Govt drags its feet on rural medical cadre programme

Top officials told Deccan Herald that Union Health Minister Ghulam Nabi Azad wanted the PMO onboard before formally launching the barefoot doctors programme as he had only received sporadic support from states. There is no uniformity on the structure of rural paramedics in states.

A powerful group of doctors is believed to have lobbied hard with the PMO against it, arguing it would create a rural-urban divide in the healthcare delivery system. With the PMO showing reservations, Azad has become doubly cautious.

“The Indian Medical Association was unnecessarily creating the hue and cry. It gave representation to the PMO. We will also submit our proposal to the PMO and try to convince them,” said an official.

But even that does not seem to be happening in the near future. The new board of governors for the Medical Council of India has not yet finalised the curricula and teaching modalities for the proposed bachelor of rural medicine course.

And, a public interest litigation on what these barefoot doctors should be taught and what will be their place in the healthcare delivery system is being heard by the Delhi High Court.

The original idea—ironically championed by tainted MCI chief Ketan Desai—was to launch a four-year bachelor of rural medicine and surgery course to produce a rural cadre of healthcare workers for 1,45,000 community centres.

But with objections from the academics, the surgery portion was dropped. The ambitious curricula was then modified to create a new bunch of “well qualified paramedics” required for backward states like Jharkhand and Chhattishgarh. Also majority of these paramedics would be women.

“This will not come into force automatically even after notification. States have to adopt it. Those who adopt it will have an uniform standard,” said an official. Assam and Chhattishgarh are the only two states which have a rural medical cadre and the West Bengal Assembly had passed a bill favouring them.