TN GOVT DOCTORS PAY ANOMALIES PREPARED BY TNGDA

TAMILNADU GOVERNMENT DOCTORS’ ASSOCIATION

Registered under Societies Act. Recognised by the Govt. of Tamilnadu vide Public Department G.O. Ms No. 1980 dated 7.10.1969

STATE PRESIDENT Dr.S.Kanagasababathy -Thanjavur

STATE SECRETARY Dr K.Senthil -Maduari

STATE TREASURERs Dr K.Jeyakumar -Vellore Dr P.Prakashkarat -Ramanathapuram

State Office: 208, DAS Quarters, Govt. Rajaji Hospital, Madurai

17^th March 2008

To

The Honourable Chief Minister,

Govt. of Tamilnadu, Chennai,

Respected Sir,

Subject: Govt. Doctors in Tamilnadu – Revision of Pay and allowances – demand presented, regarding.

Reference: Our representation to the Honourable Chief Minister dated 27^th Dec 2007.

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The Tamilnadu Government Doctors’ Association demands the following pay and allowances to the government doctors in Tamilnadu. The work of the doctors should be seen as “life-saving service” rather than a routine govt. work. An extra touch of passion and dedication for the work would make a lot of difference. Life is precious and every govt. doctor work with lot of responsibility and stress. Stress in medical field – right from Primary Health Centers to tertiary institutes cannot be compensated with any amount of salary or allowances. The doctor sustaining the enormous stress takes care of the pain and agony of sick patients and their family. Of course seeking solace in relieving the suffering of sick and when saving a life.

But still all doctors are humane and they need the minimum requirement to live their life. The sense of security is essential for involvement and commitment in the job.

In Tamilnadu, most health indicators are at the best and all health programmes are implemented to near perfection to the envy of even developed countries. All this is possible due to the hard work of the govt. doctors. Improved health means improved economy.

Even the Task Force report of the National Rural Health Mission appointed by the Union Health Ministry insists that the pay scale of doctors should be on par with class 1 officers in the state.

Respected Sir, the Tamilnadu Government Doctors Association appeals to you to consider the following demands favourably.

I. DOCTORS IN MEDICAL AND PRIMARY HEALTH CENTRE SIDE *

Scale of Pay:

Name of the post	Existing Scale of pay	Demanded scale	Remarks
Assistant Surgeon	8000-275-13500	9100-275-14050 + existing DA	Health officers in Tamilnadu gets the scale with same qualification
Senior Assistant Surgeon	9100-275-14050	10000-325-15300 + existing DA
Civil surgeon	10000-325-15300	12000-375-16500 + existing DA
Senior civil surgeon	12000-375-16500	14300-400-18300 + existing DA

• * pre pay commission

Allowances:

Name of the allowance	Existing allowance	Demanded allowance	Remarks
PHC allowance	Rs 900 – Rs 1200	25% of basic	To encourage rural service (PHC)
GH allowance	-	25% of basic	To encourage rural service (GH)
Risk Allowance	-	20% of basic + Health insurance for Rs 2 lakhs / year	In view of rampant Pulmonary TB/ HIV, Hepatitis
PG qualification allowance	One/ two increments for PG degree respectively	30% for PG degree and 20 % for PG diploma	After 2 to 3 years of qualification providing specialist service to be encouraged
Special Duty allowance	-	Rs 1000/- per duty + TA	Camps like Varumun kappom/ VIP duty/ Jail duty/ Medical Board etc
Emergency Duty allowance	-	Rs 1000/- per day + TA	CEMONC, Casualty, epidemic duty
Stay Duty Allowance	-	Rs 1000 per stay duty for MBBS Rs 1500 per stay duty for Diploma Rs 2000 per stay duty for master degree	- Many times in case of shortage of doctors; made to do 10 duties a month against 4 duties
Call duty allowance	-	Rs 250 per call	To encourage attendance in out of duty hours calls
Post Mortem Allowance	Rs 75/- per case	Rs 250 per case	Difficult job. Have to attend court.
Court Allowance	TA/DA but no allotment	- local court flat rate of Rs 300/- per visit - other court duty the TA/DA as per rules	Most of the time sent back with a adjournment
Administrative allowance	Rs 0 to Rs 300/-	10% of the basic pay	CMO/ BMO & other cadres
Other compensatory allowance	Rs 150 p.m.	10% of the basic pay	In lieu of restricted private practice.
Overtime allowance	-	Rs 200 per hour beyond 45 hours a week	Inhumanely made to work for 54 hours stay duty and 45 hours call duty
Conference Allowance	-	20 days special CL and TA/DA (for participating in the National Conference. The Union government insists on all doctors to refresh and update knowledge.
Supervisory allowance	Rs 250 p.m. per PHC	Rs 1000/- p.m. per medical officer	For supervising field work in PHCs
Uniform allowance	Rs 275/- p.a.	Rs 2000/- p.a.	For 3 sets of overcoats and foot wear
Washing allowance	-	Rs 250 p.m.	For washing coats
Conveyance allowance	-	Rs 500 p.m.	For faster response during call duty, emergency duty and epidemic duty May help save precious lives
Mobile allowance	-	Rs 500 p.m.	For faster response during call duty, emergency duty and epidemic duty May help save precious lives - Closed user group
Fixed TA	Rs 125 p.m for medical officers in PHCs	Rs 1000/- per month	- No vehicle in most PHCs. But for supervision and outreach work have to travel.
Leave Travel Concession	As applicable as for any other govt. servant	- once in 4 years/ 8 years all India/ Foreign tours to be allowed	For doctors alone
Loans	As applicable as for any other govt. servant	in subsidized interest of 5 -8 % p.a.	- for Children Education (5 to 10 lakhs) - Car (5 to 10 lakhs) - House (10 to 20 lakhs)
Weekly off	1 day	2 weekly off in PHC/ GH side	With heavy duty hours 5 days a week is a must.
House Rent Allowance & other regular allowances	As applicable as for any other govt. servant	As applicable as for any other govt. servant except in rural areas and hilly areas where extra to be given

Promotion structure:

Name of the post	Existing promotion structure	Demanded promotion structure	Remarks
Assistant Surgeon	Entry level	Entry level	Doctors in Kerala Medical Service were given time bound promotion in 3 slabs in 8/ 12/ 15 years
Senior Assistant Surgeon	Usually takes 16 years since entry	In 5 years
Civil surgeon	Takes 19 years since entry	In 10 years
Senior civil surgeon	Takes 22 years since entry	In 15 years

II. DOCTORS IN MEDICAL EDUCATION SIDE*

Scale of pay:

Name of the post	Existing Scale of pay	Demanded scale	Remarks
Tutor/ Senior Resident	8000-275-13500	9100-275-14050 + existing DA	Asst. surgeon scale + diploma allowance as applicable.
Assistant Professor	9100-275-14050	12000-375-16500 + existing DA	Entry level for qualified faculty + teaching allowance + Academic allowance + Rare specialty allowance
Reader	12000	14300-400-18300 + existing DA	1st promotion + same allowances
Professor	12000	16400-450-20000 + existing DA	2nd promotion + same allowances
HOD	-	17400-500-21900 + existing DA	In the cadre of Dean

Allowances:

Name of the allowance	Existing allowance	Demanded allowance	Remarks
Risk Allowance	-	20% of basic + Health insurance for Rs 2 lakhs / year	In view of rampant Pulmonary TB/ HIV, Hepatitis
PG qualification allowance	One/ two increments for PG degree respectively	30% for PG degree and 20 % for PG diploma	After 2 to 3 years of qualification providing specialist service to be encouraged
Special Duty allowance	-	Rs 1000/- per duty + TA	Camps like Varumun kappom/ VIP duty/ Jail duty/ Medical Board etc
Emergency Duty allowance	-	Rs 1000/- per day + TA	CEMONC, Casualty, epidemic duty
Stay Duty Allowance	-	Rs 1000 per stay duty for MBBS Rs 1500 per stay duty for Diploma Rs 2000 per stay duty for master degree	- Many times in case of shortage of doctors; made to do 10 duties a month against 4 duties
Call duty allowance	-	Rs 250 per call	To encourage attendance in out of duty hours calls
Post Mortem Allowance	Rs 75/- per case	Rs 250 per case	Difficult job. Have to attend court.
Court Allowance	TA/DA but no allotment	- local court flat rate of Rs 300/- per visit - other court duty the TA/DA as per rules	Most of the time sent back with a adjournment
Administrative allowance	Rs 0 to Rs 300/-	atleast 10% of the basic pay	HODs/ Dean & others
Other compensatory allowance	Rs 150 p.m.	10% of basic.	-
Overtime allowance	-	Rs 200 per hour beyond 45 hours a week	-
Conference Allowance	-	20 days special CL and TA/DA (for participating in the National Conference. The Union government insists on all doctors to refresh and update knowledge.
Supervisory allowance	-	10% of basic pay	CMO/ BMO/ DD/ JD and others
Uniform allowance	Rs 275/- p.a.	Rs 2000/- p.a.	Over coat/ Foot wear etc
Washing allowance	-	Rs 250 p.m.	For washing coats
Conveyance allowance	-	Rs 500 p.m.	For faster response during call duty, emergency duty and epidemic duty May help save precious lives
Mobile allowance	-	Rs 500 p.m.	For faster response during call duty, emergency duty and epidemic duty May help save precious lives “closed user group”
Fixed TA	Rs 125 p.m for medical officers in PHCs	Rs 1000/- per month	-No vehicle. But for supervision and outreach work have to travel
Leave Travel Concession	As applicable as for any other govt. servant	- once in 4 years/ 8 years all India/ Foreign tours to be allowed	-
Loans	As applicable as for any other govt. servant	in subsidized interest of 5 -8 % p.a.	- for Children Education (5 to 10 lakhs) - Car (5 to 10 lakhs) - House (10 to 20 lakhs)
VRS	Ban on VRS	As applicable as for any other govt. servant	Legally untenable
Teaching Allowance (Patient Allowance)	-	40 % of the basic pay	The teachers in medical colleges in specialist treatment of patients apart from teaching students.
Academic Allowance	-	- 40% of basic pay for those who teach undergraduate. - Additional 20% to those who teach post graduates also.	PG institutes teach both MBBS and diploma/ PG degree
Rare Speciality Allowance	-	The allowance should vary from 75 to 100% of their basic pay depending on the rarity.	To attract essential but rarer faculty as in Community Medicine, Forensic Medicine, Biochemistry, Anatomy and Radiology this allowance to be given to them.
House Rent Allowance & other regular allowances	As applicable as for any other govt. servant	As applicable as for any other govt. servant except in rural areas and hilly areas where extra to be given

Voluntary Retirement from Service:

This is a fundamental right of every govt. servant who has put in 20 years of service or attained 50 years of age. But the doctors in Tamilnadu Medical Service both in education and non-education side are refused of this option because of shortage of faculty. This ban should be withdrawn and those willing can be re-employed on post-retirement posts with attractive salaries and perks.

Promotion structure:

Name of the post	Existing promotion structure	Demanded promotion structure	Remarks
Tutor/ Senior Resident	Entry level	As in DMRHS side	Tutors who will be an Assistant/ Senior Assistant/ Civil surgeon cadre in general cadre.
Assistant Professor	1 year after entry	Entry level	As recommended by the Medical Council of India time bound promotion in 2 slabs in 5 & 9 years.
Reader	Takes 5 to 20 years since assistant professor in different specialties.	in 5 years after entry – time bound irrespective of vacancy
Professor	Takes 4 years since reader ship	in 4 years after entry – time bound irrespective of vacancy
Head of Department	-	Vacancy based	In the cadre of Director

(State Secretary)

ANNEXURE

ALLOWANCES:

Teaching Allowance: (Patient Allowance)

The teachers in medical colleges are unique in that that they do additional job unlike teachers in engineering or arts colleges. The teachers are involved in specialist treatment of patients apart from teaching students. These teachers are given just Rs 100 p.m. extra as teaching allowance. As this allowance for teachers are in fact a compensation for their specialist curative job in medical college hospitals, all the faculty in medical colleges should be eligible, except Department of Anatomy and Physiology. The allowance should be 40 % of the basic pay.

Academic Allowance:

This allowance should be given to all teachers in medical college. This allowance should depend on the rarity of the speciality. The allowance should be 40% of basic pay for those who teach undergraduates. Additional 20% should be given to those who teach post -graduates also.

Rare Speciality Allowance:

The faculty in some departments are very rarer then others. These rare specialists tend to opt for private medical colleges because of very high offer. So as to attract these essential faculty teachers – as in Community Medicine, Forensic Medicine, Biochemistry and Anatomy, this allowance to be given to them. The allowance should vary from 75 to 100% of their basic pay depending on the rarity.

Overcoat Allowance: (uniform allowance)

At present the doctors were given an overcoat allowance. This to be changed as uniform allowance and enhanced from Rs 275/- to Rs 2000/- p.a. This should include 3 sets of overcoats/ theater coats and 1 set of appropriate foot wear.

Post Mortem Allowance:

The doctors were given post mortem allowance of Rs 75/- per case. The postmortem is an important legal procedure and has lot of protocols. This allowance is to be enhanced from Rs 75/- to Rs 250 /- per post mortem.

Court Allowance:

The doctors have to attend court as an expert witness regarding the treatment of medico-legal cases or in postmortem cases. The court duty is either to a local court (within district) or outside court. The TA/DA for local court (all courts within the district) visit can be given as flat rate of Rs 300/- per visit and for other court duty the TA/DA as per rules can be claimed.

Administrative allowance:

The administrative allowance of at least 10% of the basic pay should be given to all medical officers doing administrative work. It should be given to all medical officers who do administrative duty apart from clinical duty and may range from a Block Medical officer in PHCs to Directors.

Other compensatory allowance: (Hospital Allowance)

This allowance is being given to the doctors in lieu of restricted private practice. Presently Rs 150 p.m. is being given to doctors in GHs and Medical Colleges. This should be raised to 20% of basic.

Risk allowances:

This allowance is a mandatory allowance for doctors in the present context of the risk of infection of Tuberculosis, HIV and Hepatitis. The doctors with the poor protective gears and other infrastructure in the hospitals coupled with poor hygienic and sanitary practices of our patients are a “high risk” group for contracting infection. An allowance to compensate this risk is at most essential and this risk allowance should be 10% of basic pay. (Vertinary doctors are getting a risk allowance for rabies)

Overtime allowance:

Doctors especially in DMS and DPH side on an average work for 52 to 70 hours every week against the stipulated working hours of 45 hours weekly. So these doctors who do duty in excess of 45 hours weekly should be given an overtime allowance of Rs 200/- per hour of overtime as allowance. Doctors also have to do out of hours duty during emergencies and epidemics.

Conveyance allowance:

As medical officers attend emergency duty at odd hours it is a must that all of them have their own conveyance. This allowance is given to them to maintain their conveyance to be used for calls and urgent works. A consolidated amount of Rs 1500/-pm to be given as conveyance allowance.

Mobile allowance:

Better communication is very essential in medical service. Even inside the hospital, contacting a specialist through mobile phone may save crucial minutes in saving lives. With most mobile service providers providing “closed user group” facility, wherein the call between the groups is free, this will help better utilization of doctors’ service. A monthly mobile allowance of Rs250/- pm should be given.

Uniform allowance:

Presently the doctors were given an overcoat allowance of Rs 250/- per annum. With increased risk of deadly infections it is essential doctors wear overcoats, theater dresses, protective foot wear, goggles etc. So an annual uniform allowance of Rs 200/- per annum should be given.

Washing allowance:

The doctors work in atmosphere where the cleanliness is very important both to avoid infections and to sport a neat appearance among the sick patient. So a washing allowance of Rs 200 per month should be given to maintain the uniform for the doctors.

Stay Duty Allowance:

In hospital setup the most important work of doctor/ specialist in order to encourage doctors doing stay duty for 24 hours a sum of Rs 1500 per each stay duty. 40 & 25% extra for PG degree and diploma doctors doing respectively.

Call duty allowance:

In hospitals, specialists and other doctors are called to attend cases; give opinion, do surgeries, procedures during out of duty hours. To encourage these services a call duty allowance of Rs 250/- per calls should be given to the doctors.

House Rent Allowance:

As applicable to other sectors + PHC/ GH allowance.

Conference Allowance:

Medical Council of India insists on presentation of papers in national/ regional conferences and insists on exchange of information and knowledge to all medical teachers. A TA/DA for participation of the National Conference of the particular speciality be given. The Union government insists on all doctors refreshing and updating their knowledge by attending Continuing Medical Education (CME) for stipulated hours every 5 years. Hence, the doctor in government service should be allowed to attend recognized CME/ conferences for at least 24 hours every year.

PG qualification allowance:

Doctors basically finish 5 ½ years of academic course (MBBS) and join service. The entry level for all class one officers is graduation ie 3 years after schooling. Like wise the basic qualification for Assistant Surgeons is graduation that is MBBS. But many doctors do specialty service with additional qualification - postgraduate diploma or degree in all the cadres. These PG diploma/ degree holders hold all cadres from assistant surgeon to senior civil surgeon. Presently two additional increments were given to those completed PG Master degree. One increment was given to those who has PG diploma. But the nature of work vary enormously with regard to the specialist with PG needing a better renumeration. Such doctors are very much wanted in CEMONC centers, BEMONC, trauma centers. Even after repeated recruitment drive these specialist posts are yet to be filled. In order to attract them and as a reason for utilizing their special qualification it is mandatory that such extra renumeration are given. The association demands 40% of basic pay for Master degree and 25% for Diploma as post graduate allowance.

Emergency Duty allowance:

Doctors apart from doing their routine work like attending to emergencies, disposing OP cases, treating ward patients, doing surgeries and also teaching students (in medical colleges) were made to do emergency duties like CEMONC, Casualty, Epidemic duty which involves lot of stress and needs commitment and dedication. To encourage taking part in such duties this allowance should be given.

Special Duty allowance:

Doctors apart from doing their routine work like attending to emergencies, disposing OP cases, treating ward patients, doing surgeries and also teaching students (in medical colleges) were deputed to do many other additional duties like VIP convoy/ Medical Board/ Jail visit/ Physical check-up for students, staff; Camps-VKT, disability/ calamity duty etc. Most of these duties do not have any restricted timings. The association demands additional allowances to all these activities.

PHC Allowance:

This allowance is given in lieu of special pay to encourage doctors to work in Primary Health Centers. At present the doctors were given a PHC allowance in two slabs; those PHCs were there is doctor’s quarters and those without quarters – Rs 900/- and Rs 1200/- respectively. This allowance should be raised to 20% of the basic to all those doctors working in PHCs.

Supervisory Allowance:

The medical officers in PHC in addition to curative work – ie out patients, wards, surgeries, emergencies, deliveries have to do the primary prevention work. Though PHCs are meant primarily for preventive work, in Tamilnadu almost all PHCs function like a hospital unlike in other parts of the country.

But immunization, prevention of epidemics, implementation of national health programmes still has its importance with rising incidence of deadly diseases like tuberculosis, HIV, malaria etc. For this primary prevention the medical officers should effectively supervise the field staff. At present the supervisory allowance given is very meager with lot of procedural difficulties. This allowance should be raised to Rs 1000/- per month per medical officer in each PHC.

Fixed TA:

In PHCs for doing the preventive work like immunization, prevention of epidemics, implementation of national health programmes a medical officer has to visit the field on a regular basis. At present a paltry sum of Rs 125/- is given. With no vehicle for transport, most of the times the doctors use their own transport. For this the medical officers Fixed Traveling Allowance should be enhanced from Rs 125 to Rs 1000/- and should be sanctioned by the drawing officer.

Leave Travel Concession:

All the govt. officers are availing LTC all these years. The association demands that for doctors once in 4 years/ 8 years all India/ Foreign tours to be allowed

Loans:

As a special case a corpus fund may be allotted for the benefit of doctors. Loans in subsidized interest of 5 -8 % p.a. may be given for doctors for the following cases.

1. Children Education (5 to 10 lakhs)

2. Car (5 to 10 lakhs)

3. House (10 to 20 lakhs)

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