Soon, doctors can negotiate their salary in government hospitals, on the lines of appointments in private hospitals, with the state government keen to find out if higher salaries will attract doctors to tribal areas. Under the new policy, the health ministry will appoint paediatricians, gynaecologists and anaesthetists in selected rural, district, civil and corporation hospitals.
The government has identified 245 hospitals, mostly in tribal and rural hamlets, which will be ‘first preference unit’ for healthcare facilities for locals. Of these, 175 are functional under the state health department, while others are under the Directorate of Medical Education and Research.
Until now, the state government had fixed salary slabs for doctors posted in rural or tribal hamlets. Under the new policy, a paediatrician, gynaecologist or anaesthetist can negotiate and quote a salary with the district health officer for a tribal post.
“If the post is not filled by any other doctor, the doctor with even a very high salary quote will be appointed. We are willing to pay at par with private hospital rates,” said Dr Satish Pawar, Director, Directorate of Health Services (DHS).
He added: “In 60 per cent of the 175 hospitals, we already have the medical staff. It is for remaining the 40 per cent that we are appointing doctors and negotiating their salaries.”
Health Secretary Dr Pradeep Vyas said high salaries to the selected doctors would still be more feasible than the huge cost incurred on transportation of critical patients to higher referral centres.
“Instead of spending on patient’s transportation from a tribal region to civil hospitals where we pay 108 emergency ambulance service, and also face the risk of delay in treatment, it is cost effective to strengthen local health centres and rural hospitals,” said Vyas.
The state government currently pays a fixed price to the BVG India Pvt Ltd, with which it has signed an agreement to run the emergency medical service. After a fixed distance, the government has to pay per kilometre. “Sometimes, the distance can cross 100 km,” Vyas added.
Latest data from the health ministry shows as many as 199 (35 per cent) out of the 561 sanctioned posts of paediatricians in districts across the state are vacant. For anaesthetists, there is a 64 per cent vacancy, with 416 of the 648 sanctioned posts lying vacant. The vacancy for gynaecologists is 26 per cent, with 159 posts vacant across Maharashtra.
In Washim and Gadchiroli, there is a single anaesthetist for the entire district, while not a single anaesthetist is available in Nagpur district, data from the DHS shows. In tribal areas such as Palghar, Nandurbar, Yavatmal, and Gadchiroli, over 50 per cent posts of gynaecologists are vacant.
The state government has identified critical districts and areas such as Bhandara, Gadchiroli, Nandurbar, Nashik, Melghat, Chandrapur and Gondia where maximum vacancies are there and doctors can negotiate salary for appointments in government hospitals.
“We have already started the procedure and interviews with doctors for selected posts have begun,” said Dr Kamlesh Bhandari, district health officer in Bhandara.