Kerala doctors' body opts out of 24x7 specialty plan, cites staff crunch

The Kerala Government Medical Officers' Association (KGMOA) has decided not to cooperate with the working arrangement order issued by the Kollam District Medical Officer (DMO) that reshuffles doctors to provide round-the-clock specialty care at Punalur taluk hospital. The association said it would wait until the government provides clearer guidelines on implementing the initiative, given the acute shortage of human resources in the State health services.

The government had earlier announced that it would pilot the initiative to offer 24x7 specialty services in secondary hospitals at Punalur taluk hospital. Following this, the Kollam DMO issued orders pulling out doctors from various institutions in the district and reassigning them to enable the round-the-clock service.

At an emergency meeting of the KGMOA State committee held online on Tuesday, members pointed out that there are currently 799 vacancies for doctors in the health service. Of these, 300 are in the specialty cadre, 476 in the general cadre, and 23 in the administrative cadre. The association argued that with such a large shortfall, it is impractical to provide round-the-clock services merely through working arrangements without creating new posts.

The meeting also noted that the Health department does not have enough human resources to sustain even the existing services. The KGMOA State committee urged the government to implement the decision only after filling the current vacancies and creating the required specialty-cadre posts for the stay-duty system.

In a statement, KGMOA President P.K. Sunil said the government must create adequate posts for casualty medical officers and emergency physicians, and strengthen emergency wings in government hospitals. "At present, what is urgently required is that the government equip all hospitals to provide casualty services round-the-clock. There are busy hospitals where at least two casualty medical officers are required to keep the system running. In some hospitals, in the absence of casualty medical officers, specialist doctors end up working in casualty all night, with the result that their OP clinics next day are affected. This is something that we have been pointing out for a long time, but the government does not seem to understand," he said.

The KGMOA also stressed that doctors do not work in isolation. Additional pharmacy staff, lab technicians, nurses, and nursing assistants would need to be posted before round-the-clock service provision can become a reality.

According to Health department rules, a specialty must have at least seven doctors to provide 24-hour service, and at least four doctors to allow one doctor to take on-call duty. The association noted a serious imbalance in the number of sanctioned posts in district and general hospitals across the State. It called for urgent standardisation of staffing patterns in all such hospitals.

Government medical colleges are already providing round-the-clock medical services, including specialist care. The KGMOA has asked the government to conduct a comparative study to assess the necessary infrastructure and staffing patterns required for 24x7 services in any institution.