Shortage of doctors in the ESIC Hospitals: Where did the home-grown PGs go?

The Administration of the ESIC has chosen to transfer large number of IMOs from Bangalore and Chennai to far off places in the North. The reason advanced is that they are surplus medical officers here. But, the fact is that the number of patients has been increasing multifold requiring more medical personnel.  Besides, it is a paradox that while the regular doctors are transferred out, there are many doctors engaged on contract basis and they are allowed to remain.

The doctors transferred are told that they were granted Study Leave “for personal growth” in their “career”. It is also said that the ESIC obliged them and “contributed to their personal growth by granting them study leave”.

But, the fact is otherwise. As per Rule 50 of  the CCS (Leave) Rules, Study Leave is to be granted only “with due regard to the exigencies of public service“. As per Rule 50 (3) of the CCS (Leave) Rules, “Study leave shall not be granted unless it is certified by the authority competent to grant leave that the proposed course of study or training shall be of definite advantage from the point of view of public interests. Moreover, as per a Proviso under the aforesaid Rule 50 (3), a “Medical Officer may be granted study leave for prosecuting a course of postgraduate study in Medical Sciences if the Director-General of Health Services certifies to the effect that such study shall be valuable in increasing the efficiency of such Medical Officer in the performance of his duties.”  It is only when the authority considers that granting Study Leave to a person would be useful and definitely advantageous to the organisation that Study Leave is granted. It is not  and  it cannot be done as a charity.

The ESIC which utilises the services of the Medical Officers who were sent outside on Study Leave, is now transferring them to far-off places in a selective manner. At the same time, something  peculiar had already happened.

The ESIC authorities had, in a fit of frenzy,  set up large number of medical colleges in 2011 and 2012, at a stretch and justified that action before the Court also in the W.P. 12953 of 2015.

Home-grown Post-Graduates 

Those medical institutions were intended to produce PG students and make use of their services for a specified period of service as per the terms of the Bond executed by them.They had to execute a bond to serve the ESIC for specified period of years.

 

But, although the ESIC Medical Colleges had been producing many post-graduates, they were sent out, without their services being used  in the ESIC hospitals, anywhere, across the nation. How many such  Post Graduates churned out by those colleges from the year 2014 onwards were let off without the ESIC utilising their services is not known. But, around 500 were being sent out every year from 2015 onwards. They were, simply, let off.

Strangely, the newspaper Livemint had reported on 16.12.2015 that “the labour ministry has rejected a plan to mandate a Rs. 25 lakh bond on students enrolling in medical colleges run by the Employees’ State Insurance Corporation (ESIC), fearing the move could have been seen as anti-people”. That was really puzzling! For, that was an unlawful decision!

 

What is more? The Livemint reported, “Instead of the bond plan, Kataria said, ESIC will now offer students a 100% placement as soon as they complete the courses. “In 2016-17, we will absorb the 100 doctors graduating from our medical colleges, and by 2019-20, we will absorb 500 of them,” Kataria said. “It’s a 100% placement for our own students in our hospitals.” In that case, all those post graduates should have been posted in the ESIC hospitals. But, that was not done.

If only that bond had been executed, those PGs’ services could have been used by the ESIC as IMO-Gr. II for, at least, five years. Why did the ESIC use the workers money to produce PGs who were not of any use to the organisation, at all? Is that not anti-people?

It is even more puzzling, how the Administration is now transferring the doctors from the existing hospitals and sending them out to places in other states. The lack of knowledge of the local language, which is a prime factor, in the appointment of doctors, has not been taken into consideration at all.

The 2006 Transfer Policy for Medical Officers

It is true that the IMOs of the ESIC are subject to all India transfer liability. But, in the year 2006, a policy decision was taken and circulated too, informing the Medical Officers that inter-regional transfers would be effected only when they get promotion to the Senior Administrative Grade. It is that decision which holds the field till date.

Selective application of all-India transfer liability

Moreover, if at all, there has to be Rationalisation, the Administration should fill up the vacancies in all the centres by transferring all the people everywhere in a cyclical manner  and not just from a few centres in the South to a few centres in the North.

It is a fact that there is patent discrimination by the Administration in the matter of transfer of officials, depending upon their States. It is a long-time anomaly. The transfer policies brought in, in the year 2005, to set right this anomaly and to ensure  impartiality, uniformity, universality and predictability in the matter of transfer of officers have been silently buried and forgotten by the Administration.

Striking the balance between public and private interests in transfers

Hon’ble High Court of Kerala has held that the “right to transfer an employee is a powerful weapon in the hands of the employer. Sometimes, it is more dangerous than other punishments. Recent history bears testimony to this. It may, at times, bear the mask of innocuousness. What is ostensible in a transfer order may not be the real object. Behind the mask of innocence may hide the sweet revenge, a desire to get rid of an inconvenient employee...”Asserting that there can a “deceptive innocuousness” in the transfer orders, the Hon’ble Court said, “atransfer can uproot a family, cause irrepairable harm to employee and drive him to desperation.”  {Pushpakara Vs Chairman Coir Board, Cochin 19.12.1977- (1979) ILLJ 139 Kerala)and in llyas Ahmad Vs Station Director, All India Radio, Hyderabad (1979 – 2.5 LR -58, 1979-Slj -592. K. K. Jindal Vs. General Manager, Northern Railway}.

Colourable exercise of power

Hon’ble Supreme Court of India has observed, on 25.8.2003, that “Transfer is an incidence of public service and the power to transfer is available to be exercised by the employer unless an express bar or restraint on the exercise of such power can be spelt out.  The power, like all other administrative powers, has to be exercised bona fide”.  (State of Rajasthan & Ors  Vs. Anand Prakash Solanki –C.A.NO. 6733 OF 2003). If there is shortage of officials / medical officers in one region, the Administration should make it a routine to transfer all the officers everywhere in a cyclical manner and post them everywhere. Holding out the condition of all-India transfer liability only to one section of officers / doctors amounts to selective discrimination, through arbitrary and colourable exercise of power.

“One cannot but deprecate that frequent, unscheduled and unreasonable transfers can uproot a family, cause irreparable harm to a Government servant and drive him to desperation. It disrupts the education of his children and leads to numerous other complications and problems and results in hardship and demoralisation. It therefore follows that the policy of transfer should be reasonable and fair and should apply to everybody equally. But, at the same time, it cannot be forgotten that so far as superior or more responsible posts are concerned, continued posting at one station or in one department of the Government is not conductive to good administration. It creates vested interest and therefore we find that even from the British times the general policy has been to restrict the period of posting for a definite period. We wish to add that the position of Class III and Class IV employees stand on a different footing. We trust that the Government will keep these considerations in view while making an order of transfer”, observed the Supreme Court in Varadha Rao vs State Of Karnataka And Ors. on 26 August, 1986.

Students are not substitutes 

The ESIC Administration should not make any attempt to show the PG Students as Doctors. Students cannot be shown as substitutes for doctors. Besides, they had not been taken into account to calculate the Sanctioned Strength of medical officers or to arrive at the findings on the so-called Rationalisation, in the hospitals both in the South and in the North.

Double-speak impermissible

An organisation that officially declared some doctors as those belonging to teaching faculty cannot take a different stand stating that it did so just in order to help those doctors to have an impressive CV. That would be a confession in having cheated the MCI. No law permits anyone to approbate and reprobate at one and the same time.

What fairness necessitates

It is only fair that the existing doctor-patient ratio is not disturbed, specially when more and more patients are coming in to these Hospitals for treatment. It is necessary that less number of doctors are not made to take care of more number of patients.

It is only fair that the vacancies, if any, at other places are filled,  not by posting only the doctors from the South but by evolving a uniform policy that applies to all the doctors everywhere.

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