The Chennai Corporation, which has recruited 80 doctors in the last three years, still has 12 vacancies.
Though the salary is attractive with opportunities of gaining experience in handling a variety of cases, very few show interest, according to Commissioner Rajesh Lakhoni. Speaking to The Hindu recently, he said a doctor in the corporation health centre works an eight-hour shift with one night shift every week.
There are 173 health centres, health posts and emergency obstetric care centres within the Chennai Corporation limits.
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Health Department officials admit that though 47 per cent of the population lives in urban areas, they still do not have access to primary healthcare. The reason is shortage of doctors and medical facilities in health posts run by corporations or the municipalities.
This lack of interest among doctors to work in a corporation/municipal health centre increases the burden on government hospitals. Every day, the tertiary care government hospitals receive a large number of patients for simple ailments such as fever or scrapes resulting from accidents or assaults, which could be treated at a civic-body run dispensary.
One reason for not wanting to work in a corporation/municipal health post is that the doctors, who are often the most qualified persons, must report to the administrative head, who sometimes does not respect the doctor's abilities to make decisions, a Health Department official said. They are also constrained as they cannot access modern medical equipment. “The administrative system in a corporation or municipality is different from that of a government hospital. Lack of understanding also compounds the problem. The doctors are subjected to unnecessary disciplinary action and they do not receive the equipment required to run a health post,” the official said. Another reason is that unlike in government hospitals, doctors working in health posts worry about losing out on post-graduate and in-service training. Public Health Department officials say one option is to have the government conduct the recruitment for the corporation/municipality health posts. According to the officials it is a policy decision that the corporation/municipality has to make. Currently, the local bodies are responsible for providing the funds to run the health posts and the salaries of the doctors.
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Director of Medical Education S. Vinayagam said though the hospitals run by local bodies are generally health posts with medical or health officers, these doctors could apply for training programmes. “The teaching institutions conduct many training programmes that doctors can make use of,” he said.
If the students make a representation that their work should be considered for admission to postgraduate courses, the government would consider it, he said, adding that it rests on the doctors to build confidence in the Corporation/municipal health centres.