ANDHRA PRADESH

Doctors’ Strike Forces Govt To Relent

                                                                            M Venugopala Rao

THE 43-day unprecedented strike of about 11,000 junior doctors and medical students in Andhra Pradesh, with all-round support coming from the opposition parties, mass organisations and different sections of the people, and finally the intervention of the High Court, forced the adamant Chandrababu Naidu government to agree to the appointment of a five-member expert committee to examine the issues raised by the junior doctors and withdraw orders of suspension issued against some of them. Their demands include, among other things, putting an end to collection of user charges from patients in government hospitals and an end to the moves to privatise government hospitals and medical education in a phased manner.

To a suggestion of a division bench of the High Court consisting of Chief Justice Devinder Gupta and Justice G Rohini, both the junior doctors and the government agreed to the appointment of a committee of experts to examine the issues raised by the junior doctors striking under the banner of the joint action committee (JAC), and both sides suggested names of experts to be included in the committee. Following the stand of the junior doctors to call off their strike, the bench said that the names of the members of the committee would be announced on January 27. The order of the bench was given on January 23, following hearing a writ petition filed by an advocate, seeking a declaration that the strike by junior doctors was unconstitutional. Though the strike was called off, the Andhra Pradesh Junior Doctors’ Association announced that the junior doctors and medical students would continue to educate the people about the anti-people policies of the government. In this direction they started padayatras from Hyderabad and Kurnool from January 24. JPC chairman Dr Sridhar Reddy announced that padayatras would be started from other districts also and that after campaigning for 20 days, all the padayatras would culminate in Tirupati where a public meeting would be held.

The GO No 90 empowers the government hospitals, among others things, to collect user charges from patients and proposes to hand over the hospitals to hospital development societies under the chairmanship of a member of the legislative assembly. The junior doctors are demanding scrapping of this GO. The assurance of the government that no user charges would be collected from patients having white ration cards (below the poverty line) is being violated in practice. Moreover, one of the anti-people conditionalities imposed by the World Bank is to limit white cards to 35 per cent of the population of the state. Regarding medical education, the government announced three per cent of seats in government medical colleges, as also 25 per cent of seats in post graduation courses, as payment seats. Due to lack of adequate basic facilities in government medical colleges, the number of seats were reduced by 270 by the Medical Council of India (MCI). Another issue raised by the junior doctors was the indiscriminate permissions given to start private medical colleges in the state. During the last four years, 17 medical and 11 dental colleges were permitted. The junior doctors say that their experience during the last three years shows that medicare is not within the reach of the poor patients, with the collection of user charges in the government hospitals. As a result of the implementation of GO No 90, which asks the hospital development societies to raise required funds for running the hospitals, if necessary by taking loans from the Banks and individuals and mortgaging the assets of the hospitals for raising loans, without government guarantees, service orientation will give way to commercialisation.  Therefore, they are demanding scrapping of the GO. While agreeing that the GO is defective, the government says it is willing to amend the GO but not to cancel it. Criticising the government policy of payment seats as selling medical education as a commodity in the market, the junior doctors are demanding abolition of the system of payment seats. The government argues that the non-resident Indians are investing hundreds of crores of rupees in the state and therefore there is nothing wrong in allotting payment seats to the NRI students. 

When compared to government medical colleges, facilities, teaching staff and teaching standards are poor in private medical colleges, besides the fees in the latter being exorbitant. With money being the sole criterion for allocation of payment seats, even without any common entrance examination, in private medical colleges, merit and standards of education are the casualties. Moreover, the government itself is spending money for the students who are allotted seats under reservation in the private medical colleges. Therefore, the junior doctors demand that the government itself should set up medical colleges whenever necessary; no private medical colleges should be permitted and no more essentiality certificates be given to them. Recently, MCI teams inspected some of the private medical colleges in the state and found that the managements had put up a show, masquerading some of the doctors in government hospitals as well as some workers and others as their own doctors and the people hired by them as patients in their hospitals! The government says it has no intention to start new medical colleges and its policy to permit private medical colleges will continue. On the demand of the junior doctors to restore the 270 seats cancelled by the MCI by creating necessary facilities and to increase the PG seats in a similar way, the government’s response is evasive. Also, on the demand of the junior doctors to abolish the system of appointing doctors on contract basis, the response of the government is negative. Moreover, the government is arguing that the junior doctors have no right to question its policies by raising their demands on issues like user charges, payment seats and permitting private medical colleges. The BJP, too, has echoed the arguments of the government. The JAC leaders have made it clear that these are public issues and that they have every right to question the policies of the government. As a result of the adamant attitude of the government, three rounds of talks it had with the JAC leaders on the demands during the strike period failed.

The strike of the junior doctors and medical students went on for 43 days, exposing the anti-people policies of the government and its adamant attitude and foiling all its attempts to divide them and weaken their strike. Braving repressive measures of the government like lathicharges, arrests, ordering vacation of hostels and issuing orders for suspension of some of them, the striking junior doctors adopted several forms of protests --- indefinite hunger strikes, rallies, dharnas, picketings, rasta roko, gherao, burning of effigies, etc., in different districts. The Left parties, including the CPI(M) and the CPI, the Congress, TRS and MIM extended their support to the demands of the striking junior doctors. They expressed their solidarity with the striking junior doctors by taking out rallies, holding dharnas and conventions. When GO 90 was issued last year, it was the CPI(M) which took up the issue and focussed on the anti-people stance of the government. State secretary of the CPI(M), B V Raghavulu, wrote letters to the chief minister and the minister for medical and health, protesting against the anti-people GO and demanding its withdrawal. The CPI(M) independently, and along with other Left parties and mass organisations, organised conventions,  round-table meetings and agitations in different parts of the state, protesting against the anti-people move of the government. Its state organ, Prajasakti, brought out a special supplement on the agitation of the junior doctors, besides giving extensive coverage to their struggle. The Prajasakti Book House also published a booklet on the demands and struggle of the junior doctors. On the call given by nine Left parties, the effigy of the chief minister was burnt at the office of AP Vaidya Vidhana Parishad at Koti on January 22. The Left parties warned the government that they would resort to direct agitational action all over the state if the problems of the junior doctors were not solved immediately. Besides Raghavulu, T Lakshminarayana (CPI), Murahari (SUCI) and G Vijaya Kumar (CPI-ML) addressed the gathering. Similar programmes were conducted by the Left parties in East Godavari, West Godavari, Visakhapatnam, Krishsna, Guntur, Warangal and Kurnool districts.   

The strike of junior doctors has brought up the issue of user charges, which so far only the Left parties have been talking about, as a statewide agenda, which is likely to become a debatable point in the coming elections in the state. However, the Chandrababu government is reluctant to settle the issue, because it had committed itself in the past to the World Bank to introduce user charges and reiterated that stand while negotiating the pending structural adjustment loan. It shows how the government has mortgaged larger public interest to the World Bank. This unprecedented strike of junior doctors is a sign of the accumulated dissatisfaction among the people and indicative of the changing mood of a section of the people who have hitherto been supportive of the World Bank-inspired reform process. This strike has once again brought to the fore the necessity of fighting for a larger cause by combining sectional interests with those of the society at large to be successful. The fight against privatisation, so far confined to the workers and employees, is now extending to the students and intellectuals also. The strike also has underlined the need for different streams of isolated struggles converging into a mighty stream for solving problems and the time is opportune for that.

Another lesson to be drawn from the strike is that the government can no more go ahead with its anti-people agenda and that the people will not tolerate imposition of unjust burdens all in the name of development.

Contrary to the earlier strikes of workers and employees of the erstwhile APSEB, APSRTC and Singareni Collieries Company Limited when some of the unions dropped out in the middle of the struggle, the continued unity and resolve of the junior doctors and medical students all through the struggle is a source of reassuring strength. Above all, outside support from different sections of people is the main reason for successful conduct of this long drawn strike of the junior doctors.