Dr Satya Dev Gupta
Medical Colleges are the final tertiary institutions that teach medicine and award professional degrees for physicians and surgeons. They also provide post-graduate and other paramedics, super medical courses certifications and degrees.
In an article by Kenneth D Segel October 23, 2017, with a title “Bureaucrcy is keeping health care from getting better” it is mentioned that
* Bureaucracy is growing, not shrinking.
* Bureaucracy is destroying value in innumerable ways, including slowing problem solving, discouraging innovation, and diverting huge amounts of time into politicking and “working the system.”
* CEOs are substantially less likely than frontline staff to see bureaucratic barriers in their organizations.
Erasing the powers of Principals
In a peculiar move, the administration in Jammu and Kashmir has mulled to empower administrators, personal officers and administrative officers of Government Medical Colleges and subordinate departments of Health and Medical Education department. J&K government has proposed that a major share of powers and responsibilities of the Principals of Government Medical Colleges of J&K be delegated to the government-appointed administrators.
As per the order, these officials, who are usually officers appointed from the administrative services would have a major share of the powers related to the administration of the GMCs as well as the hospitals these medical colleges run.
The works that are proposed to be assigned to the administrators have been with the principals of GMCs till now. These are the service records and promotion of all employees – permanent, non-permanent, gazette and non-gazetted, many financial matters including budgeting and planning, surveys, purchases, monitoring of various health schemes, the GMC website, vigilance of medical colleges, matters related to students including admissions and many others.
However, medical faculty and their associations are condemning this step. As per reports, medical experts said that while doctors all over India are demanding distinct cadre of Indian Medical Services so that the doctors can govern their own administration, but J&K administration is trying to snatch rights of Principals of Medical Colleges.
Work profile of Medical Academia
A medical college teacher in India has to do multiple roles of a classroom teacher, a clinician cum instructor, a clinical supervisor, a student facilitator cum mentor, a researcher with good publication output, a postgraduate dissertation guide, a conference delegate/speaker and an undergraduate/postgraduate examiner. Research promotes basic knowledge, develops new drugs and instruments and provides guidance in planning health policies. The quality of teaching improves if the faculty is research oriented.
An Unhealthy Plan
August 7 2021,(Ref, Daily Excelsior) “While the Union Government led by Prime Minister Narendra Modi is promoting ‘one nation one rule’ in every sphere whether we talk of taxes, ration cards and elections but to the contrary the J&K Government is promoting ‘one UT two rules’ and that too in medical education system with Government Medical Colleges (GMCs) of Jammu/Srinagar and five new Medical Colleges having two different types of recruitment rules for the faculty. Official sources told Excelsior that throughout the country, there is 3-tier teaching cadre system in Government Medical Colleges and the entry level post in these institutions is Assistant Professor. They said even in five new Medical Colleges of Kathua, Rajouri, Doda, Anantnag and Baramulla, there is 3-tier system for faculty, but GMCs of Jammu and Srinagar are still running with 4-tier faculty system and the entry level post in these two premiere institutions of J&K is Lecturer,”
Injustice to medical faculty
*The first entry post in medical faculty in Jammu and Kashmir i.e. (Lecturer), which is considered as Senior Resident outside of the state. The author and many other faculty members in this state remained as Lecturers more than a decade. This reflects bureaucratic inefficiency that hampered promotional benefits of the faculty members. Medical Council of India (MCI) in 1998 categorically stressed for adaptation of 3 tier system for state medical colleges, the authorities remained unresponsive; and further in 2019 an attempt was made by Health & Medical Education (HME) department in this direction but because of hindrances, and obstacles from Finance department the proposal is in doldrums. If post of lectures are upgraded to recognized standards of MCI/MNC, it would have definitely increased the strength of Postgraduates to carry on the clinical load efficiently. The uncalled interference of authorities and appointments resulted into misunderstanding, clashes and dereliction of the working.
Court’s Directions
In response to two PILS 28 February 2020, for improvement in medical facilities and services, the Division Bench of Chief Justice Pankaj Mittal and Justice Punit Gupta on December 22, 2021, directed the academic experts to present the report of committee headed by retired Director of PGIMER Chandigarh Dr Yogesh Chawla towards the betterment of medical and health services in both in Jammu as well as Kashmir Divisions separately within a month.
Staff Deficiency
About 40 percent posts pertaining to Medical, and Paramedics are still lying vacant and haven’t been fulfilled yet. This deficiency well precipitated in Covid-19 pandemics. The medical staff worked day and night in fighting against the dreadful disease at the risk of their own health and life. As Police, Anti-Corruption Bureau and other Covid warriors were bestowed with 20 percent of Basic pay, the Paramedics and Residents were devoid of such advantages. In combating Covid-19 the bureaucratic authorities as it seems didn’t acknowledge and endorse the medical expert’s advice resulting dumping the ventilators at tehsil level, however the wisdom prevailed at last and DRDO hospitals emerged.
The bureaucratic masters had a whip of (Private Practice and Stability at one station) in their hand to exploit and frighten the medical faculty and kept their emoulments even lesser than an ordinary medical officer. It is astonishing that our faculty members happily endorsed this torture. This is still a big gamble. Medical fraternity should come out of these shackles and fetters.
Appeal to authorities
Government shouldn’t curtail the powers of Principals of Medical Colleges, rather it should create posts of Dean Academics who shall share the Academia. The medical institutions should be made autonomous and statutory bodies as SKIMS Srinagar or made Deemed institutions etc. to curtail the unwanted political and bureaucratic interferences. In an emergency meeting the faculty of GMC JAMMU on 24th January 2022 projected the following demands :
* Redesignation of Post of Principal as Director Principal and Creation of Post of Dean Academics for GMC Jammu/Srinagar and other medical colleges so that the medical colleges become institutions of excellence.
* Implementation of guidelines of NMC in totality in J&K UT Medical Colleges including 3 Tier system of faculty in GMC Jammu/Srinagar.
* Implementation of career assured program for faculty to remove stagnation on the analogy of other states of the country and SKIIMS Srinagar. e.g., some faculty members are stagnant at entry level post i.e. Lecturer for than 10 years.
* Revision of pay grades of faculty at par with other states like Himachal Pradesh, Uttarakhand etc.
* Upgradation of GMC Jammu to Post Graduate institute of Medical Science.
* Establishment of Medical University –one each in Jammu and Kashmir province. GMC, Jammu and GMC Srinagar can become deemed universities.
* Release of COVID incentives announced last year during second wave in favour of Residents/Medical Officer/Paramedical staff which have not been paid till now and grant of incentive to healthcare workers equivalent to 20 percent of basic pay on the analogy of incentives given to staff working in A.C.B and S.I.T.
* Removal of disparity of stipend paid to Residents working in various Medical Institutions of the J&K selected through same examination.
* Fast track recruitment to fill the 50 percent vacant posts of faculty, 50 percent post of medical officers, 40 percent post of Paramedical staff in GMC Jammu.
* Establishment of a separate Medical Commission for Recruitment in Medical Colleges on the analogy of Uttarakhand state so that posts are filled without delay.
* Implementation of the recommendations of the Dr. Yogesh Chawla (Ex-Director PGI Chandigarh) committee which was constituted under directions of Hon’ble High court of Jammu and Kashmir.
(The author is President – Jammu Doctors Forum Ex HOD Anesthesia & ICU GMC Jammu)
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