Ranchi man suffering from blood cancer gets a new lease of life

Source: avenuemail.in

Ranchi, July 31: Doctors at Fortis Memorial Research Institute, Gurugram successfully treated a 60-year-old patient Lal Mani Mahto of Ranchi who was suffering from Chronic Myelomonocytic Leukemia (CMML) which is a type of Blood Cancer with no definitive medicines available. The patient was presented to Fortis Gurugram with the complaints od fever, low hemoglobin, weight loss and low platelets. The patient underwent successful Bone Marrow Transplant performed by Dr. Rahul Bhargav, Director, Haematology and BMT, Fortis Memorial Research Institute, Gurugram and his team.

Lal Mani Mahto was presented to the hospital with the diagnosis of advanced Blood Cancer. He was given chemotherapy for the advance stage of cancer. Mahto started losing weight drastically. The reason for same was unknown, on consulting a doctor in Ranchi, it was revealed that he was losing blood but the reason for same could not be traced. The patient was given Folic Acid to control the level of blood, but the patient’s condition started deteriorating. He soon had to start the process of Blood Transfusion in every 20 days.  After taking consultation from several doctors in Ranchi, the patient was diagnosed with Blood Cancer. The only permanent solution for same was to get a Bone Marrow Transplant. The patient was presented before Dr. Rahul Bhargava who performed the surgery successfully.

Dr. Rahul Bhargava, Director, Haematology and Bone Marrow Transplant, Fortis Memorial Research Institute, Gurugram said, “Diagnosis of blood cancer is difficult, secondly, once the diagnosis is done there is no clear-cut medicine BMT is the only thing. Ion the process of BMT, RBC, WBC and platelets are Eradicated from the body. The patient is like a new born baby and is susceptible to infections. Stabilising the patient in such a condition is a challenge. Stem Cells from a different body are transferred to the patient’s body and acceptance of same is essentials for a successful transplant. However, when it comes to the donor, there is no risk involved at all. The donor just donates 300 ml of a blood stem cells and there is noting to be scared. The patient was very lucky as ideally the donors match is 30 %, but in this case the sister and Brother matched 100 %. The donor was discharged the very next day of donation. The patient has successfully been discharged from the hospital and is now leading a normal life”

Patient Mr. Arun Kumar said, “When I came to Fortis I had very little hope left in me.  I had to undergo blood transfusion in every 20 days. My family was seeing me getting weak day by day and I could not do anything about it. When Dr. Bharagava gave me hope that after the BMT I could resume my life like before, I thought it was miracle. My younger sisters stem cell matched and saved my life. While I was in ICU, I was very critical and my family was starting to lose faith. It is through persistent treatment I received from Dr. Rahul Bhargava  at Fortis Gurugram that I am healthy today and doing my normal day to day activities with ease.”

Dr.Ritu Garg, Zonal Director, FMRIsaid, “This was one of the most challenging case presented to the hospital as patient was brought with an advanced stage of Blood Cancer which is very rare. There were many complicationsand stabilising patient after the surgery was a big achievement. The patient’s situation could have been life threatening, however these were successfully avoided due to the diligence with which the case was handled. FMRI is equipped to handle such complications with the help of comprehensive team o handle all Blood Disorders and advanced technology. This case shows we are equipped to handle all the challenges from different specialities.”

Ranchi doctors protest ‘quack’ bill

Source: telegraphindia.com

Outdoor patients in the capital suffered on Wednesday as OPD services at private and government hospitals stayed suspended due to the doctors’ nationwide strike against the National Medical Commission Bill 2019 passed in the Lok Sabha on Monday, which doctors claim will legitimise quacks in the country.

The 24-hour national protest, called by the apex body representing the country’s medical fraternity Indian Medical Association, started from 6am on Wednesday with the withdrawal of non-essential services. Emergency, trauma, ICU and related services were outside the ambit of the strike.

In Ranchi, as well as elsewhere in the country, poor patients seeking OPD services at government hospitals faced the brunt of the strike.

At the state’s largest government-run Rajendra Institute of Medical Sciences, nearly 200 poor patients, many from outside Ranchi and districts of Jharkhand, had come on Wednesday. They did not know anything about the strike. On an average, over 500 people come to RIMS OPD every day.

Amar Nath Dubey, 62, who came from Baijnathpur in Deoghar to get his post-surgical check-up, said the strike was a big financial blow. “I met with an accident on February 7 and had a surgery at RIMS the same month. My doctor called me a month ago and again today (Wednesday) to the OPD for post-surgical check-up. I’ve come spending Rs 16,000 on a private vehicle as I am in no position to take buses or trains, but the OPD is closed. It means I have to stay in Ranchi, an added expense,” Dubey said.

Four-year-old TB patient Arvind from Chandankyari in Bokaro, who came for a consult at RIMS with his grandparents, slept outside the OPD, as the elderly couple worried about where to stay the night.

At Sadar Hospital, poor people from across the capital and nearby localities who turned up for free treatment at the OPD, had to leave. “I am suffering from toothache,” said Salia Khatoon, who came from Brambe to Sadar Hospital. “I was asked to come tomorrow (Thursday).” Usha Devi from Hatma, who came for a pregnancy-related test, said the same. Seven-year-old deaf-mute Raja from Dhanbad came with his grandparents to obtain a disability certificate. His grandfather, mason Ramchandra Sah rued he did not know about Wednesday’s strike.

District civil surgeon Dr Vijay Bihari Singh said outdoor patients at Sadar Hospital needing immediate attention were treated at the emergency ward that was open.

RIMS director Dr D.K. Singh did not reply to calls. President of RIMS Junior Doctors’ Association Dr Ajit Kumar said they were compelled to strike work to “save medical science.” Through the National Medical Commission Bill, the central government is taking a step that will transfer medical science in the hands of those who have not studied medical science. The new system will promote quacks. This will affect the poor the most,” Dr Kumar said. “However, all emergency services were exempt from the strike.”

On its website, the IMA has alleged that “Section 32 of the NMC Bill provides for licensing of 3.5 lakh unqualified non medical persons to practise modern medicine”.

It claimed the new bill vaguely defined the term “community health provider”, thereby allowing persons without medical training to practise and prescribe independently. If the bill comes in force, the quality of healthcare services will fall drastically, the doctors fear, calling the bill “draconian”, “anti-people”, “anti-poor” and “anti-students”.

OPD open

Dhanbad: OPD services largely stayed open at state-run Patliputra Medical College and Hospital on Wednesday. IMA state president, Dr A.K. Singh said they were “totally against the National Medical Commission Bill” but decided to let OPD services function to help the poor.

Bihar: PMCH doctors on strike, health services crippled

Source: business-standard.com

Health services at the Patna Medical College and Hospital (PMCH) here have crippled with juniors doctors on strike since Friday.

According to agitating doctors, they have to strike the work after five students in the Department of Orthopaedic were failed in an examination.

They have also alleged that they were under pressure from the senior of the department to prescribe the medicines of one particular company.

“We are trying to resolve the issue with the junior doctors. Hopefully, the strike will end soon. We have also written to the District Civil Surgeon to send more manpower. We hope the situation is resolved by tomorrow,” said PMCH Superintendent Dr Rajeev Ranjan Prasad.

“Five students were failed as we had requested that patients should be prescribed medicines provided by the government or cheaper medicines,” said Vikas, a junior doctor.

Dr Prasad said: “The hospital administration has formed a three-member committee to look into the matter raised by the agitating doctors.”

Due to strike, patients are suffering like anything. Vijay, who had brought his relative to the PMCH for treatment, said: “My patient has suffered a severe brain injury. We are being asked to go to the AIIMS for treatment.”

PMCH has a daily intake of 3000 patients and on an average 70 surgeries are performed in the hospital every day.

Doctors’ strike 2.0: Jharkhand doctors threaten to strike, demand protection laws

Source: indiatoday.in

Earlier this month, Bengal witnessed a deadlock between the medical fraternity and the state government over violence against doctors. What started as clashes between doctors and a patient’s family, became a nationwide protest which also spread to other parts of the country. The medical fraternity across India expressed absolute solidarity on the demands of their safety.

Now, Jharkhand is headed in the same direction. A delegation of doctors met Health Minister Ramchandra Chandravanshi on Sunday and handed over a charter of demands to him. One of the demands included the introduction of the Medical Protection Act after reports of violence and assault on doctors at Rinchi Trust Hospital where a patient was allegedly brought dead but the family of the deceased accused the medical staff of negligence.

On Friday, a 21-year-old man, Ashutosh Pandey was brought to Rinchi Hospital near Kathal More in Ranchi after he reportedly drowned in Patratu Dam. Doctors claim that Pandey had died of asphyxiation before being brought to the hospital. However, his attendants and about 100 locals vandalised hospital property and allegedly thrashed three doctors, who sustained severe injuries.

Doctors across the State on Sunday worked wearing black badges as a mark of protest against the attack on doctors at Rinchi Hospital on Friday.

The Indian Medical Association (IMA) Jharkhand chapter has threatened to protest if the state government does not act on their demands for doctors’ safety.

A special meeting of the IMA, Junior Doctors’ Association (JDA), Jharkhand State Health Services Association (JSHSA), the hospital board, and the women wing of the IMA was held on Sunday at 4:45 pm at IMA Ranchi.

The motive of the meeting was to plan a future course of action regarding the Clinical Establishments (Registration and Regulation) Act, Pre-Natal Diagnostic Techniques Act (PNDT) (Dr Seema’s case in Koderma) and the agitation regarding Medical Protection Act (MPA). Around 143 doctors were present at the meeting.

Decision summary of meeting:

1)To stop wearing the black Ribbon from now onwards as police administration did a commendable job by arresting the main culprit within 24 hours on order of chief secretary of Jharkhand, much before our ultimatum of 48 hours. “We are thankful to the police administration,” the doctors said.

2) A high level delegation will meet the chief Secretary of state and submit a memorandum by 6 pm on June 24 at Project building.

The doctors listed out their demands for the state government:

A) We are hurt by the brutal attack on doctors in Rinchi hospital, when the patient attendant came for treatment of a dead body (already declared dead at CHC Patratu) and damaged the hospital. We request that the remaining assaulters be arrested at the earliest. We also request that the case of Rinchi be dealt with speedy trial in a fast track court.

B) Free treatment of griviously injured medical superintendent of Rinchi hospital.

As the superintendent will not be able to work for the rest of his life, so monetary compensation be given to him. The damage to the hospital should be compensated either by the assaulters or the government itself.

C) To prevent any future attacks on doctors and provide a safe environment for doctors to work, the Medical Protection Act should be made applicable in Jharkhand so that we can give our 100 per cent to the society.

D)In Koderma, false allegations has been levelled against Dr Seema Modi with regard to PNDT as the pregnancy was of eight months and the PNDT Act is applicable only to 3-5 months pregnancy. She has been arrested in an unlawful manner. A fact finding commitee report should be sent to court so that Dr Seema Modi of Dhanbad gets justice.

E) The Clinical Establishment Act should be implemented in practical ways. For example, a skin specialist cannot handle an emergency like a gunshot injury or a patient of heart attack.

F) Clinical Establishment Act should be applicable only to hospitals having more than 5O beds.

G) Single window certification for all clinical establishments.

J) Setting up of a police official cell number and a Nodal officer in each hospital

I) We would follow up the situation every 15 days if there are no further arrests or any action on our demands. We will plan a graded action like a protest march. Strike will be our last resort.

K) Our legal advisor will be affixed.

-IMA state and District officials

The arrest of Koderma-based doctor Seema Modi, on charges of sex determination test last month, is also believed to have irked the doctors’ fraternity. They are backing up the incarcerated lady gynaecologist and claim that she is not guilty.

Violence, altercation, and brawls between the attendants and the patients’ kin puts other patients at risk and affects the morale of the medicos, says Dr Pradip the secretary general of IMA Jharkhand chapter.

The Cabinet had approved the Medical Protection Act in Jharkhand in 2017. Later, a select committee too gave a report on it. But it is yet to be passed by the assembly.

The Act mandates imprisonment of up to three years and a fine of Rs 50,000 for attacks on doctors, nurses and hospital establishments.

Earlier, when the bill was tabled in the House, it was referred to a select committee. Further, when it was initiated again, the government itself withdrew it.

However, the meeting between the health minister and the delegation of doctors seems to have been successful this time. While it is not clear when the government will table the Medical Protection Bill or when the session will be convened, the chief secretary has directed DGP KN Chaubey to ensure the safety of the medical practitioners.

An order has also been issued to the SPs of all the 24 districts to be more vigilant and keep an eye on the security and protection of the doctors.

The intervention of the government has been seen as a major step to pre-empt a Bengal-like situation in Jharkhand. At the same time, the decision and the move of the government will raise the morale of medicos. The order to make doctors safety a priority is also set to mollify the agitating doctors for the Medical Protection Act already exists in 17 states.

Doctors on strike in Jharkhand, OPDs across the state to remain shut on Monday

Source: hindustantimes.com

The out-patient department (OPD) services at government hospitals across Jharkhand are off on Monday after doctors decided to skip duty following Indian Medical Association (IMA) call to boycott health service in protest against the assault on doctors in West Bengal.

IMA-Jamshedpur general secretary Dr Mrittunjay Singh on Saturday appealed to the doctors of government and private hospitals to boycott work from Monday 6am to Tuesday 6am in solidarity with the assault on junior doctors at Neel Ratan Sarakar Medical College Hospital (NRS) in Kolkata on June 10 after the death of an 85-year-old patient during treatment there.

However, emergency services in all the hospitals and nursing homes will be operation. “Emergency service will be operational but OPDs will be closed as our members will be on strike following call by national chapter of IMA across the country. We have also appealed to the doctors in all private hospitals and nursing homes like Tata Main Hospital (TMH) to support the cause of doctors demanding security and healthy working atmosphere in hospitals,” Singh told media.

IMA-Jamshedpur president, Dr Umesh Khan, said all the doctors would congregate at Mahatma Gandhi Memorial Medical College Hospital (MGMMCH) at 10 am tomorrow and march to the deputy commissioner’s (DC) office.

Dr Amal Patro, a member of IMA, said doctors were all set for a decisive fight this time. “If government doesn’t provide us security, we will close down OPDs. We won’t tolerate attacks on us anymore,” said Dr Patro.

Meanwhile, city-based Dr SP Foundation, a doctors body in Jamshedpur, also condemned the attack on doctors in West Bengal and demanded strong action against the culprits. The foundation director, Dr TK Chatterjee, said murderous attacks on doctors were an alarm bell for the society. “We ask union health minister Dr Harsh Vardhan to ensure adequate security for doctors on duty and healthy workplace atmosphere,” demanded Dr Chatterjee.

Jamshedpur has several leading hospitals like Tata Motors Hospital, Tinplate Hospital, Mercy Hospital, Bramhanada Hrudalayala Hospital, Medica Hospital and a host of private hospitals and nursing homes.

Junior doctors in Jharkhand protest against Bengal impasse, OPD boycott hits patients

Source: hindustantimes.com

Patients in Ranchi, Jamshedpur and Dhanbad had a harrowing time on Friday after junior doctors in the three government-run medical colleges and hospitals boycotted OPD services in a show of solidarity with the protesting doctors in West Bengal. Junior doctors across West Bengal are on strike since June 10, protesting against an alleged assault on a medical intern by relatives of an 87-year-old patient who died in Kolkata’s NRS hospital premises.

Junior doctors boycotted OPD duties at Rajendra Institute of Medical Science (RIMS), Mahatma Gandhi Memorial Medical College Hospital (MGMMCH) and Patliputra Medical College Hospital (PMCH) and demanded that West Bengal chief minister Mamata Banerjee take action against the culprits immediately. However, senior doctors across the state attended to patients, wearing black badges.

The massive impact of junior doctors’ boycotting their duties was felt at RIMS Ranchi where long queues of patients were seen at all OPDs. Patients particularly had a difficult time at medicine, surgery, skin, eye and orthopaedic OPDs. Some of the patients were seen returning from OPDs due to the seemingly unending queues.

Govind Mahato, a patient from Powarganj in Lohardaga town, about 70 kms from Ranchi, visited RIMS but returned due to the commotion in the hospital. “I had no information about the sudden strike of doctors. I came here for the medical examination of my ailing grandson but had to return without treatment,” said Mahato.

Malti Murmu (45), a resident of Namkum in Ranchi, failed to consult a doctor despite waiting till noon at the gynaecology OPD. “The hospital should not have registered my name in the morning if the doctors were on strike. After being registered, I thought the doctor would check patients in the OPD, but they wasted my time and money,” she said.

Before beginning their boycott, junior doctors at RIMS staged a street play on the role of doctors in providing health services in the campus and sought cooperation from all teachers for their OPD boycott. Junior doctors also wore helmets and staged a sit-in protest in front of RIMS director Dr DK Singh’s chamber.

“We strongly condemn the attitude of Bengal chief minister Mamata Banerjee. We would be compelled to intensify our agitation if all the culprits are not arrested soon,” said Dr Ajit Prasad, JDA president.

Junior doctors at the Ranchi Institute of Neuro-Psychiatry and Allied Science (RINPAS) in Kanke also boycotted OPD services in solidarity with the JDA.

OPD did not function after 10.30 am at PMCH Dhanbad due to the boycott call by junior doctors. At MGMMCH, OPD did not function after 11 am. IMA Jamshedpur secretary Dr Mritunjay Kumar Singh said many doctors in private nursing homes also skipped their OPD duties in solidarity with protesting junior doctors.

Patients at Bokaro General Hospital (BGH) had also returned unattended from OPD as junior doctors boycotted services.

In the evening, the Jharkhand chapter of Indian Medical Association (IMA), Jharkhand Health Service Association (JHSA) and JDA took out a protest march from RIMS.

“It is unfortunate that doctors who serve patients day and night were thrashed and the government did not act properly against culprits”, said Dr Pradeep Kumar Singh, IMA secretary.

In Bihar, doctors treat patients on floor as hospital tries to cope with rush

Source:hindustantimes.com

So chock-a-block are the wards at Muzaffarpur’s Sri Krishna Medical College Hospital with patients suffering from Acute Encephalitis Syndrome (AES) that doctors are being forced to treat children on the floor.

At least 43 of the 50 deaths due to AES in Bihar have taken place at this hospital, with Muzaffarpur being the epicentre of the outbreak. Ten other districts have also been affected.

Sri Krishna hospital medical superintendent Sunil Kumar Shahi said, “We have an in-patient bed strength of only 610 whereas the number of patients admitted to our hospital is around 876. We do not refuse any patient, so we put mattresses to treat them on the floor.”

To cope with the rush of patients, the superintendent has converted all 20 beds of the intensive care unit (ICU) into paediatric intensive care units (PICU).

“If we come across patients, who need to be admitted to ICU, we will admit them in the coronary care unit (CCU). Against 14 existing beds at our PICU, I have converted all our 20 ICU beds into PICU, taking the number of beds in PICU up to 34,” Shahi said.

“Given the disease burden, even the central team which is here has suggested increasing the number of PICU beds to 100,” he added.

The government has ensured the availability of all drugs free of cost to AES patients. Sri Krishna hospital is also providing food to patients as well as their attendants. “Though we are not supposed to provide food to patients in PICU, on the advice of health minister Mangal Pandey and principal secretary, health, Sanjay Kumar, I am supplying milk, supplements, fruit, bread and eggs to all AES patients and their attendants on humanitarian grounds,” said Shahi.

The parents of some children being treated at the hospital are satisfied with the facilities provided. Some of them, including Md Aslam Madan Sahni, Ram Bharos Thakur and Gayatri Devi, are hoping the hospital will start supplying diapers free of cost too.

Blood banks across Jharkhand struggle with severe shortage

Source: hindustantimes.com

An unprecedented crisis in blood banks of medical colleges and hospitals across Jharkhand has put patients in a spot and the lives of many are on line as doctors are not able to carry on with treatment due to lack of blood. In the last 72 hours, two patients have died at the Patliputra Medical College Hospital (PMCH) in Dhanbad and surgeries of over a dozen critical cases in different wards are on hold due to the blood crisis.

The crisis in blood banks has been attributed to several factors by authorities of hospitals such as PMCH, RIMS and MGMMCH. Many have cited the long duration of the recently concluded Lok Sabha elections, which meddled with the regular stocking up of blood at the blood banks.

PMCH authorities on Thursday held an emergency meeting and sent an SOS alert to donor clubs across the district for bailing out the institution immediately, as several critical patients continued to suffer.

On Thursday, relatives of three bullet-injury patients, Manoj, Nageswar and Sanjay, had to look for blood donors from their homes district of Giridih, so that the trio could be operated upon at PMCH. All three were admitted to PMCH in a critical condition on Wednesday night. Since the PMCH blood bank was nearly empty, doctors had to call for donors from Giridih.

Earlier on Tuesday, two gynaecology department patients Jyoti Kumari (20) and Shahjadi Khatoon ( 35) died allegedly due to lack of blood. However Dr AK Singh, an official at the PMCH blood bank said that both were severely complicated cases by the time they arrived from nursing homes. Under Janani Shishu Siraksha Yojana, both patients were entitled to get free blood from hospital. “The hospital had provided blood to them in time,” Dr AK Singh said.

PMCH Dhanbad requires 50 units of blood per day to cater to the requirement of patients. But on Thursday, the hospital’s blood bank was left with merely seven units of blood. “Of course there is an unprecedented crisis of blood as incoming flow is almost choked. However, we do not let the patients of hospital to suffer by linking them with donors”, said Dr AK Singh of PMCH.

Patients at hospitals Rajendra Institute of Medical Science (RIMS) in Ranchi and Mahatma Gandhi Memorial Medical College Hospital (MGMMCH) in Jamshedpur are suffering from a similar crisis. Dr KK Singh, blood bank in-charge of RIMS Ranchi on Thursday said the crisis had aggravated badly but now the situation has improved. RIMS requires an average of 82 units of blood per day. On Thursday, the blood bank at RIMS had a stock of 200 units.

MGMMCH had 150 units of blood stocked on Thursday. The hospital requires 20 to 25 units of blood per day to cater to the requirement of patients. “We were facing a major crisis of blood for the past few days but now the stock has improved “, said Dr VVK Chaudhary, blood bank in-charge of MGMMCH Jamshedpur.

Ban private practice of Bihar government doctors, give allowance: IGIMS director

Source: dustantimes.com

With the Bihar government considering granting autonomy to some of its health facilities, director of the Indira Gandhi Institute of Medical Sciences (IGIMS) has advocated banning private practice of government doctors while granting autonomy to healthcare institutions for improved patient care.

The IGIMS, which is Bihar’s only autonomous medical institution, built on the pattern of the All India Institute of Medical Sciences (AIIMS), has achieved many milestones during the recent past. Seeing its success, the state government now wants to replicate the IGIMS model at five other healthcare institutions of Bihar.

Among the institutions being considered for grant of autonomy are the multi-specialty Patna Medical College Hospital (PMCH); the Indira Gandhi Institute of Cardiology (IGIC), a superspecialty centre for cardiology; Rajendra Nagar Government Hospital, a superspecialty centre for eyecare; Lok Nayak Jaiprakash Narayan Hospital, a superspecialty centre for orthopaedics; and the New Gardiner Road Hospital, a superspecialty centre for endocrinology and nephrology.

Bihar’s principal secretary, health, Sanjay Kumar, had recently said that the government was actively considering autonomy for five of its premier health facilities on the pattern of IGIMS.

Dr Nihar Ranjan Biswas, who belongs to the AIIMS-New Delhi and is on deputation to the IGIMS as its director, suggested that government doctors be given non-practising allowance (NPA) and should be available round the clock, as was the practice at AIIMS.

Dr Biswas had floated the idea of “full autonomy to medical institutions” in presence of health minister Mangal Pandey, speaker of the Bihar legislative assembly Vijay Kumar Choudhary and principal secretary, health, Sanjay Kumar, during a seminar on kidney transplant organised at the institute on May 26.

Sharing his recipe of success, Dr Biswas said, “Medical institutions should be granted full autonomy in the true sense. With autonomy, appointment of director as also selection of faculty members should be done through all-India competitions.”

Dr Biswas was also averse to the idea of extending free treatment to patients. “The government should subsidise the cost of treatment and diagnostic tests, but not make healthcare facilities available free of cost to patients,” he added.

Doctors were, however, divided on banning private practice in Bihar. While the Bihar Health Services Association (BHSA) supported giving doctors NPA and remuneration at par with the Centre, the Indian Medical Association (IMA), Bihar, opposed it, saying it should be “optional”.

“Government doctors should be given the choice whether they want to avail of NPA or not take it and do private practice. The decision to ban private practice should not be thrust upon all doctors. If doctors who do not opt for NPA were to resign, many government medical colleges will risk being derecognised by the Medical Council of India (MCI) due to faculty shortage,” said Dr Sahjanand Prasad Singh, immediate past president of IMA-Bihar.

Asked if that meant that doctors wanted to have the best of both worlds, Dr Singh said, “In a way, yes… but it will also benefit the state. Giving NPA and remuneration to all state government doctors at par with the Centre will be a huge burden on the state’s exchequer.”

BHSA general secretary Dr Ranjit Kumar said, “We have already given an undertaking to the government in 2007 that we want NPA. Private practice remains banned on paper after the government withdrew NPA from March 2001. However, a majority of government doctors continue to do private practice.”

Senior doctors of the two associations, on condition of anonymity, said that many doctors of AIIMS-Patna and IGIMS, all getting NPA, were continuing with their private practice due to poor implementation of rules.

The Bihar government had banned private practice and paid NPA to its doctors for a limited period of 11 months between March 1, 2000 and February 2001 before withdrawing NPA.