The government’s employee adjustment process, which was started with a view to adjusting civil servants in the new federal set-up to ensure effective service delivery, does not seem to have worked in the health sector.

Since doctors working at government health facilities too have been put in the same basket as other civil servants, services at different hospitals are likely to be affected, while specialist doctors may not be able to use their expertise in some health facilities where they have been adjusted.

Dr Badri Rijal is an orthopaedist and trauma surgeon at the National Trauma Centre. A few days ago he learned that he has been transferred to Dadeldhura Hospital.
Rijal’s concern is he won’t be able to use his expertise in Dadeldhura as the hospital there does not have trauma care facilities.

A major operation theater, back-up of intensive care, an anesthetic doctor, a team of a trained team for surgery and advanced equipment are needed to conduct major trauma surgeries including spinal surgery, said Rijal, who has been involved in academic activities of the National Academy of Medical Sciences. “But Dadeldhura hospital lacks all those.”
On the other hand, Rijal’s absence will also affect academic activities at the National Academy of Medical Sciences.

Like Rijal, dozens of specialist doctors have been transferred to various health facilities in Kathmandu and other districts, where they might not be able to use their expertise.
Experts say transfers in the past were also made without giving much thought about how that could affect services and patients. According to them, the recent employee adjustment process has made matters even worse.

Subaj Bhattarai, a consultant radiologist with the training on interventional radiology from All India Medical Institute of Medical Sciences, has been transferred to Maternity Hospital from Bir Hospital.

The National Academy of Medical Sciences had requested the India Medical Institute of Medical Sciences to provide training to Bhattarai, as Bir Hospital lacked interventional radiologists. At the maternity hospital, Bhattarai has been conducting ultrasound of pregnant women.

“Other technicians can conduct ultrasound for which you don’t need an interventional radiologist,” Bhattarai told the Post.

With Bhattarai’s transfer, Bir Hospital has not been able to provide services to the patients who are forced to go to private facilities and pay exorbitant fees.

“I had requested Health Ministry officials and the Bir Hospital administration to let me continue at Bir, but to no avail,” said Bhattarai.

Interventional radiology is a medical specialisation to perform a range of imaging procedures to obtain the images patient’s organs and other internal parts. A trained interventional radiologist can interpret the images to diagnose injury and disease and perform interventional medical procedures.

“Due to lack of an expert at our hospital, we have not been able to provide services to our patients for the last one and a half years,” Dr Swyam Prakash Pandit, programme director at Bir Hospital, told the Post.

Students pursuing higher medical degrees at NAMS have been deprived of learning due to lack of an interventional radiologist.
Dr Dipendra Pandey, chairman of the Government Doctors Association of Nepal, said that dozens of consultants’ doctors have been transferred to health facilities, where they cannot use their expertise.

“It is a waste of investment by the state on medical doctors,” said Dr Pandey. “Neither patients nor the state benefits by such haphazard transfer of experts.”
He said that consultant doctors would quit the government service if they cannot use their expertise.

Dr Baburam Marasini, a public health expert, said haphazard transfers of health workers, without knowing the repercussions, would hamper health care services further.
“While years of investment on health workers will go down the drain, patients will be forced to bear the brunt,” said Marasini.