A Medical graduate who passed the examination for recruitment of Insurance Medical Officer Gr. II in the ESI Corporation presents himself before an officer in the ESI Corporation and says, “ Sir, I have been selected for recruitment in the ESI Corporation. I have also been selected for admission to the PG course in the PGI, Chandigarh. What shall I do?” Without any hesitation, the well-meaning officer advises him to join the PGI. It happened years ago.
In the same year another Medical graduate enters into the office of the Railway authorities. He has also passed two examinations. One, the examination for recruitment as Medical Officer in the Railway hospital and two, the examination for admission in a Post Graduate Medical course. He seeks advice from the Railway authorities. He is advised by the authorities to join the Railways first. And, immediately, thereafter, he is sanctioned Study Leave and permitted to undergo the post-graduation course, keeping lien in the Railways.
Are there provisions in the Leave Rules? Apparently, there is no provision at — first sight. An employee should have put in, at least, three years of service to be given Study leave without pay. So, a new entrant cannot eve n think of doing post-graduation. But, there is a provision for relaxation in Rule 65 of the CCS (Leave) Rules. The Railway authorities invoked the similar provision in the Indian Railway Establishment Code to permit that new entrant to prosecute higher studies. Rule 557 in Chapter 5 of that Code contains Leave Rules for the Railway employees. The authorities there got a bond executed by that candidate as provided in Rule 530(3)(a)(b) therein.
The candidate has nothing to lose. Railways have everything to gain. They would get a P.G. level doctor after three years who will be with the Railways for a minimum period of five years and draw the salary of only an entry level doctor without the PG qualification.
Systematic discouragement in the recent past
But, in the ESIC, there was no encouragement to the existing doctors to acquire higher qualifications. On the other hand, there was systematic discouragement. Even those who passed entrance tests and got seats in the P.G. courses were denied Study Leave, in spite of the fact that they fulfilled all the conditions laid down in the Leave Rules. Peculiar reasons were given to deny them their legitimate expectations.
This ESIC went to town, later, proclaiming that it was starting medical colleges to fetch required number of medical personnel to meet the shortage. And it started constructing buildings for medical colleges in numerous places, even before obtaining the very essential Parliamentary approval for setting up medical colleges. Now, in many places, the buildings have not been completed and it is said that the contractors are asking the Corporation to meet the escalation in cost. This is the position after three/four years.
Meanwhile, advertisements are out inviting applications for various posts in the teaching side. The serving Medical Officers of the ESIC are in a dilemma. They are not aware whether continuing to remain in the clinical side or switching over to the teaching side would benefit them in the long run. The organization can step in to ward off the apprehensions of its personnel. The Association of the ESIC Medical Officers can also play a positive role in this regard.
Skyrocketing Tie-up Bills
The fact is that the ESIC has, so far, not made any realistic analysis whether the huge expenditure in running the medical colleges could afford to bear it for a long time. The public also share that view, because the ESIC has not publicized the estimated expenditure in running the medical colleges vis-à-vis the expected revenue of the Corporation through Contribution for a period of, at least, ten years. How many medical colleges will be actually run and for how long is not known, especially when the ESIC does not show interest and earnestness in running even the existing ESIC Hospitals properly. The existing ESIC hospitals are very much lacking in terms of infrastructure, equipments and quality of healthcare, etc.,etc., as is evident from the skyrocketing bills of Super-speciality treatment in the tie-up hospitals. The existing Medical Officers witness this ground reality.
There is an hospital where there is no proper space at all to accommodate the ailing beneficiaries. Delivery of a child took place in the corridor. Many Medical Officers are asked to sit in one single room for out-patient examination. Nurses are not accommodated in the hospital premises and they are scared while commuting from outside for night duty. If the ESIC could not find resources even for construction or expansion of hospitals of the required size, how could it be expected to feed so many white elephants called Medical Colleges, which will result in additional expenditure only without any income, and, that too, for a long time to come? It is a fact that huge funds of the ESIC were diverted for questionable purposes during the recent past by flouting the established procedural safeguards. The Medical Officers of the ESIC are, therefore, justified in their apprehensions.
What the system does deserve
In the circumstances, the minimum the authorities could do is to permit the existing Medical Officers the following facilities:
- The existing medical officers who switch over to the teaching side should be given pay protection and time-bound promotion, even after they switched over. This will help the organization to utilize the services of the medical officers in the clinical side in a better manner in the teaching side also.
- The existing medical officers who switch over to the teaching side should be absorbed in the parental clinical side, if they could not be kept in the teaching side, for any reason, in the future. Because, while everyone wishes the ESIC to run the Medical Colleges well forever, the lurking fear regarding the continued functioning of medical colleges, in the backdrop of past experiences with the hospitals in Nagda and other places, cannot be considered to be an unfounded one. No organization should make things uncertain and create a situation where its employees will have to wager about their future.
- The ESIC does not lose anything by extending this facility to the serving medical personnel who apply for teaching side.
- If the serving medical personnel are extended this facility, which they deserve anyway, it will result in their acquiring better knowledge by utilizing the newly equipped libraries in the medical colleges and pass on the knowledge to the other practicing medical personnel in periodical in-house meetings.
- If the ESIC creates a separate cadre for Medical Officers in the teaching faculty, it will not be beneficial to anyone. There will be no cordial relationship between the teaching and clinical sides. The way the practicing medical personnel are denied access to the books in the library is a small pointer in this direction.
- Such arrangement will also prevent a situation where there will be no post graduate doctor in the hospitals.
The ESIC Medical Administration will do well by keeping options open for utilizing the services of the teaching faculty with medical qualification in the clinical side also. Even if the CGHS Rules provide for two separate and distinct sub-cadres, one for teaching sub-cadre and the other for the non-teaching cadre, the ESIC can have a better system to ward off the problems faced by enforcing the CCHS Rules. There are precedents in this regard. A senior officer recalls that earlier in a State service, Specialists beyond certain level were inter-changeable between teaching and non-teaching assignments. A precedent is thus available too.
Study Leave for D.M. course
Similarly, the ESIC can encourage its Medical Officers to pursue the D.M. course. If considered necessary a Bond for ten years can also be got executed. Rule 65 of the CCS (Leave Rules) can be invoked for that purpose. The ESIC will then have prestigious faculty as its own and it will cost less, very very less than what it would take to achieve what is claimed to be achieved through its omnipresent medical colleges.