The Maharashtra government’s attempt to fill vacancies by wooing private doctors to government hospitals — by first allowing them to negotiate salaries and later providing additional incentives — has yielded results. In the last six months since the scheme was announced, the government has appointed 356 specialists.
At least 12 gynaecologists and anaesthetists have bargained for a pay package of over Rs 3 lakh per month to serve in rural districts of Beed, Raigad, Yawatmal and Chandrapur.
Until October last year, Maharashtra noted 64 per cent vacancy in 648 posts for anaesthetists, 35 per cent vacancy in 561 pediatrician posts, and 26 per cent vacancy in 612 posts for gynaecologists.
The state government decided to allow private doctors to negotiate their salary in tribal and Maoist-affected regions. In other areas, it offered a fixed salary along with incentives such as Rs 4,000 for each Caesarean surgery, Rs 40 for each ante-natal check-up, Rs 1,500 per assisted delivery and Rs 1,200 per pediatric case treated. Since December 2017, 142 gynaecologists, 143 anaesthetists and 71 pediatricians were appointed under the new scheme with incentives. Pune got 70 specialists followed by Satara (39), Chandrapur (28) and Yawatmal (24).
Buoyed by the increase in appointments of anaesthetists, gynaecologists and pediatricians, the state health ministry now plans to expand the scope of salary negotiation to all other 12 specialities including ENT, dermatology, and general surgery across Maharashtra.
“Doctors have realised they can earn on a par with private hospital rates. Since it is incentive-based, doctors are encouraged to see more patients. The state is not incurring a huge financial burden as other factors like cost of transporting a patient to a higher centre is reduced,” said Dr Sanjeev Kumar, director of National Health Mission, Maharashtra.
In Chandrapur’s Rajura taluka, a Maoist-affected area, Dr Priti Bambole joined as a gynaecologist in December 2017. “Since then, I managed to earn incentives totalling Rs 2 lakh over my fixed salary. I can also do private practice along with government service. Since it is incentive-based, doctors don’t feel they are working overtime,” she said.
Dr Taral Nagmoti, a gynaecologist in Brahmapuri, has earned Rs 5.2 lakh in incentives in the same period. “Since these are tough areas to work in, doctors need some incentive in the government sector,” she said. Latest state health ministry data shows that of the 356 doctors, 12 earn a monthly salary package of over Rs 3 lakh, 12 earn between Rs 2-3 lakh, and the rest earn below Rs 1 lakh.
Before the state government took the decision to incentivise salaries to serve in government hospitals in December 2017, specialists received a salary of Rs 50,000 to Rs 90,000 per month, depending on their work experience.
Following the appointments, in June alone, the state recorded 4,437 Caesarean deliveries conducted by the newly appointed gynaecologists, 1,021 major surgeries by anaesthetists and 2,606 emergency pediatric cases in rural and tribal regions.
Dr Neelambari Salunkhe, attached with Directorate of Health Services, said in some districts where vacancies are huge, negotiation in salaries has been government’s last resort. “These are tribal and Naxalite areas mostly,” she said.
In Beed, where seven doctors are earning over Rs 3 lakh package, state officials said private doctors were allowed to negotiate after government hospitals reported an acute shortage in specialists. Civil surgeon Dr Ashok Thorat said, “After specialists increased in rural and sub-district hospitals, in Beed, records show there is a dip in women going to the private sector for delivery, from 40 to 20 per cent.”
There, however, have been no takers in districts like Nandurbar, Thane, Sindhudurg, Ratnagiri, Jalna, Bhandara and Gondia. “Doctors in Nandurbar’s hilly terrain need more than just money. We have been requesting to provide them proper accommodation, proper toilets. Infrastructure remains poor,” said Latika Rajput from Narmada Bachao Andolan.