Mumbai: The Maharashtra Association of Resident Doctors (MARD) has written to the Maharashtra State Human Rights Commission (MSHRC) drawing its attention to the long-working hours at public hospitals.
In a letter to MSHRC, the resident doctors said they have to work for around 30 to 36 hours at a stretch at medical colleges. Long-working hours, irregular sleep and poor food hygiene are making doctors fall ill, according to MARD.
However, in its reply, the Directorate of Medical Education and Research (DMER) has stated, “If doctors are on call for 48 hours, it does not mean that they are working at a stretch for all the hours. Their interpretation is incorrect.”
Speaking to India Medical Times, Dr Sagar Mundada, president, Central MARD, said, “We had sent the letter first in August 2015 and that was regarding a Supreme Court judgement which says that a central uniform residency scheme for doctors should be implemented.”
As per the directives of the Supreme Court, in a judgment dated September 25, 1987, all the state governments, medical institutions and universities were required to amend their rules and regulations to introduce a uniform residency scheme by 1993.
Subsequently, the union health ministry sent its directive, in a letter dated June 5, 1992, to all the states and union territories administrations regarding implementation of the Uniform Central Residency Scheme. But many states are reportedly yet to take necessary actions to follow the said directive.
In its letter the health ministry said, “Continuous active duty for resident doctors will not normally exceed 12 hours per day. Subject to exigencies of work the resident doctors will be allowed one weekly holiday by rotation. The resident doctors will also require to be on call duty not exceeding 12 hours at a time. The Junior Residents should ordinarily work for 48 hours per week and not more than 12 hours at a stretch subject to the condition that the working hours will be flexible as may be decided by the Medical Superintendents concerned keeping in view the workload and availability of doctors for clinical work.”
Dr Mundada said, “The residency scheme says 48 hours a week shifts for doctors all over India. The central government has asked all the states to implement the same but Maharashtra has not implemented it and in spite of many requests and letters to the concerned authorities nothing really happened.
“Then we filed a petition to the State Human Rights Commination saying that we are working almost 24×7; we are not even getting sleep; we are not going home; we don’t have time absolutely for anything, which is violations of very basic human rights.
“Subsequently, DMER replied saying that non of the things is true; doctors don’t work for 24 hours; they keep getting diseases because they are stressed out. Now, again we have filed a petition to the State Human Rights Commination as the Supreme Court had directed the states to implement uniform residency scheme but till now it has not been implemented in Maharashtra.”
Dr Mundada also said that at some of the government hospitals even very basic needs are not available, residents are living in very unhygienic conditions, not getting good foods and at places proper sanitised water is also not available which affect the health of doctors.
Dr Shrikant Balwande, medical officer, Primary Health Centre (PHC), Bembli, Osmanabad, Maharashtra, told India Medical Times, “We doctors of Maharashtra are asking for eight-hours duty as the doctors who are placed in rural areas like Osmanabad have to work for 24 hours and there is no holiday on Sunday as well. We face too much of family problems and there is a lot of physical as well as mental torture due to the overburdened long shifts.”
He further said, “Recently, the government made a resolution that biometrics is compulsory. But we are asking them to fix our working hours before putting compulsory biometric attendance system, because they will be taking our attendance in the morning at 9am and in the evening at 6pm and thereafter we have to work also then why go for biometrics when one has to work beyond that time.” He added, “At times of need we are ready to work on stretch but we too need rest.”
Speaking to India Medical Times, Dr Dheeraj Agrawal, a member of the FORDA (Federation of Resident Doctors Association, Delhi), said, “In Delhi, there are very few hospitals where doctors have to work for 24-36 hours at a stretch.” He said the Supreme Court has directed that no one should be allowed to work at a stretch for more than 12 hours.
According to Dr Agrawal, “The shortage of doctors in government hospitals is one reason for long shifts; mainly post-graduate medical students have to work continuously. At some hospitals people work for more than 48 hours which is against the Residency Scheme.”
He further said, “When doctors work at a stretch it harms their body’s orientation. For doctors, it’s very important to be mentally active. Long duty hours at a stretch may affect their mental alertness.”
He also said that some of the government hospitals have started using biometric attendance system. “It’s not possible for a doctor to punch on the exact time as he might be engaged in some case but if a doctor comes late at work their CL (casual leave) is deducted; these biometric systems should be used for other departments not for doctors.”
“Medical residents are also people. They should not be overburdened with long duty shifts, as the quality of care will suffer,” Dr Agarwal said, adding, “Right administrator and policy is must for the proper functioning of the healthcare system.”
by Pooja Pandey