Print Edition - 2019-04-11  |  Health and Living

Why doctors at government hospitals nationwide are on strike, explained

  • Thousands of patients—mostly the poor—are facing the brunt of the strike while the government has largely remained silent
- Arjun Poudel, Kathmandu

Apr 11, 2019-

Thousands of Nepalis across the country are bearing the brunt of the strike imposed by government doctors who have refused to attend to patients at government health facilities. Government doctors said on Wednesday—the sixth day of their strike—that they would provide emergency services from outside the hospital buildings, but would not enter the facilities. Patients with serious injuries and surgery said they were at their wits’ end, as they could not afford treatment at private health facilities. A majority of Nepalis rely on government health facilities for treatment, but when there are strikes, they have nowhere to turn to. The situation becomes more complicated when the government chooses to be silent. At the heart of this strike is the Civil Servant Adjustment Bill. Here is an explainer of what’s happening:

How dependent are people on government hospitals?

There are a little over 1,400 doctors serving in state-run health facilities across the country in primary healthcare centres, zonal hospitals, sub-regional hospitals,  regional hospitals and central hospitals. There are 8,000 beds in total in all public health facilities. They make up the backbone of the country’s healthcare system and provide a majority of patients across the country with treatment at rates cheaper than private hospitals and nursing homes. According to estimates, around 100,000 people visit government-run hospitals across the country every day to seek treatment.

What is the Civil Servant Adjustment Bill?

The Civil Servant Adjustment Bill was passed by Parliament on February 15. The bill was introduced with a view to readjusting civil servants across the country in line with the new federal system the country adopted after the promulgation of the constitution in 2015. The bill is a provision that seeks to deploy government employees at all levels of government—federal, provincial and local. As per the bill, the federal government transfers staff to provincial and local levels on a permanent basis. Since the bill was introduced, with an aim to deploy government staffers at different levels, it meant doctors working at government hospitals would also have to follow the decisions that are taken for other civil servants. Government doctors took exception to the bill, saying doctors transferred from the federal government to provincial and local health facilities would not be able to work under the federal government, as it would limit their potential.

Why did the trade unions active in government health sectors submit a memorandum?

Government doctors and other health workers submitted a memorandum to the health minister, Minister for Federal Affairs and General Administration, chief secretary and the Office of the Prime Minister and Council of Ministers, saying the authorities had failed to understand the sensitivity of the health sector and that the government had taken an immature decision by trying to readjust them along with other civil servants.


How did the Health Ministry respond?

The Health Ministry told government doctors on January 14 that it would keep doctors and health officials appointed by the federal Public Service Commission, under the federal government’s jurisdiction. It said it would also request the Ministry of Federal Affairs and General Administration to make necessary arrangements for the same—so that the concerns of government doctors could be addressed. Doctors said the Health Ministry gave assurances but did nothing. They then staged a protest in front of the ministry, where police arrested 25 doctors and also baton charged them, injuring three doctors. The arrested doctors were released the same evening.

The government doctors decried the police’s intervention in a peaceful protest. They then announced a series of protest programmes on February 17. They held a press meet to inform the media about their problems, collected the resignations of government doctors serving throughout the country, appealed to the chairman of the National Assembly to not pass the Civil Servant Adjustment Bill, and appealed to President Bidya Devi Bhandari to correct the bill. They also decided to go on leave en masse and stop services,  except for emergencies.

What happened in the meeting between the doctors and the health minister?

The agitating doctors put forth their concerns before Health Minister Upendra Yadav, but he refused to agree to their demands. The ministry formed a dialogue team, which held discussions with the agitating doctors and made suggestions to the minister.

Why did the doctors withdraw their protest?

After Prime Minister KP Sharma Oli assured doctors that the government would address their “genuine” concerns, they withdrew all their protest programmes and returned to work. A team comprising of government doctor representatives, officials from the Ministry of Federal Affairs and General Administration, and officials from the Ministry of Health and Population was formed to address the concerns of the government doctors. The team furnished a report that included the doctors’ concerns to the ministry. The report continues to gather dust.

Why did the doctors restart their protests?

The agitating doctors restarted their protest after the Health Ministry published a list of doctors integrated in all three tiers of government. Government doctors said they were forced to boycott services, as the government did not pay heed to their genuine concerns and used coercive measures instead. They said they wanted to work under the federal government and were ready to be posted in any part of the country, but the postings had to be made by the

federal government.

What are they demanding?

The agitating doctors say they wish to remain under the purview of the federal government, instead of under the jurisdiction of the provincial and local governments as suggested by the bill. They say they are willing to be posted anywhere so long as the deployments are made by the federal government.

What is the government’s response?

The Ministry of Health and Population has been saying that both the demands and protests of the agitating doctors are illegal. They have also warned of legal action against protesting doctors if they refuse to return to services immediately. Health Minister Yadav has said that the ongoing protest is against the spirit of federalism.

Is there a way out?

Since the Civil Servants Adjustment Bill has already been introduced, the doctors’ demands are technically against the law. The only way to address the government doctors’ concern is to make an amendment to the bill.

Published: 11-04-2019 11:10

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