‘Blanket ban on private practice will derail public healthcare’

Patna: As CM Nitish Kumar announced a ban on private practice by govt doctors, the medical community raised sharp concerns over manpower shortages and weak infrastructure. Dr Rohit Kumar, general secretary of the Bihar Health Services Association, tells STOI’s Adwitiya Deb that enforcing the move without systemic reforms could trigger resignations and worsen access to care for the poor. Excerpts:What is the reaction of the govt doctors and the BHSA to the CM’s proposal to ban private practice for govt doctors?The govt should not tease the system until it is fully fixed.

Currently, the number of doctors is extremely low. If this is implemented as a blanket ban now, the entire system will collapse because the govt hospitals might not be able to handle the total patient load.Will this ban actually benefit the patients, as the govt claims?No. In interior areas like Saran or Kishanganj, patients rely on govt doctors practising privately after hours. If these clinics shut down, where will a poor patient go at night? They will be forced to travel to cities and get “looted” by big corporate hospitals.

This move will not benefit the poor.Many have said that govt doctors neglect their duties to focus on private clinics. Is the ban not necessary to ensure presence in govt wards?There should be zero compromise with duty hours. However, doctors in Bihar are currently working 48 to 72 hours a week; they are not “disappearing”. The problem is not the doctor’s absence; it is the lack of infrastructure in govt facilities like emergency staff, pathologists, and blood banks.

Without these, even a 24/7 presence of doctors is useless.Would the medical community accept an “Optional NPA” (non-practising allowance) instead?An optional NPA is a better route, but it is not a magic fix. Even if you increase the allowance according to the central standards, there will still be a shortage of manpower. The govt must first increase the actual number of doctors and nursing staff to the central standards before asking anyone to give up their private practice.There are allegations of referral rackets or brokers through whom doctors send govt patients to private clinics. How do you respond?This must stop immediately. We believe strict action should be taken against such middlemen. If a doctor is caught involved in such cases, the civil surgeon and district magistrate should suspend them and take action accordingly. We are in human service and not “dalali” (brokerage).If such a ban on private practice by govt doctors takes place, then what is the reaction of the state doctors going to be?Several doctors will resign, and the healthcare system and needy patients will bear the brunt of it.Why do you predict mass resignations if this ban is implemented?A doctor spends nearly a decade completing their degrees. Currently, starting salaries are just Rs 70,000-80,000 — almost the same as some nursing staff.

If you take away their right to practise privately, new pass-outs and specialists will run away to other states or join private hospitals where they can earn double without the govt’s restrictions.What is the BHSA’s final stance on the govt’s decision?If the govt forces this decision without consulting the IMA (Indian Medical Association) or BHSA, the doctors of Bihar will strongly oppose it. We need the govt to strengthen the infrastructure, fill the vacancies, and consult with stakeholders first. Otherwise, the healthcare situation will deteriorate.