The issue of absentee doctors

Many doctors on the government’s health services in connivance with unscrupulous officials in the Health Ministry are usually able to avoid serving in the rural areas. Many of them remain in Dhaka month after month and draw their salaries and other benefits without doing adequate work at their properly designated places while the health services in the rural areas suffer very seriously from absence of doctors. Prime Minister (PM) Sheikh Hasina warned such absentee doctors for their dereliction of duty time and again. They were told by the PM without mincing any words that they should give up their jobs if they do not like to stay in the rural areas at the 19th annual conference of the Bangladesh Medical Association (BMA). The PM also warned how the nation and taxpayers make financial and other forms of sacrifices for doctors to be educated and trained only not to get the expected services from them.
However, like in all other cases of the taste of the pudding coming from eating it, the tough words from the PM will count for something only after the actual taking of the steps that would be required to ensure that the doctors do indeed feel obligated to serve in the rural areas. This is no easy task for on the one hand there are involved problems of psychology and character and, on the other, the doctors can point to the disincentives that keep them away from rural areas. The solution lies in psychologically curing the doctors of their inordinate fascination for working in urban areas as much as also providing them with further incentives, as far as would be truly justified, to have peace of mind to serve with dedication in the rural areas. But the greatest stress will have to be put on strict enforcement of rules and regulations to make it very difficult for them to go on so unconscientiously avoiding their duties in rural areas.
The health ministers of nearly all previous governments ordered stronger supervision of doctors who neglected their duties in the rural areas, But little appears to have been achieved in this direction. It seemed that the ministers’ directives were thrown to the winds and the tradition of doctors staying away from their places of posting in the rural areas continued in much the same form. Not much positive changes have been experienced either in relation to absentee doctors under the present government. Therefore, the government needs to take up a more pragmatic and realistic attitude in relation to this serious heath related issue putting emphasis of service rules above everything else to achieve any significant positive results.
Nearly 90 per cent of the people of the country live in the rural areas. Successive governments invested substantially in setting up health or medical care centres in the rural areas with a hope that these centres would extend minimum health care to rural people. But even partial benefits of these centres are not being realized due to the phenomenon of the absentee doctors .The incumbent government planned to establish 18,000 community clinics and out of these 8,000 such clinics have been already established mainly in the rural areas with a view to extending health services to rural people. But these functioning community clinics are also suffering from the phenomenon of absentee doctors.
The nation makes much sacrifice to produce a doctor with highly subsidised medical education and then further pays not unreasonably for his or her upkeep with salaries and other facilities. In return, the nation should duly expect to get his or her sincere service. If the same is not honestly discharged, then the nation should have the right to apply coercion so that the same is discharged.
The problems complained by the doctors may not be ignored and steps may be taken to solve them . But the imperative is keeping up consistent pressure on them as per their service rules to do their bounden duties at their work stations.