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Thursday, June 25, 2009

Frequently asked Questions on Private Practice

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State Office: 208, DAS Quarters, Govt. Rajaji Hospital, Madurai
14th June 2009

What is the choice of the TNGDA if the government bargains the private practice with central pay?
The central pay cannot be bargained for the central parity, but it can be bargained only with NON PRACTICING ALLOWANCE (NPA). The NPA given to central doctors is 30% of basic pay and it will be calculated for DA.
With central parity, this NPA will vary from Rs 10000 to 25000 for various grades of doctors. The total extra expenditure will work out to about 80 crores per annum to the govt.
What is the choice of the TNGDA if the government bargains the private practice with NPA?
    The TNGDA will choose NPA, if compelled.
    But, very unlikely for the following reasons…
  • the govt. or the public will not benefit in any way – already the duty timings are more than prescribed for any govt. servant.
  • NPA cost will be about Rs 80 crores per annum.
  • Almost all the states permit private practice as it benefits the public.
What if govt. bans Private Practice?
  • Very unlikely. Especially with a people friendly CM and govt.
  • Please see the disadvantages given below.
  • No advantage to public or govt.
  • In case if PP is banned, we would gain central pay + NPA.
  • It will be easy for TNGDA to persuade govt. to repeal ban in a year or two - as it wont cost any financial burden.
  • Even during the ban, in evitable practice, due to patients’ compulsion cannot be stopped. If at all any action is tajen it can be done only on conduct rules. (this will be dropped once the ban is repealed)
  • Repeal will be natural – in the capitalist economy, also in public interest, pressure of the association. Similar repal was done three years back in Andhra after a ban of about 1 year.
What are the disadvantages of banning private practice?
    1. Among the total actively practicing 40000 doctors in TN, about 12000 are in govt. service ie about 1/3rd of the total doctors. Ban will deprive the public of the private services of every third doctor. The demand will up and will be the cost – directly affecting the public.
    2. About 60% of the specialists in TN are in govt. service. Ban will restrict access to the remaining 40% - again increasing the cost. (among the 40% - 10 % are in corporate sector)
    3. 70% among the rurally practicing (baring the bigger towns) doctors, are govt. doctors. Ban will increase the suffering of the poor rural public.
    4. Already doctors are reluctant to join service in interior PHCs and difficult terrains. Ban will aggravate this situation.
    5. Above all – ban will force all the talented hands to leave the govt. service. Almost all super specialist and other specialists with good private practice will quit service. The quality of govt. institutions will go down.

Is the argument that banning Private Practice will raise the concentration of doctors to serve the public?
No. the earnestness and serving nature is individualized. Except a few, almost all doctors work with passion and sincerity. But the exorbitant load of patients – mask it and the stress shows off.
Even the UNIVERSITY GRANTS COMMISSION since this year has liberalized and has permitted all the college teachers to take up “Private Consultancy Assignments” – vide the UGC – Pay Review Committee Report of 2008. It justifies saying that such assignments will help community to augment their educational quality.
Is it possible that awarding UGC scales, increase the duty timings in DME side?
No. The UGC permits 10 weeks vacation to the teachers. Vacation to certain npn-clinical departments possible. Already they work on par with other college teachers.
In the clinical side, vacation is not possible. So, titrating the 10 weeks vacation and the 24 hours stay duties; the existing timings is already more than the stipulate 30 hours a week norms of UGC.

    State Secretary

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