Per capita availability of doctors and other medical staff is low in India as compared to developed countries. But, it is also a fact that, in the last couple of decades, India has taken major strides in generating this precious human resource. The private sector has played a major role in this development after being unshackled from the inhibiting factors of repressive policies. The regulatory regime to ensure quality is maintained is also working quite effectively, although there is no reason for complacency. Also, there is considerable inequity in the distribution of medical services, with these being concentrated quite naturally in urban areas, particularly where there are better off populations and quality of life.
This divide is very visible in Uttarakhand, with even government medical services not being adequately available in the hill areas. It is not for want of trying, with even medical universities being opened for local students more used to living in the region. But market forces naturally have led to out-migration of trained doctors and para-medical staff for greener pastures. Even the bonds they sign that require them to serve in the region for a certain period are ignored. They prefer to pay the bond amount instead. Despite hikes in salaries of government doctors, the difficult work conditions prove too much for many and they prefer to quit and join the private sector.
So, with all the effort being put in by government, the particular objective for which the medical universities and colleges were established is not being fully served. It would seem as though the system will have to wait till such time enough surplus of doctors becomes available that even posting in the hills become attractive.
Or, a more innovative approach can be adopted with doctors being allowed to live in cities like Dehradun and contracted to serve in the hills. That would become possible by building the entire necessary infrastructure at strategic locations and doctors, particularly specialists, being helicoptered in on specific days. Investing in helicopters may seem an expensive option but it would prove cheap in the long run. An example of this is Australia’s Flying Doctors service that has traditionally supported small populations living in very remote areas. These ‘hospitals’ can be kept operational by skeleton staff posted at the site, ready for use by doctors flying in for a day or two. The helicopters can also be used for emergency extraction of serious medical cases when required. A little bit of political will can make this come true.
