Doctors oppose Bihar govt's ban on private practice

Patna: With the Bihar Government approving a proposal to impose a blanket ban on private practice by government doctors and medical teachers under the allopathic system as part of its 'Saat Nischay 3' programme, doctors in the state have protested the move, urging authorities to adopt an optional Non Practice Allowance (NPA) based regulatory model instead of a mandatory prohibition.

The opposition comes following a resolution issued by the state health department on April 11, 2026, in which the State Government gave its consent to prohibit private practice by doctors working under the Bihar Health Service Cadre, Bihar Medical Education Service Cadre, and the Indira Gandhi Institute of Cardiology.

The resolution stated that the approval has been granted under Clause 5(c) of the "Saat Nischay-3" programme to implement the ban on private practice for doctors and medical teachers in these cadres.

"Regarding the approval of the State Government on the proposal of the Health Department to impose a ban on private practice by doctors/medical teachers working under the Allopathic system in the Bihar Health Service Cadre, Bihar Medical Education Service Cadre, and Indira Gandhi Institute of Cardiology Medical Service Cadre, under Clause 5 (c) of the program announced under the State Government’s 'Saat Nischay–3'," the resolution read.

It further mentioned, "Under Clause 5 (c) of the program announced as part of the State Government’s "Saat Nischay–3", the State Government has accorded approval to the proposal of the Health Department to prohibit private practice by doctors/medical teachers working under the Allopathic system in the Bihar Health Service Cadre, Bihar Medical Education Service Cadre, and the Indira Gandhi Institute of Cardiology Medical Service Cadre."

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The Health Department further informed that detailed guidelines on implementing the decision, including provisions for Non-Practising Allowance (NPA) or incentives for doctors, will be issued separately after approval from the competent authority.

Meanwhile, the medical fraternity, including the Indian Medical Association (IMA), has strongly opposed the move. In a representation to the Principal Secretary, Health Department, IMA Bihar urged the government to adopt a consultative, incentive-linked and legally sustainable policy based on an optional NPA model rather than a blanket ban.

The association warned that a complete and uniform prohibition on private practice, without addressing structural and administrative realities, may lead to serious unintended consequences, including depletion of experienced manpower, academic weakening of medical colleges, and avoidable judicial intervention.

"At the outset, IMA, Bihar wishes to place on record that the Association is fully committed to improvement in quality, availability and accountability of public health services in the State. The concern regarding the absenteeism of doctors and compromised patient care in government institutions is genuine and deserves urgent policy attention.

However, we respectfully submit that a complete and uniform prohibition on private practice, without addressing structural and administrative realities, may lead to serious unintended consequences, including depletion of experienced manpower, academic weakening of medical colleges, and avoidable judicial intervention," mentioned the representation.

A blanket ban, without differentiation or incentives, the association said, may be perceived as arbitrary and disproportionate, and could invite challenges under Articles 14 and 21 of the Constitution. The association said that courts have consistently held that policy measures must satisfy the tests of reasonableness, proportionality, and fairness.

It proposed the adoption of an Optional NPA Model, wherein:

1. All government doctors are given a clear option to either:

i. opt for non-practice and receive NPA equivalent to Central Government doctors, or

ii. Continue private practice without NPA, under declared conditions.

2. All administrative and leadership posts (Civil Surgeon, Superintendent, Principal, HOD, etc.) be declared mandatory non-practicing posts, with admissible NPA, if applicable.

3. Doctors receiving NPA must give a statutory undertaking not to engage in private practice, with graded penalties for violation.

While payment of NPA entails additional expenditure, IMA said that this cost is offset by improved OPD/IPD utilisation, reduced referrals, and enhanced public trust, and the present system already causes hidden financial loss due to underutilisation of public infrastructure. Thus, NPA should be seen as an investment in governance, not merely a financial burden, the association said.

The association expressed serious concern that a blanket ban may encourage the best senior faculty to join new private medical colleges, result in non-compliance with NMC faculty norms and weaken teaching, research and postgraduate training. Medical Education Cadre, therefore, requires flexibility, including optional NPA, academic incentives and Research and conference support.

Citing the real causes of doctor absence, IMA said that absence is often facilitated by lack of residential accommodation, inadequate security and infrastructure, staff shortages, excessive administrative burden and fixing responsibility/disciplinary action on controlling officers.

It stressed that punitive action without first correcting these facilitators would be unjust and counterproductive, and corrective measures must precede disciplinary action, except in cases of wilful misconduct.

To ensure rural availability, IMA strongly supports that rural area allowance for institutions beyond 10 km from the district headquarters, lease-based/need-based residential accommodation for doctors and staff in PHC/APHC/Referral Hospitals. These measures will significantly improve attendance and morale.

"IMA supports surprise inspections, biometric attendance, geo-fencing, graduated penalties with right of explanation and appeal. Such a framework minimizes arbitrariness and judicial interference," the representation read.

"In view of the above, IMA, Bihar, urged the state government to adopt a consultative, incentive-linked, and legally robust policy based on Optional NPA, rather than a blanket prohibition," IMA stated, assuring full cooperation in strengthening public healthcare.

Speaking to Medical Dialogues, Dr Sunil Kumar, Senior Vice President of IMA Bihar, said, "We have submitted the memorandum. If the government fails to address our demands, we will take further action. For now, we are hopeful of a positive resolution."

Also read- Bihar govt doctors oppose private practice ban, demand non-practice allowance