Doctors neglecting professional nobility: Madras HC slams Medico for Violation Govt Service Conditions

Chennai: Taking stringent cognizance of the fact that medical practitioner take subsidized education and training in government medical colleges with a promise to serve in government setups and then leave in between in search of more profitable private practice, the court recently announced a series of directions to the government to check this practice.

The court was seen directing the government to recover adequate compensation from the Government Doctors, who all are violating the terms and conditions of their services with reference to the expenditures met out from the public money for acquiring P.G. Degrees, Speciality Degrees etc.

The directions came in response to a petition filed an anaesthetist, whose passport had been impounded by the regional passport office pursuant to the notice issued against him by the Madras Medical College. Tamil Nadu Government contended that the doctor had committed an act of misconduct by remaining unauthorisedly absenting himself from duty in attending the public duty. This apart, as per the Medical Council of India Notification, the doctor has committed the misconduct by not performing his duties of Physician to the public and to the Para Medical profession, he was unauthorisedly absenting from duty for the past 7-1/2 years and he has resumed his private practice by undergoing the Specialist Course from and out of the taxpayers' money and now refusing to serve the public at large

As per the procedure, three call notices were issued and the Immigration Department was asked to inform whether the writ petitioner left out the country. When the doctor went for travel, actions were taken against him and the passport was impounded

Demanding his passport back, the doctor filed an appeal with the Madras High court. The doctor before the court argued that he had tendered his resignation in 2010 but the govt reply came that it never received the resignation

The Court dismissed the plea and directed the authorities to keep a check on the unauthorised absentees in the department.

The court went through the literature of case and was seen observing the recent trend in the Medical Profession is that the Doctors, on registration of their names in the Medical Council of India, are simultaneously aspiring to secure public employments through Tamil Nadu Public Service Commission or otherwise.

Thus, the Doctors, at their young age, are gaining experience from the Government Medical Colleges, Government Hospitals or any Government Headquarters Hospitals and after gaining experience and after exploiting all the Government resources at free of cost for acquiring their Speciality qualifications and practical experiences, they are leaving their job for their personal enrichment.

The court further pointed out that while there is a freedom of profession along with certain duties towards the people.

 Undoubtedly, the freedom of profession is the fundamental right. However, the fundamental rights are subject to certain restrictions. The Doctors, who acquired the Speciality Degrees and qualifications, at the cost of the public and by providing certain undertakings, are bound to serve for the public. However, Medical Profession, being commercialised, day by day, the Doctors are also neglecting their professional nobility and the responsibility to provide quality medical treatment to the citizens of our Great Nation. Medical Profession is now commercialised to the larger extent, and privatisation is inevitable. This Court is also of an opinion that no one is questioning the decision of a Doctor to develop their private practice. However, the Doctors have to take a decision before entering into the public services and before undergoing the Speciality Courses at the cost of the taxpayers' money. When the Doctors had undergone the Speciality Courses or PG Courses, at the cost of the taxpayers' money and by providing an undertaking and after gaining experience from the Government Hospitals, they are bound to serve for the public and they have to show devotion to their duty as Medical Professionalists.

Adhering to the constitutional principles and ethos, the court further stated-

 Contrarily, if those Doctors are allowed to escape from the performance of their public duty, then this Court is of an undoubted opinion that, we are not adhering to the constitutional principles and ethos. These Doctors must be made to work in the public hospitals in view of the fact that they had not only given undertaking at the time of undergoing the Speciality Courses and P.G. Courses, at the cost of the public money and gained experience from the Government Hospitals.

The court further reminded the duties of a doctor towards the poor section of the society, it stated-

 It may be little harsh in stating the reality that few Doctors, who all are in the habit of neglecting their public duty towards the public at large, had gained their experiences from the poor man's body in Government Hospitals and undoubtedly, they gained experience by dissecting those poor man's body, who have no option but to take treatment in Government Hospitals at free of cost. After gaining vast experiences from those poor man bodies or by providing treatment by utilising the infrastructure facilities provided by the Government in Government Medical Colleges and Hospitals. These Doctors are enriching themselves by treating the rich by charging exorbitantly. It is not possible for a common poor man or the middle income group families to get treatment from reputed Corporate Hospitals. However, the Doctors on gaining experience from utilising the resources provided by the Government and by learning the medical intricacies and diagnosis from and out of the poor man's body and thus, they are making money for their personal enrichment. Such conduct of the Doctors, who all performing the noble duties are to be deprecated and the said situation is to be construed as violation of the Medical Council of India Regulations.

The Court further opined to balance between the ambition and duties-

Undoubtedly, every Doctor is to be ambitious both regarding the development of practice as well as regarding the monetary considerations. A balance approach is to be adopted by the Doctors since they are performing the noble duties. Everyone is aware that economic resources are also important for the medical professionalists. However, such medical resources cannot be created by compromising the public duties and the constitutional perspectives. Without having a balanced approach, few Doctors are abandoning their job either by way of unauthorised absence or by submitting resignation or voluntary retirement applications and those circumstances are contrary to the provisions of the Service Conditions Act as well as certain conducts are denoted as “misconduct” under the Medical Council of India Regulations.

The Court further stated-

“…right to life includes providing of decent medical facilities to all the citizen of this Great Nation and it is the duty of the State to ensure such medical treatments and facilities are provided at par and equally, since the Government Hospitals are equipped with advanced medical equipments and infrastructures. Mostly utilisation of these medical equipments and infrastructural facilities are not regulated. The Machineries are not maintained properly as per the instructions provided by the manufacturers of such medical equipments. Sometimes, those medical equipments are misused by the medical practitioners and employees of the Hospitals by mishandling or not operating as per the instructions.

The court further examined the prevailing situation and conditions of Government Medical Hospitals across the State of Tamil Nadu.

Huge public money are being invested for developing infrastructures and for purchase of advanced medical equipments from companies within India as well as from abroad. Question arises whether those advanced equipments are maintained and utilised for the benefit of the patients. There is no adequate supervising and controlling mechanism in vogue and thus, the public money is being wasted.

Constitutional importance and the decent medical facility, which is ensured under Article 21 of the Constitution of India, this Court is inclined to pass the following orders:-

(a) The relief, as such, sought for in the writ petition on hand stands rejected.

(b) The respondents are directed to initiate all appropriate actions against the writ petitioner under the Tamil Nadu Civil Services (Discipline and Appeal) Rules.

(c) The respondents are directed to lodge a complaint with the Medical Council of India regarding the misconduct enabling the Medical Council of India to institute appropriate proceedings under the Statute and the Regulations.

(d) The first respondent is directed to constitute a 'Monitoring Committee' to supervise the attendance and assess the performance of Government Doctors as well as regarding the maintenance of Government Medical Hospitals as per the prescribed standards.

(e) The respondents are directed to recover adequate compensation from the Government Doctors, who all are violating the terms and conditions of their services with reference to the expenditures met out from the public money for acquiring P.G. Degrees, Speciality Degrees etc.