District-level committees have been set up to fix rates for specialists at hospitals in their jurisdictions
Grappling with a shortage of specialists in rural areas, the State Health Department has now realised that the poor response to its ‘on call’ hiring of doctors is due to low rates per case fixed in 2017-18. The department is now working on revising rates for various hospitals, based on the jurisdictional availability of specialists, transport, and distance from the district headquarters.
Of the 3,400 sanctioned posts of specialists in the hospitals run by the Health Department, 779 are vacant.
The department has set up district-level committees, headed by the deputy commissioners, for suggesting rates for ‘on call’ specialists for each community health centre, taluk hospital, district general hospital, and other health and family welfare hospitals in their jurisdictions.
These committees will have the jurisdictional Zilla Panchayat CEO as vice-chairman and Director/Dean of Government Medical College, District Surgeon, District Health and Family Welfare Officer, Reproductive Child Health officer, and president of the local Indian Medical Association as members.
The committees will analyse the shortage of specialists in hospitals every year and arrive at the ‘on call’ rate for specialists (of various specialities). “The rate for each hospital will differ as it will be based on the local conditions, such as availability of specialists in the private sector, distance from district head quarters, and availability of easy transport,” stated a circular issued by the Health Commissioner Pankaj Kumar Pandey on March 5.
If the rate fixed by the committee for a particular hospital is abnormally high, the reason should be explained.
While the freedom to fix the rates per case for various specialities will be given, the final approval will be done by a State-level committee, headed by the Commissioner. This exercise will be taken up every financial year, the circular stated.
Asserting the need to attract more specialists to its hospitals, Mr. Pankaj Kumar Pandey told The Hindu that due to the shortage of specialists, operation theatres and other modern facilities in many hospitals are not being used.
“The investment made by the government in the health sector is going waste because of this shortage. Following the launch of Ayushman Bharat-Arogya Karnataka scheme, public health institutions are duty-bound to provide all health services and carry out as many procedures as possible. For this, we need adequate number of specialists,” he said. “The government is trying to recruit specialists and has started DNB and CPS courses. Despite regular recruitment through the Karnataka Public Service Commission (KPSC) and doctors hired on contract under National Health Mission (NHM), the situation has not improved,” he said.
In 2017, the department started an aggressive drive to hire doctors on call and on contract.
While a monthly remuneration of Rs. 1 lakh to Rs. 1.2 lakh had been fixed for doctors opting to take up a job on contract, a retention fee of Rs. 10,000, apart from a daily out-patient fee of Rs. 2,000 had been fixed for those who are on-call.
A stipulated fee had also been fixed for every procedure they conducted.