Dr. KC And Ailing Medical Sector

Narayan Upadhyay


The government has relented to some of the demands of Dr. Govinda KC, whose latest fast-onto-death being held at the TU Teaching Hospital premises enters the 11th day today (Wednesday). Though his health condition is critical, the senior orthopaedic doctor’s latest protest has sought wider reforms in the nation’s medical education system.



During his earlier protest, the agitating doctor had put some demands with the government with the clear intention of seeing reforms in the medical sector. These demands included a stoppage to the haphazard granting of affiliation to the mushrooming number of medical colleges; keeping the fees minimal for medical education throughout the nation; and appointing heads and chiefs at the education institutions on the basis of seniority and merit, without political interference.


After finding that new medical colleges - most of which do not have adequate infrastructure or faculty teachers and professors - have received affiliation by violating the past agreement, the doctor was forced to sit for the fifth round of his fast-unto-death. This time Dr. KC and his supporters have come up with stronger demands that include the resignation of the education and health minister, and officials involved in granting affiliation.


Dr. KC’s team has accused them of coercing Kathmandu University to grant affiliation to two new medical colleges - Birat and Devdaha Medical colleges - although the government in the past had agreed not to grant affiliation without bringing a composite medical education policy. The team has also demanded scrapping the affiliation granted to many medical colleges that have no sound infrastructure and other facilities.


The supporters who have thrown their weight behind the agitating doctor contend that many medical colleges have received or are on the verge of getting affiliation from the major universities largely through political connection. Many of the medical institutions in the nation, which have opened mostly with a profiteering motive by charging exorbitant fees on the medical students, have been established with heavy investments by the leaders, businessmen and senior doctors of the nation.


One incident should make it clear how the leaders and their cronies are involved in the operation of medical colleges. After Dr. KC’s earlier protest played spoilsport in getting affiliation for a newly built medical college in Kathmandu, an UML leader, Rajendra Pandey, declared in Parliament that he would go to the limit of committing suicide if the government did not grant affiliation to Manmohan Medical College in which he had invested money.


Many, including the supporters of Dr. KC, believe that the UML honchos are pressing the government to grant affiliation to the medical colleges, and the government had given in to their pressure.


Dr. KC’s fast has opened a can of worms in the Nepali health sector. The large number of Nepali medical colleges has produced abundant doctors at home, but each of the doctors in the nation has had to pay a high capitation fee to become a medical practitioner. And a doctor who has paid such high fees is not motivated to provide service to the people but only keen to make a quick buck to recoup his expenses.


On the other hand, a student who receives his/ her certificate from a below par medical college cannot be trusted for his skills. In short, the arrival of new medical colleges, most of which are concentrated in the big cities and towns, are producing doctors who are commercialising the medical sector.


At present, there are 17 medical colleges - three in the government sector and the rest owned by private operators - operating in 2 districts of the nation, while 16 or 17 medical colleges are awaiting affiliation from different universities. Clearly, once they come into operation, they will start enrolling students by imposing exorbitant fees in case the government fails to put a cap on such fees.


Indeed, the exorbitant medical education fees are to be blamed for the existing woes in the Nepali medical sector. Talented students belonging to the economically deprived strata cannot opt for medical studies.  


Medical treatment in the nation is getting more expensive by the day, thanks to the mushrooming number of new private hospitals, nursing homes, clinics and others. The failure of the government hospitals to provide sound health services is one of the reasons that have led to a rise in private hospitals where patients need to pay a higher cost for medical treatment. 


There is growing dishonesty on the part of the doctors and paramedics working in the government health institutions. The doctors, nurses and other health workers in the government hospitals are often less careful while treating a patient. But the same persons are extra careful and work skilfully while providing services to the patients in a private institution. This business motive of our doctors, nurses and paramedics is what is making our health services inaccessible to the poor and middle class people of the nation. Again, it boils down to the high fee structure for a medical education.


Stop political interference

If the nation is to make the medical sector more service-oriented, then the government must introduce several reforms. One of the key reforms will be making the fee structure for medical studies affordable and allowing more talented but poor students to join medical studies. Effectively stopping political interference in the medical sector will be another prudent step to make it more vibrant. Medical colleges, according to Dr. KC, should be opened in the rural parts to make them poor-oriented. 


Our medical education, health institutions and whole health sector are indeed ailing, and they call for reforms. Political interference in them has made the matter worse for all. The government must come up with a firm, reliable and positive medical education policy that must aim at ending all the ills of the medical sector.

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