In the second week of November, the Madhya Pradesh High Court had directed the Indian Council of Medical Research (ICMR) to fill the vacant posts of doctors and paramedical staff at the Bhopal Memorial Hospital & Research Centre (BMHRC) within the next 14 days.
However, till November 30, when the court was hearing the matter — a Public Interest Litigation (PIL) petition regarding medical care of the Bhopal gas tragedy victims, clubbed with a contempt application — the recruitments had not been made. The ICMR told the court that it had forwarded to the Secretary, Union Ministry of Health and Family Welfare a proposal for improving the pay structure for doctors at the BMHRC which was set up in 2000 for the treatment of victims of the 1984 tragedy.
The flight of doctors, including experts who are crucial for providing quality treatment to the victims of the tragedy that took place 38 years ago on the night of December 2, 1984, at the BMRCH is now almost a decade-old issue.
The BMHRC administration refuses to divulge the numbers, but an earlier letter written by former Chief Minister Digvijaya Singh to Union Health Minister Mansukh Mandaviya provides a glimpse into the current situation. Quoting an earlier court order, Mr. Singh wrote that the vacant posts of medical faculties and Specialist Grade doctors was as high as 41 (i.e., over 60%) of the 68 sanctioned posts.
He further wrote that of the 18 departments, five (namely, medical gastroenterology; surgical gastroenterology; nephrology; neurology; and endocrinology) had remained closed for a long time due to the failure to recruit the requisite number of professors, associate professors and assistant professors with proper remuneration and facilities to run them.
‘Serious lack of parity’
According to those working with the victims of the world’s worst industrial disaster, on the one hand, there is a “serious lack of parity vis-à-vis remunerations offered by the BMRCH compared to other institutions, government or private”, on the other, there is little political will to resolve it.
“Until a decade ago, the Bhopal Memorial Hospital and Research Centre was recognised as a national-level super specialty hospital. Today, it is a perfect example of the lack of vision. Due to the neglectful attitude of the Central government, the exodus of 10 prominent doctors and many other staff members from the hospital for the last seven-eight years has further deepened the crisis,” says Purnendu Shukla, a member of the Supreme Courts Monitoring Committee for Gas Victims.
Much of it, he adds, began since the entry of the ICMR into the administration in 2012 as compared to the period till 2010 when the administration was being run by a trust.
“Till then, experts used to receive a ‘Private Patient Share’ amount when the hospital treated non-gas victims as well. These specialists received an incentive amount which was two-three times their salary. It was a smooth system and both gas and non-gas victims were benefited. But due to the Supreme Court’s order in June 2010 to dissolve the trust and hand over the responsibility of its operation to the Central government, it was not possible to maintain such a system,” says Mr. Shukla, adding that the incentive of the consultants reduced by almost two-thirds and mainly due to this, the exodus started.
“Taking suo motu cognisance of the matter, committee recommended giving special allowance to such superspecialist doctors with higher qualification as incentive in addition to the Central payscale, so that their migration from the hospital can be prevented. But the Central government did not agree to this,” he says.
Several doctors who have left the BMHRC in recent years are posted at prominent private hospitals, but the reasons are not always financial, say some.
Explains a cardiologist, who joined the BMHRC in 2013 and left six years later: “When I first joined, I was given the designation of an assistant professor and what I was eyeing was teaching and research opportunities which I considered vital for personal growth. However, there was no progress on that front and even the recruitment rules took a long time to come by. There were talks of a merger with the All India Institute of Medical Sciences, Bhopal, in a way that we could treat patients at the hospitals and teach at AIIMS. But even those talks fell through and in these years, my contemporaries had gained much more experience serving at hospitals with medical colleges,” the doctor, requesting anonymity, said.
He added that those who join now are mostly those who see the BMHRC as a training ground and then move for greener pastures.
In its submission before the High Court on November 30, the ICMR said that the financial implication arising from the said change (recruiting doctors with higher pay structure) would be about ₹7.17 crore per annum and that “Along with the letters, a detailed justification for pay parity of BMHRC doctors with that of doctors of the AIIMS has been proposed,” it said.
Mr. Shukla says that this calculation itself had taken a long time to come by. “This is for the first time, the ICMR has been talking about financial implications in the course of the writ petition that was filed a decade ago. They should have done the calculations much earlier and even if more money is needed, so be it. This is after all a hospital meant for the gas victims and they deserve the best possible treatment. What we see instead is a tragedy within a tragedy,” he says.
The doctor quoted above says that a possible solution could be deputing doctors at various hospitals within Bhopal while allowing them to continue treating patients at the BMHRC.
Rachna Dhingra, co-convener of Bhopal Group of Information & Action, which is one of the petitioners in the PIL petition regarding medical care of gas victims, says that in June this year, Mr. Mandaviya announced that a hospital would be set up, but she adds that is not a silver bullet.
“Setting up a hospital is not an overnight thing. It would take seven to eight years, what do the patients do till then. The only options till then are either they are forced to go for unaffordable treatment or are left to die. Medicines are not available, wait for scans and other procedures are long, despite a hospital exclusively meant for the gas victims,” says Ms. Dhingra.
The victim families also speak about the implications they face. Aslam Qureshi, a 34-year-old who works at a printing press, is dreading that is family may have to shell out ₹15,000 for a catheter for his 56-year-old father Mukeem. “The BMRCH could not tell us by when he will receive the catheter. The replacement is due in another couple of months and the clock is ticking,” he says.
The Hindu also visited the BMHRC on Friday and requested director Prabha Desikan for a meeting, but the request was denied.