The Tamil Nadu Government Doctors' Association has issued a stark warning about the severe understaffing crisis in government hospitals across the state, where nearly 30% of doctor positions remain vacant. With around 5,000 of the 18,000 sanctioned doctor posts unfilled as of October, the association is urging swift action to prevent a healthcare crisis. Association President Dr. K. Senthil shared concerns with The Times of India, noting that the situation is set to worsen as close to 1,000 doctors are expected to leave their posts between December and February to pursue postgraduate education.

The issue of inadequate staffing in Tamil Nadu’s government hospitals has been long-standing, but recent changes, including the addition of new hospital beds and expanded services, have intensified the strain on medical staff. “The original number of sanctioned positions was already below the actual need,” explained Dr. Senthil. “Now, with added responsibilities and unchanged staffing levels, the pressure on existing doctors is becoming unsustainable.”

Dr. Senthil emphasized that the current vacancy rate is leading to overwhelming workloads, contributing to physician fatigue and raising concerns about delays in emergency treatments, potential complications, and even avoidable deaths. “Non-service PGs have also started leaving as their bond period is over. It will take at least until March 2025 for a new batch of medical students to fill the gap,” he added.

In an appeal to the government, the association has submitted a letter to Health Secretary Supriya Sahu, urging expedited action in both promotions and new hires to prevent a crisis. Among the vacant posts, there is a severe shortage in primary healthcare facilities, with 2,500 doctor vacancies (representing 40% of positions) in primary health centers. The association reported that secondary care hospitals have 1,000 vacant positions (33%), and maternity hospitals and medical colleges each have 2,500 vacant posts needing urgent attention.

While doctor shortages are prevalent across many specialties, the most significant shortfall is among obstetricians and gynecologists. Under the guidelines of the Union Health Ministry’s LaQshya program, which aims to enhance quality in labor rooms, Tamil Nadu government hospitals require 2,000 obstetricians. Currently, only 850 are available. “Nearly 60% of the state’s 950,000 annual deliveries occur in government hospitals, and gynecologists are among the most overworked,” said Dr. A. Srinivasan, the association’s state general secretary.

Highlighting the issue further, Dr. Srinivasan noted specific instances where shortages are impacting services. In Sivagangai district, for example, only two gynecologists serve three CEmONC (Comprehensive Emergency Obstetric and Newborn Care) hospitals, which require a minimum of 17 doctors. Similarly, Trichy’s five CEmONC centers only have nine obstetricians against a required 30. In Manaparai headquarters hospital, there are no gynecologists, while at least seven are needed to meet demand. Many Primary Health Centers (PHCs) operate with just one doctor, despite needing a team of five. “Without sufficient doctors to screen pregnant women, how can we aim to reduce the maternal mortality rate to 10?” Dr. Srinivasan questioned.

Tertiary care facilities, such as medical colleges, also face a significant staffing shortfall, with vacancies for 500 professors, 1,000 associate professors, and 1,000 assistant professors across Tamil Nadu. Promotions for associate professors have been stalled for over 20 months, Dr. Srinivasan noted, stressing the need for urgent action in both promotions and recruitment.

Responding to these concerns, Health Minister Ma Subramanian told reporters that recruitment is an ongoing process. He mentioned that while legal cases complicate some aspects of hiring, the Medical Recruitment Board is actively conducting examinations and processing candidates for various medical and allied health positions.

(Input from various sources)

(Rehash/Yash Kamble/MSM)