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Skewed doctor rule pops up in court by Tapas Ghosh and Sanjay Mandal

The Bengal government had introduced a remote-area incentive system that rewarded doctors working in Calcutta for all practical purposes but not in some places that could be reached only by crossing rivers.

Calcutta High Court today stayed the order, which was issued by the Mamata Banerjee government last year but did not draw much attention beyond medical circles.

The government order denied several doctors who had served in villages the advantages due to them in the entrance test for scarce seats in postgraduate courses.

According to rules set by the Medical Council of India (MCI), junior doctors serving in backward areas after their MBBS are entitled to a quota (for diploma aspirants) and a grace of 10 per cent (for postgraduate degree courses) in the entrance tests.

The list prepared by the Bengal government on November 23, 2011, classified 12 of the 19 districts in the state as backward, following which all health care institutes in the dozen districts were termed “remote and difficult”.

So hospitals even in developed areas of South 24-Parganas, like the MR Bangur Hospital in Tollygunge and the Baghajatin State General Hospital, are deemed “remote and difficult”. Never mind that both places are effectively seen as part of south Calcutta.

However, a block primary health centre in Sandeshkhali, in the riverine Sunderbans with little road connectivity, is not remote because the state does not consider North 24-Parganas backward.

Instead of district-wise classification, an institute-specific policy — followed by Maharashtra — would have helped Bengal avoid the odd situation.

But lack of time appears to have forced the state to follow a central funds allocation formula and draw up the district list.

Last week, postgraduate trainee Buddhadeb Bhattacharya and 71 other doctors stationed in rural health care institutes “in remote areas” filed 72 writ petitions before the court to challenge the validity of the notification.

“Primarily, this court feels that there should be an interim injunction on the government notification so that the health department cannot give effect to the said notification at least till March 15, when the case will be heard in detail,” Justice Tapen Sen said today.

The judge asked the state health department to file an affidavit.

Bhattacharya, 32, who has done his MBBS from RG Kar Medical College and Hospital in Calcutta and lives at Kalikapur off EM Bypass, said: “I was sent to a primary health centre about three years ago in a remote village in Sandeshkhali where there is no proper road connectivity. This year, I had planned to sit for the entrance examination but was shocked to find the new notification which didn’t include my area.”

“The petitioners had pointed out the discrimination in the state government’s notification,” said Rajarshi Halder, an advocate for the doctors.

The mess traces its roots to the Left regime. On November 17, 2009, when the Left was in power, the MCI issued a gazette notification to incentivise service in rural and remote health facilities.

It declared that 50 per cent of the postgraduate diploma course seats should be reserved for medical officers working in government health care institutions in remote and difficult areas for at least three years.

“For those who want to pursue postgraduate degrees (not diplomas), a 10 per cent weightage over the total marks obtained is given,” MCI secretary Sangeeta Sharma told The Telegraph from Delhi. “However, it’s the state government’s prerogative to decide which areas would be identified as remote and difficult,” Sharma added.

The earlier Left Front government had not accepted the MCI directives until 2010 when a group of 42 doctors had moved the division bench of the high court. In June that year, the court directed the state government to implement the MCI guidelines.

The Left government dubbed “all rural health care institutions” remote following the court order, said a Swastha Bhavan official in Calcutta.

However, after Mamata became chief minister (she holds the health portfolio, too) in May 2011, the policy was reviewed and the new directive was issued in November.

According to the new guidelines, even the medical colleges in Midnapore, Bankura and Malda towns are in “remote and difficult” areas.

Health officials blamed lack of time for the skewered list, which had to be readied in time for the examinations in January.

The list of districts was modelled on classifications made by the Union ministry of panchayati raj, under its backward region funding programme based on economic and social parameters.

A senior government doctor said that in a state where doctors were scarce, lack of incentives for rural practitioners might make the situation worse. “At least 750 specialist posts are now vacant across Bengal,” a health department official said.

But the government’s notification defeats the purpose of the incentives. “Nearly 75 per cent of the total geographical area of the state has been identified for benefits under the MCI regulations,” a health department official said.

“A district as a whole has been classified as backward, ignoring pockets either of affluence or deprivation,” he pointed out.