Why PM has no faith in AIIMS

Nidhi Mittal New Delhi
Exclusive

In what can be termed Union Health Minister Dr Ambumani Ramadoss’ long-term vendetta plan, 185 super specialist doctors, mostly from the critical diseases departments of the All India Institute of Medical Sciences, have been quietly shown the door.
All of these senior residents were in the forefront of the agitation against the Minister in the Venugopal and the anti-reservation protests.
Not that Ramadoss can be legally faulted in his game plan as he has used a long dormant clause in the AIIMS statute book to get his baiters out of the way and carry on his agenda to have more Governmental control over the autonomous body.
These senior resident doctors have been refused a routine extension of their three-year term, which has long been done automatically. On January 3, these doctors, most with AIIMS for six and more years, were issued a 10-day notice to vacate their rooms, ending their long and crucial association with the institute.
Such has been the resultant shortfall that even the Prime Minister has been indirectly affected. Out of the 15 mandatory senior residents on call for VVIP duty, there have been only seven left with the rest being axed, courtesy Ramadoss. A new and relatively inexperienced set of eight doctors had to be called in to deal with the situation.
Other than that, AIIMS, which has long been reeling under an acute shortfall of doctors, will now be even more pressed. Already, an inner circular has restricted the number of OPD cards to be issued daily. The ENT department, for instance, will now take in only 50-60 cases a day. “Earlier, there was no such restriction on OPD. Now people will have to wait for months to get into even the OPD,” another resident doctor said.Some of the departments which have borne the brunt are ophthalmology, surgical oncology, radio therapy, anaesthesia and hospital administration.
Explaining the line of events, radiation oncologist Dr Harsh Kumar, who was the doctors’ union president and at the forefront of the anti-reservation stir, said: “A few days back, the administration posted an ad for recruitment of senior residents. It said that the exams were due and it was to be completed by January 31. But then, the ad was withdrawn. When we approached the Dean, he said he couldn’t do anything because of orders from higher authorities, and that this was a lawful step.”
The outgoing doctors say that though a Parliamentary regulation has bestowed the AIIMS Director with the authority of extending the term of resident doctors in case of a controversy — like exams not being held — the authorities, “i.e., the Health Ministry”, has this time put out a rule that only three years of senior residency would be allowed.“All this is about dirty politics. People in power want to create a crunch so that when a hue and cry happens, they can push in their own people,” alleged Dr Rahat Habi, senior resident in the radio therapy department.
While 50 of these 185 doctors who have just completed their PG and MD, have survived for now as they are yet to complete their three-year term, they will function only as “ad-hoc” doctors and their term will automatically expire after completion of their present contract.
Even a complete strength of 550 doctors is unable to cope with the work load of seeing 9,000 out patients daily apart from the in-house ones. With 135 less specialists, the situation will only get unmanageable.Asked why there was no effort to recruit more doctors immediately, Dr Sunil Chumber, sub-Dean, clarified: “That’s not true. In January, 35 seats fell vacant. We have put in place 30 doctors. An ad inviting applications for more senior doctors will be out next week. There is no doctor crunch in the hospital as we have put junior residents on temporary duty.”He defended ending the three-year tenure of senior residents calling it law. “That some senior residents had been serving for more than six years was unacceptable.”
However, as Dr Rahul Bhargava, who has replaced Dr Harsh in the Oncology department, said: “They should have let them (135 who have packed up) serve till the time they brought in new doctors so that the patients didn’t suffer. That’s a valid and selfless demand.”
With the ouster of 185 doctors, most of them assistant professors, the education of students will also suffer hugely. Which would mean a huge dent in the reasons AIIMS was set up.India’s first Health Minister Raj Kumari Amrit Kaur, while passing a Bill to bring up AIIMS in 1956, had said: “It has been one of my cherished dreams that for post-graduate study and for the maintenance of highest standards of medical education in our country, we should have an Institute... which would enable our youth to have their post-graduate education in their own country, in their background with the necessary experience that we would like to give to them to do research in the various spheres of medical education.”
Apart from this, the pressure that serving doctors will feel is bound to add to patient woes. Officially, a doctor is supposed to give in just 48 hours a week. However, at full strength, every resident doctor is doing continuous 48 hours duty at least once a week. So the total work they do per week far exceeds the residency scheme — more than 110 hours a week per doctor.
“With us leaving, these doctors will have more duties to do. Due to increasing pressure there have been cases of suicides in the neurology department. Mishandling of patients will increase too. How much pressure can a human being take, even if he is a doctor? There is a limit to which one can work,” said Dr Harsh.
Though most of the 135 doctors have already got offers from private hospitals, that too at four times more salary than AIIMS, which is Rs 50,000 for a senior resident doctor, the specialists want nothing of the sort, if they can continue at the apex institute.

Published in The Pioneer on January 25, 2009