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VIEWS OF DADWA ON RULES FOR DELHI HEALTH SERVICE: AS SUBMITTED TO SPL. SECRETARY (H&FW) GNCTD ON 16-7-07

 

As a follow up of the meeting taken by Pr. Secretary (H&FW) on 28-6-07 DADWA submitted its suggestions after highlighting present problems of CHS These views and suggestions were outcome of recommendations of a committee of officers from both GDMO and non-teaching specialist sub-cadre of CHS. These were then discussed in steering committee of DADWA and subsequently ratified in the GBM on 14-7-07.

 

These suggestions are in line with the decision of GNCTD notified through a public notice that Rules of DHS would be “more of less similar to those of CHS” but not same as there are problems therein. The following is the text of the letter

 

VIEWS OF DADWA:

  1. Background:
    1. The Central Health Service or ‘CHS’ was created about four decades back to provide a cadre of medical professionals to its constituent organizations. These included MOHFW, several other ministries, UT’s (including Delhi), Assam Rifles etc. but in last few years recruitments in the cadre have greatly reduced.
    2. The Four sub-cadres of CHS came into existence in 1982. Exodus of a large number of senior doctors in teaching hospitals due to very low career growth opportunities was the trigger. Instead of creating more posts at higher level across the board, the MOHFW created sub-cadre wise SAG posts. The poor promotional avenues and unfair management of cadre led to a strike by CHS doctors in 1987. this drew attention at the highest level and amends came in form of time bound in-situ promotions and recommendations by Tikku committee that led to some amends in CHS Rules.
    3. Later, multiple seniority queues have come up within the CHS and within its specialist sub-cadres with differential benefits.  There are reportedly as many as 60 seniority queues within CHS. There are different ages of retirement, different movement and career growth in different sub-cadres.
    4. CHS Rules do not facilitate smooth movement from one sub-cadre to another, even if the officer concerned is carrying out same or similar job. Such movement is vacancy driven the officer looses seniority when he moves from GDMO sub-cadre to specialist sub-cadre or from non-teaching to teaching specialist sub-cadre.
    5. On the other hand, Army Medical Corpse and Indian Railways Medical Services are examples of organized services that have officers from both GDMO and Specialist streams who work as a team to achieve the objectives of their respective organizations. This is not happening in CHS
    6. DADWA supports the vision of GNCTD as contained in the notification dated 18-12-2006 and minutes of the meeting taken by Hon’ble HM GNCTD on 1-3-07. But the notified view of GNCTD that “Delhi Health Service would be more or less similar to CHS” warrants a clear interpretation, analysis of present situation and a study of impact of merger of regular UPSC appointed officers and those appointed on contractual/ad-hoc basis.

2. VISION FOR D.H.S. AS A MODEL TECHNICAL GROUP 

    ‘A’ SERVICE:

a. Delhi Health Service should be recognized as a technical GROUP ‘A’ service incorporating an arrangement wherein both graduate and post-graduate doctors coexist and work together like a cohesive team to achieve the desired objectives.

 

b. While sub-cadres are necessary to meet the functional needs of the service; instead of present four sub-cadres, only two sub-cadres should suffice, viz. 

 

i.  The stream of graduate doctors in essence are technical officer who can be called as Comprehensive Health Providers & Managers instead of GDMO’s. They work as comprehensive health providers, leaders of the health team and managers of health delivery system. They work in diverse and trying situations, in various public health programs at peripheral level in dispensaries and hospitals and acquire skills of health management. They should be encouraged to do PG in disciplines as per state needs and move to the other sub-cadre. Like the N.H.S. of UK they should be the most important part of health system of Delhi as per their role envisaged in the National and State Health Policy and as per guidelines of N.R.H.M.

 

ii. Stream of Post Graduate doctors with requisite post PG experience and skills should be called Specialist Health Providers in their respective disciplines (All medical, surgical and public health specialties). DADWA does not see need for a separate teaching sub-cadre as officers of this stream if eligible and desirous can take teaching assignments. A package or allowance specific to teaching assignments would bring prestige to them and flexibility to the system. Members of this stream should be duly compensated at entry level in DHS for the number of years put in for acquiring PG qualification (degree or diploma) and experience thereafter.

 

c. The DHS Cadre like any other cadre should have a common seniority queue at entry level where the two streams meet first viz. SMO/ Jr. Specialist grade. Thereafter officers based on needs of the service and suitability can move from one sub-cadre to other without any loss of seniority. At present there are innumerable examples where officers of one sub-cadre loose several years of their seniority while moving horizontally one sub-cadre to another in the same scale because post-PG experience and teaching experience in one sub-cadre is not counted. The last example of a GDMO sub-cadre officer joining teaching sub-cadre of CHS as Assistant Professor was in mid-nineties. Due to reasons not known this has been stopped and experience of a PG doctor in his own specialty as GDMO is not counted for appointment within CHS in another sub-cadre.

 

d. There are no reserves for leave and deputation in CHS. Training reserve is inadequate (5%) and present only in GDMO sub-cadre.

 

e. Cadre management is poor and not according to best practices of HRD

 

3. Summary of recommendations of DADWA

 

3.1  DHS should provide excellent career growth opportunities at par or better than CHS to ensure entry of one of the best doctors in the country.

 

3.2  All recruitments should be done in consultation with UPSC as is already notified by GNCTD on 18-12-07.

 

3.3 Cadre management should be in the hands of an empowered standing committee with an HRD consultant as its member.

 

3.4 There should be provision for adequate reserves (10%) each for leave, training and deputation in DHS.

 

3.5 There should be reservation in Delhi / IP University / DNB for PG degree/diploma seats for deserving members of DHS. Similarly, there should be reserved seats for Senior Residency and Super-specialization (DM and MCH) for Officers of PG stream/specialist stream of DHS.

 

3.6 DHS should facilitate movement from one sub-cadre to other if the officers are eligible and deserving for that post and to teaching assignments and vice-versa. Such a mix and horizontal movement would help members of the DHS cadre to grow, bring homogeneity and the cadre would be able to address to its needs internally besides preventing compartmentalization of the service. All such officers who grow within DHS would be assets for the GNCTD in the long term.

 

3.7 For meeting the functional needs of DHS, only two instead of 4 sub-cadres should suffice. This would bring more homogeneity in the cadre.

 

1. Comprehensive Health Physicians / Health managers and

2. Specialists of the various disciplines of medicine/surgery/public health.

 

3.8  Posts of Heads of hospitals and other health institutions should be identified as cadre posts with requisite R/R’s depending on the size, function and complexity of the institution. The present practice of posting SAG Officers solely on basis of seniority irrespective of past experience in health administration should be stopped. The justification and impact of recent transfer/postings of 31 such SAG officers of various sub-cadres of CHS as heads of hospitals in Jan/Feb. 2007 may be studied and policy reviewed.

 

3.9  The existing models of Army and Indian Railways are worth examining by the committee before they adopt CHS rules mutatis mutandis.

Posted On: 23-07-2007

Modified On: 23-07-2007