Telangana-Andhra bifurcation blues hit doctors, common man suffers

Hyderabad is a hotbed of discontent. Bifurcation blues which have soured relations between Telangana and Andhra Pradesh have now invaded the arena of postings of government doctors. This battle comes in the wake of thousands of Telangana judicial officers wanting their Andhra counterparts to move out of Hyderabad.

“We launched Telangana movement to end the rein of Seemandhra (Rayalaseema region and coastal Andhra region, now the area comprising Andhra state) people exploiting our land, resources (water and minerals) for their gains,” said Balka Suman, Osmania student leader and an MP with the ruling Telangana Rashtra Samiti in Telangana. “They were worse than the British who looted our wealth. It is high time that doctors, engineers, students, advocates and judges who were relegated to second (class) citizens in their own lands, were given back the posts usurped by the people of Seemandhra,” he said.

Doctors in Telangana are now up in arms against the division in cadre for the Directorate of Medical Education based on nativity of doctors from Telangana and Andhra Pradesh. Mostly the tussle is between doctors for postings in government hospitals of Hyderabad which account for nearly 80% of the health infrastructure — be it bed strength, paramedics or doctors’ strength.

Doctors of government hospitals in Telangana have been on the war path since January last. Dharnas and mass absenteeism were used to record their displeasure over many doctors of AP nativity being retained in Telangana as Professors and Assistant Professors in the teaching hospitals of Hyderabad.

On 28 January, government doctors in Telangana blocked all emergency services at Gandhi and Osmania General Hospitals in Hyderabad and Secunderabad. Around 100 doctors from Telangana started their protest by locking the main gate of the outpatient block in Gandhi Hospital, alleging that out of 300 doctors working there, 70% were from Andhra Pradesh. Blaming this on the Director of Medical Education Dr Ramanithey, they gheraoed her in her chambers, forcing her to submit her resignation. “I have no role, everything is listed as per SR (service records),” she pleaded with the angry doctors.

The latest skirmish began in the last week of June following a visit by Union Department of Personnel and Training Secretary Sanjay Kothari to Hyderabad and deliberations with the Kamalnathan Committee set up to resolve all issues of distribution of employees between both states. The Telangana doctors staged protest meetings and also raised the issue before the Committee.

The Telangana Government Doctors’ Association (TGDA) wanted all doctors of AP origin to be given marching orders, instead of the planned 60 doctors. They told the Kamalanathan Committee that another 170 doctors who were retained in the posts of Associate Professors and Assistant Professors in government teaching hospitals — NIMS, Osmania and Gandhi — should also be sent packing. “Whether they are doctors or engineers, the issue of nativity should be strictly followed and non-locals have no reason to hang around Hyderabad,” said Dr Ravinder Reddy, a TNGO (Telangana Non-Gazetted Officers Union) leader. TNGO is a federation of all unions of govt departments in the state.

The TGDA, in an affidavit filed before the Kamalnathan Committee, said that these 170 doctors were occupying key positions of Professors and Assistant Professors which should go to Telangana doctors. The TGDA asked Telangana Health Minister Dr Laxma Reddy to take up the issue with the Union Health Ministry and the Union Home Ministry (DOPT). “Neither are their spouses from the region and nor do they suffer from any medical condition which justifies their stay here,” said Dr Nara Hari, a senior TGDA member. Commenting on the doctors’ agitation, Laxma Reddy said, “’Nillu, Nidhulu Niyamakalu’ (water, resources and appointments) are the focus issues of Telangana agitation. We will not allow Andhras to continue in any position in Telangana, be it hospitals, courts, colleges or even government departments.”

Meanwhile doctors have been going away to greener pastures — the Gulf and African countries — for short tenure appointments as consultants, without informing their hospital managements. Officials, last June, reported to the Centre, that 89 doctors in Andhra Pradesh and 54 doctors in Telangana had been absent for the past two years. Unofficial statistics from Doctors’ Association sources show that absentee doctors number at least 1200 for both states together. “Many doctors particularly dentists and child specialists, who have political support, have gone for better paying jobs on short tenures abroad earning four to five times higher salaries and perks than what the government gives,” said a senior lady doctor at Gandhi Hospital.

Andhra and Telangana doctors are jittery at the two-year wait. “We have been getting warnings through post, posters and wall writings that we are overstaying and that if we don’t go, we will be thrown out,” said a senior cardiologist of Gandhi Hospital. This doctor has stopped going to hospital after his car was vandalised and is practising from home itself.

Employees of AP origin are especially concerned that any more delay could upset their children’s academic schedule, considering that the academic year in schools and colleges has already begun. According to Dr K Narasimhulu, president of the United Doctors’ Forum, an association representing Seemandhra-based doctors, there is more demand for doctors in Seemandhra, as there is a huge shortfall of super specialities and corporate hospitals. “2000 doctors of AP origin are keen to go away but only the future of their kids is making them hang in here for a while,” he explained. “Many are also concerned about the lack of speciality infrastructure in Seemandhra hospitals and plan to go there only after a few years,” he said.

Their counterparts in Telangana are also unhappy over the delay in division. But a worrying deficit of doctors that an immediate division would entail is the actual cause of delay, say government sources. “If the division was made effective in 2015, then there would have been a shortage of seniors in at least two premier government hospitals – Gandhi and Sarojini, as they are staffed mostly by Seemandhra doctors,” said one state Health Ministry official.

But promotion prospects of Telangana doctors have been hit by this delay and they are angry. TGDA leader Dr S Ramesh said, “It is testing our patience for a long time.” He added that Telangana doctors cannot hope to be promoted as long as Seemandhra doctors stay put. There is also popular demand that Seemandhra doctors in private hospitals should also leave so that Telangana doctors could get the opportunity to work in these super specialities in Hyderabad. “As long as they are here, they will not allow us (Telangana doctors) to work in such institutes and bring in their own kith and kin for plum postings,” complained Dr BR Ramachander, another senior doctor at Osmania Hospital. Both unions plan to approach the court to speed up the decision of the Kamalanathan Committee.

The Kamalnathan Committee agreed to complete the process of division of doctors by July end. The Centre has extended the date for the third time to August and indicated that there will not be any further extensions. The Committee directed both state governments to stop salaries of doctors and other staff if they fail to submit their school study certificate by 20 April. But another hitch arose in June when 70 members were allotted from Telangana to AP and another 250 doctors were allotted from AP to Telangana.

The big picture

Health services took a beating in the initial days of bifurcation as funds for national health schemes like the National Rural Health Mission (NRHM) took a backseat. For Telangana, more than funds, the problem is that of shortfall of doctors. According to the Sri Krishna Committee set up by the UPA government to study the ground realities before bifurcation, Telangana, excluding Hyderabad, trailed far behind Rayalaseema and coastal Andhra in terms of availability of doctors.

Realisation has dawned on both Telangana and Andhra Pradesh about the severe and massive doctor crunch that is likely to worsen soon. The requirement of doctors in the two states is likely to be around 5000. Demand is likely to increase further as every corporate hospital in Hyderabad would float branches in Seemandhra, offering lucrative incentives. Seemandhra has already opened its doors for NRI doctors to come back and set up institutions with subsidised land, power and other concessions.

So what happens if the majority of qualified doctors head to Andhra? To solve the issue, Telangana has opened up its doors to doctors from West Bengal, Maharashtra, Kerala, Odisha and Karnataka. “It will take a minimum of one or two decades for AP to develop this environment (like in Hyderabad hospitals) and until then doctors are also not keen to go away, as for most of the professionals, going to Vijayawada, Tirupati or Rajahmundry is just like going back to the ice age,” said Dr SK Purohit of Osmania Hospital.

A prominent doctor’s family’s car was stoned near Suryapet, the gateway town to Telangana from AP. “I have lived in Hyderabad since my childhood days and was also born there, but now just because my forefathers came from AP, they hounded me and my family,” lamented a veteran dentist whose three daughters and two sons are also doctors in Hyderabad.

But the TRS and Telangana government does not seem willing to back down. In several political meetings Telangana Chief Minister K Chandrashekhar Rao and his ministers T Harish Rao and KT Rama Rao said, “Seemandhra people go to their native villages for Sankranti (harvest festival) and Ugadi (Telugu New Year). They also go there for voting. Their names are in the ration card and Aadhar cards issued there. But they claim to be Hyderabadis! How is it possible?”

Hyderabad is today the bread, butter and sauce of Telangana, accounting for over 40% of the new state’s revenues. Known as a medical tourism hub, the city would lose its glitter if it had to import doctors from other states for its hospitals. Intake in medical colleges to has gone down. Of the 20 medical colleges in Telangana, 14 are located in Hyderabad. Of these, nearly 6 are facing a crunch of students and are likely to fold up this year. Colleges are already offering incentives like discounts on hostels and free laptops, in a desperate attempt to woo North Indian students, as AP students have kept away due to the acrimony.

But the politicians continue to spew anger against the other state. “Let the Seemandhra doctors go if they want. We have nothing to worry. We have plans to attract our doctors hailing from Karimnagar, Warangal and Hyderabad, who are working in Dubai and other countries, to return and take charge of the institutions in Hyderabad,” said Telangana Health Minister Lakshma Reddy. What remains on ground though, is bitterness, confusion and a lot of anger between the once-united Telugu speaking states.