Maharashtra: To Improve Rural Hospitals, Fadnavis Government Offers Doctors Pay Packages Over 3 Lakhs Per Month

To encourage doctors into accepting rural postings in government hospitals, Maharashtra government has decided to provide offer additional incentives which have shown positive results to some extent.

Since the scheme was announced six months ago, the government has appointed 356 specialists. Out of these, at least 12 gynaecologists and anaesthetists have negotiated with the government for a package of over Rs 3 lakhs per month to serve in rural districts of Beed, Raigad, Yavatmal and Chandrapur, as reported by Financial Express.

The Fadnavis Govt Scheme

In tribal and Maoist-affected areas, the government allowed the doctors to negotiate their pay packages of over 3 lakhs per month to serve in rural areas of Maharashtra. For other rural areas, it has offered a fixed salary but with additional incentives, such as Rs 4000 per caesarian surgery, Rs 40 for every antenatal check-up, Rs 1500 per assisted delivery and Rs 1200 for each pediatric case.

What are the results?

According to the Indian Express, until October last year, in Maharashtra, there were 64 per cent vacancy in 648 posts for anaesthetists, 35 per cent vacancy in 561 paediatrician posts and 26 per cent vacancy in 612 posts for gynaecologists.

In December 2017, 142 gynaecologists, 143 anaesthetists and 71 paediatricians were appointed under the scheme. In June alone, 4437 Caesarian deliveries were performed by the newly appointed gynaecologists, 1021 surgeries by anaesthetists and 2606 emergency pediatric cases in rural and tribal regions.

Following this success, the state government now plans to extend this scheme to other specialities including ENT, dermatology and general surgery across Maharashtra.

Major Health Issues in Rural Maharashtra

One of the most important medical issues in Maharashtra is that of maternal and infant mortality. With 68 maternal deaths per lakh and 19 infant deaths per thousand live births two years ago, the vacancies in rural government hospitals became a rising concern.

General and Laparoscopic surgeon Dr Sushil Deshmukh told The Logical Indian, “With the ageing population on the rise, chronic diseases like Diabetes and Hypertension need attention as the complications related to them are quite severe and expensive.”

Why Aren’t Rural Postings Preferred?

A doctor shouldn’t be made to feel like they’re working overtime without proper compensation, which is why the incentives need to be given. The lack of appropriate infrastructure and inadequate salaries in rural government hospitals turns the doctors towards private practice. Dr Sushil said, “It’s not that they don’t prefer it, rather they are discouraged towards it.” Dr Sanjeev Kumar, director of National Health Mission, Maharashtra told the Indian Express,

“Doctors have realised they can earn at 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.” Also addressing the security issues in the state in tribal and Naxalite affected areas, negotiating the salaries became the government’s last resort.

In districts like Nandurbar, Thane, Sindhudurg, Ratnagiri, Jalna, Bhandara and Gondia, the vacancy remains, primarily due to absolute lack of the necessary infrastructure, including accommodation and toilet facilities.

Beed: An Example

In the district of Beed, seven doctors earn over Rs 3 lakhs after their appointment due to acute shortage of specialists in government hospitals. The percentage of women turning to the private sector for delivery has reduced from 40 to 20 per cent.

Civil Surgeon Dr Ashok Thorat told The Logical Indian, “I could appoint specialists from the private sector on a contract basis. This helped me to develop five taluk-level hospitals where we conduct more than 750 deliveries and more than 150 caesarean sections.”

When people come up and thank him for his services, Dr Ashok feels the energy to do more for them. “My district is unique where I get 3500 ANC mothers checked on 9th of every month under PMSMA at all 50 PHC and 15 urban institutes at the hands of obstetricians, amongst them 35-40 are from the private sector. This has helped me to reduce maternal mortality and neonatal mortality.”

Recognition by the Central Government

Maharashtra was awarded the 2nd prize for the reduction in maternal mortality and involvement of private practitioners in PMSMA at New Delhi, on August 9. For his contribution to the medical sector in the state, Dr Ashok was also present to receive the award from Union Health Minister JP Nadda.

The Maternal Mortality Rate (MMR) has reduced from 68 deaths per one lakh to 61 deaths per one lakh in Maharashtra, which is only behind Kerala with the lowest MMR of 46 deaths per one lakh.

What else needs to be done?

Calling the scheme an initiative in the right direction, Dr Sushil also believes there’s more that needs to be done. “Doctors are not after money that much but want professional recognition and learn newer procedures and upgrade their skill set. The government can provide special scholarships or fellowships of sorts in advanced Medical fields to doctors serving in rural areas.”

The Logical Indian take

Doctors are human beings as well. They need to be given proper financial and infrastructural support to uplift the government hospitals in rural areas. The Fadnavis government scheme is a step in the right direction. However, there is still a lot that needs to be done to transform the state’s rural medical sector with the help of all its trained specialists.

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