While working in Uttar Pradesh, I came across several instances of medical college buildings built with hundreds of crores of rupees lying vacant. They had become the refuges of stray dogs and other squatters. When questioned, those responsible for running these institutions had a very simple explanation to offer- there is a severe shortage of doctors, nurses, MD, MS degree holders ! The question is why the people taking the decisions to go ahead with setting up of medical institutions, have constantly failed to notice and resolve the manpower shortages in the medical sector for years, writes former IAS officer V.S.Pandey
The corporatization of medical facilities and services is wreaking havoc in India but the central, state and local governments are callously disregarding the blatant exploitation of the hapless population. As our overburdened public health system is crumbling under the weight of the burgeoning population, the governments across all states and center, it seems, have chosen the easiest option -to wilfully ignore the elephant in the room. During the recent past, there has been a spate of announcements regarding the opening of AIIMS in all states and medical colleges in each district. Governments have been allocating funds for construction works which are either completed or going on unabated but whether these projects have the requisite number of experienced faculty, professors, doctors, paramedics of required caliber in place or not, seems to be inconsequential.
While working in the state of Uttar Pradesh, I came across several instances of medical college buildings built with hundreds of crores of rupees lying vacant. They had become the refuges of stray dogs and other squatters. When questioned, those responsible for running these institutions had a very simple explanation to offer- there is a severe shortage of doctors, nurses, MD, MS degree holders ! The question is why the people taking the decisions to go ahead with setting up of medical institutions, have constantly failed to notice and resolve the manpower shortages in the medical sector for years. Why did they choose to do nothing to remedy the situation? For decades, the medical education system, in private hands, has been a source of exorbitant money extraction. According to reports appearing in the media regularly, crores are needed to get admission for those aspiring for an MBBS degree and aspirants are made to spend several more crores for acquiring admission for MD, MS etc. degrees. How powerful the stranglehold of the corrupt private medical education provider lobbies is on our governments and system becomes clear from one fact -while tens of lacs of young and bright students appear for entrance examinations for medical seats, the combined number of MBBS seats in government and private sector remain woeful -at a paltry hundred thousand only in a country of more than one hundred and forty crore people.
Who is responsible for this mismatch between demand and supply? Why have all the great votaries of market economy, free enterprise, dismantling of controls, creating opportunities for our people to flourish etc. chosen to keep silent for decades on this skewed situation? The so called free marketeers who are battle ready to vociferously object on smallest of interfaces in market mechanisms, remain mute when it comes to the most critical lifesaving foundational issue – allowing acute shortage of medical seats for more than half a century. Nothing can be more mindless and ridiculous than forcing our young people to scour for medical seats across the globe including China, Ukraine, Uzbekistan etc. and forced to pay unaffordable fees in dollars, depleting our foreign currency reserves also unnecessarily. This unscrupulous exploitation of aspiring medical students has been going on for decades unhindered -due to the illicit nexus between the education mafias and our ruling class. How desperate our students are to fulfill their aspirations to become professional doctors can be gauged from the fact that after having been trapped in the dangerous Ukraine conflict zone and covid lockdowns of China, they are once again, desperately trying to get back to these countries in very adverse situations, to achieve their dreams.
It is time our governments sit-up and take notice of the alarming situation prevailing in the medical education sector in particular and the health care system in general. The Government should take a cue from the reforms undertaken in the engineering education sector in the early years of this millennium. The engineering education sector was also facing an acute shortage of seats and the rush of our students to foreign shores in search of engineering seats was exactly similar to the current situation prevailing in the medical education sector. Simple decisions taken then to unshackle the system led to increased seats . India took a giant leap in the software sector due to adequate availability of trained engineers. Similarly, the mindless bureaucratic red tape prevailing in the medical education sector needs to be dismantled to enable our bright minds to become doctors unhindered, without facing the hardships of relocating to foreign lands.
With the availability of requisite number of trained medical professionals, the stranglehold of the corporate medical sector will end It will lose the capacity to extort money from ordinary citizens and the profit centred approach will get dismantled -which has resulted in totally distorting the professional ethics and morality of this noble profession. Horror stories abound of these so-called top notch super specialty hospitals, run on corporate culture models with profits ingrained in the business model. They are treating people like a “commodity” to be milked for gain. This is the sad reality of today’s private health care industry in general, barring some exceptions. Despite several shocking cases resulting from this kind of prevailing market-oriented culture in several hospitals coming into the public domain, the governments are not enforcing accountability. It is time for the governments to act. This profit centred approach of the management has to be checked – by taking serious steps like fixing rates for commonly used facilities, appointing a health service ombudsman, a policy framework to prevent this unethical behavior on the part of these money minting machines working in tandem with certain insurance and pharma companies, in the name of providing so-called high-quality healthcare facilities. Governments must act expeditiously to save our vulnerable sick people from being fleeced and impoverished in the garb of medical treatment.
(Vijay Shankar Pandey is former Secretary Government of India)
