Stopping doctors: India is not N. Korea

The government would do well to re-examine its misbegotten restrictive policy on doctors. The new practice of not issuing no-objection certificates to doctors to stay on abroad after completing their postgraduate studies was exposed in an affidavit the Union health ministry filed in the Aurangabad bench of the Bombay high court stating the “government cannot be expected to facilitate the wish of doctors from India to permanently settle abroad by certifying that their services are not required by the country”. The ministry’s aim in such a clampdown is completely misplaced. It is testament to a narrow-minded approach which will ill serve a nation already beset with myriad problems in its public health system as well as its medical education.

On the other hand, the Centre and the states would do well to hasten efforts to set up the 58 new medical colleges they aim to help establish so a far larger pool of talent is available to work in public health services or in what is already the world’s largest privatised healthcare industry. Around 50,000 doctors with basic medical degrees a year from less than 400 medical colleges is hardly adequate to serve a population of 1.25 billion. Even twice that number would not do too much to lessen the ratio of doctors to people, currently at around one for every 1,700 people. But every Indian, be he an engineer, management student, scientist or medical professional, has an equal right to go abroad. Restrictions go against the very grain of freedom in a democratic country. India is not North Korea.

To retain the best brains, the government has to do a lot more instead of attempting to strangle them or delimit them. Given that postgraduate seats in the country are few and abysmally minuscule in the open categories, India will be discriminating against its own citizens with regard to doctors pursuing higher studies to qualify themselves better through specialisation. The route out would be to open more medical colleges even as ways are found to stop private varsities from fleecing students. Most potential doctors are either heavily indebted already or their families have forked out the money.

The system has to put in place incentives, including higher pay, to get doctors to work in India, as well as disincentives to sign off from the public system. The spending on public health can, for a start, be upped substantially from the current 1.4 per cent of GDP, which places India just above countries like Haiti and Eritrea in an important index of national well-being. Considering that medical expenses drive more than half the rural families into toxic debt, the possibilities of working a better public health system are endless. Stopping doctors from going abroad will not solve the problem. Training far more doctors and retaining some of them in an expanded public health system might.