAs, pays Rs 25 lakh for a medical course for doctors in government-assisted colleges. This is compared to the Rs 60,000 the medicos themselves each have to pay.
Patel acknowledged poor uptake of posts in government hospitals and rural service to be “a long-standing issue.” He informed lawmakers that “in 1972, the penalty was Rs 5,000 if a doctor refused to serve in rural [areas] for two years. Now the penalty is Rs 20 lakh and doctors are required to serve for one year in rural [areas]. Despite this, we are still unable to get doctors for rural areas.”
In response to the same issue last year, Patel outlined that “many doctors in Gujarat choose to go into private practice. Specialists choose to come together to set up corporate hospitals and a substantial number of them choose to go abroad. All of these factors contribute to the shortage of doctors and [specialists].”