The latest round of agitation by the Government Doctors’ Association of Nepal (GoDAN) has brought the lives of ordinary citizens seeking health service to a grinding halt. The GoDAN had used similar strategy to pressurise the government to listen to their demands in the past as well. This has not only violated the fundamental right to health (Article 35) enshrined in the new constitution but also added woes particularly to the underprivileged category of population. According to an estimate, about 200,000 people throng the government-run hospitals and health centres every day. Owing to the availability of medical treatment at lower costs, such patients visit these institutions instead of private hospitals that charge exorbitantly.
In the past few years, the medical sector in Nepal has come under several attacks in various pretexts which is really unfortunate. Even the pious civil disobedience movement of Dr. Govinda KC was embroiled in controversy many times due to the doctors’ abandoning their professional duties for expressing solidarity to his demands. In other words, the medical sector has virtually been crippled, undermining the universal principles of equitable and unperturbed access to health services time and again.
Expressing serious reservation over the provision of the recently-introduced civil service adjustment act that requires doctors to work under the jurisdiction of State government or local units, GoDAN has taken to the street. Furthermore, GoDAN has opined that the State and local authorities aren’t competent enough to supervise and monitor their work thus providing them career guidance. Such an attitude on the part of the doctors can’t be accepted as the new constitution envisages all 3 tiers of government: federal, State and local as competent governments, and equally powerful.
While it is a democratic right of every professional association to put forward its demand to the government, it is unethical to obstruct health services which come under essential service category. In this regard, a cabinet decision to publish a notice in Nepal Gazette of restricting any protest in the supply and delivery of essential services has already been taken. The government has clearly hinted at taking stringent actions if the doctors violate the law. Having said that, the government doctors have started attending patients in open spaces on hospital premises instead of their cabins. This has not alleviated the sufferings of those seeking medical treatment. It is learnt that the police forcibly opened the ticket counters to ensure public access to health services. However, the solution of this sort can only be temporary. Without finding a sustainable remedy to this issue, it will be very difficult to smoothly operate public hospitals.
Such demonstrations have exposed the larger question of the resistant mindset that has become pervasive in every sector in the federal system. How can the doctors justify the demand of not obliging to the transfer outside the centre? How can the investment of government in producing medical doctors be overlooked? These are some pertinent questions that need serious contemplation.
With employee integration emerging as an uphill task for the central government, the present strike has further worsened the situation. A few months back, the government witnessed similar kind of outrage by the civil servants of public administration. In the post-federal Nepal, although the political regime has changed, the general thinking remains the same. On the one hand, the provinces are still not in a position to recruit and select employees for public service while on the other, the concerned officials are showing sheer reluctance to abide by their duties.
It is distressing to note that no serious negotiation has started between GoDAN and government to find a win-win solution to this issue. While the government needs to heed the genuine career related demands of the doctors, it is equally important for doctors to resume their work and raise their demands in a responsible manner. At any cost, the right of the general public to health cannot be denied.
The onus is on the government as a custodian of maintaining law and order and ensuring the convenience of the daily lives of people including their health access. Taking a pro-active role, the government needs to invite the disgruntled doctors for negotiation. Equally crucial will be the government assurance to the doctors of their chances of returning to federal office even after getting transferred to the State and local levels. In fact, an amendment has already been made in this regard.
Being duty bound will be the key for the doctors to settle this issue. They need to withdraw protests of such an inhuman nature and demonstrate their professional integrity and accountability.
(The author is a member of the Social Science Faculty at NIMS College)