As tens of doctors quit the only government-run super speciality hospital for the Bhopal gas tragedy survivors in 2014-2015, former Supreme Court Judge Faizanuddin wrote: “handing over the hospital to the Government of India has in fact proved to be its burial order.”
After the Bhopal Memorial Trust — the custodian of the Bhopal Memorial Hospital and Research Centre (BMHRC) for a decade — was wound up in 2010 by the court, the former Judge had called it “nobody’s child”, before its adoption by the Centre.
Yet on January 22 this year, 13 of the 19 doctors resigned from the BMHRC, managed by the Centre’s Department of Health Research, citing lack of promotions and infrastructure, low pay and fearing loss of seniority to new entrants, adding to a string of “mass exodus” of experts and consultants that has afflicted the hospital ever since the Centre became its manager.
Autonomous institute
The 350-bed hospital, catering to the survivors of the methyl isocyanide gas leak in 1984 from the Union Carbide pesticide unit here, has changed hands three times in a decade. It is set to be tossed back as an autonomous institute under the Indian Council of Medical Research (ICMR), in a bid to improve the availability of doctors by rolling out post-graduate programmes, according to the minutes of a High Power Committee’s (HPC) meeting on August 13, 2019, perused by The Hindu .
The earlier proposal to merge it with the AIIMS, Bhopal, meanwhile, has been junked.
ICMR’s inefficacy
This is despite the illustration of the ICMR’s inefficacy in managing the hospital from 2012 to 2015 in the sixth report of a Monitoring Committee headed by retired Madhya Pradesh High Court Judge V.K. Agarwal. Noting that the situation at the BMHRC “appears to be constantly deteriorating”, the report said, “ICMR has not been able to mend the situation and to rectify the problem by filling up the vacancies which is adversely affecting the treatment facility in the hospital”.
As on January 27, there are 19 doctors, including the 13 whose resignations are yet to be accepted, against 57 sanctioned posts at the hospital, with the strength just a little over 30% against the sanctioned one. There are just three professors against a sanctioned 18, according to the BMHRC’s data.
To facilitate the teaching programmes, the hospital would be “run along the lines of” the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), an autonomous institute in Kerala, which “would help retain doctors”. The minutes, however, do not mention why the institute was picked specifically. Moreover, in an attempt to improve bed occupancy, which is at an abysmal 30-50%, the committee recommended its facilities should be “made available to the general public”, at the charges prevailing at the SCTIMST. The Centre plans to convert it into an Institute of Excellence.
‘Affected patient care’
At an earlier meeting of the HPC, BMHRC Director Prabha Desikan had admitted to a lack of enough faculty which “adversely affected” patient care. “Existing doctors have been given one promotion to the next higher grade, advertisements for contractual medical consultants have not attracted adequate response and the vacant posts could not be filled even on temporary basis,” the minutes quote her.
Moreover, the HPC noted recruitment of staff through the Union Public Service Commission (UPSC) was a “time consuming process” and the UPSC was “not able to recommend suitable candidates for all the vacant posts expeditiously”.
A doctor for 10 years at the BMHRC wrote in his resignation letter to the Director in 2018 that his appeals regarding due promotion went unheard. “I am suffering mentally, professionally and financially. The same has been brought to your notice repeatedly, but I got nothing more than false assurances. Also, the working conditions here are pitiful. We are working with significantly compromised manpower and many of the necessary departments are functioning without appropriate faculties. This is condemnable at the same time unacceptable.”
Despite several doctors resigning, the HPC decided that consequent upon the fulfilment of its recommendations, including the take over to the ICMR which may expedite recruitments on account of its greater autonomy than the UPSC, that “there may be no changes in the service conditions of the employees of the BMHRC, scales of pay, allowances, age of retirement.”
In quarterly reports since 2014, the monitoring committee has noted there has been unilateral change in the terms and conditions of the employee’s service and it was “high time” to ensure that the BMHRC should not “slide downhill”.
‘No experience’
“The ICMR has no experience or expertise in running a hospital,” said Rachna Dhingra, coordinator, the International Campaign for Justice in Bhopal. “The hospital in Kerala runs on a 60-40 [public-private] model, which the BMHRC followed when it was under the Trust. Back then, the survivors were discriminated against, drug trials were conducted on them and doctors made huge amounts of money as private share. In the minutes, there is no mention of the survivors. It is all about protecting the doctors”
Meanwhile, Purnendu Shukla, member of the monitoring committee since 2004, said under the Trust, two-thirds of the doctor’s salary came as an incentive for operating upon general patients, which was removed later. “We’ve always recommended to the Centre that if doctors are to be retained, they must get the salary as per the structure of the government of India and an incentive, which it didn’t implement,” he told The Hindu. “In the past five years, the quality of care has declined drastically, despite adequate infrastructure.”
