The Bihar health department faces a huge challenge in terms of qualified manpower as it stares at vacancies at almost every level. The government is itself responsible for this though; say those working within the system.

It has a shortage of close to 7,800 doctors, 13,800 nurses and 1,500 pharmacists against the sanctioned posts, by the department’s own calculation.

The vacancies are now beginning to pinch the government in management of coronavirus pandemic, with Bihar reporting total 1,24,827 Covid-19 cases and 644 deaths as on Tuesday.

If one were to bifurcate them, among doctors itself, there was a shortage of 4,300 general duty medical officers (GDMOs), who are generally MBBS degree holders posted in peripheries, and 3,500 specialist doctors, holding postgraduate degrees, posted generally in medical colleges at faculty level.

Similarly, at the nursing level, there was a vacancy of 4,200 general nursing midwives (GNM) and 9,600 auxiliary nursing midwives (ANMs). The ANM, which is a two-year course, are the ones in peripheries. Those holding GNM diploma, which is a three-year course after intermediate, are the ones recruited as staff nurse grade ‘A’ in medical college and hospitals.

It is the criteria for recruitment of nurses and pharmacists that has now become the bone of contention, with the nursing students taking to the streets and staging a protest near the chief minister’s residence on Tuesday.

The Bihar government is yet to incorporate changes in its recruitment rules for staff nurse grade ‘A’ despite the Indian Nursing Council (INC) deciding to gradually phase out GNM course by next year. Instead, it would have the four-year B.Sc nursing curriculum, after intermediate, as the minimum benchmark for appointment of nurses, said Imamuddin on the Bihar Health Nursing Association (BHNA).

“It still insists on having GNM diploma as a prerequisite for staff grade A nurse. In doing so, those with higher degrees, having done B.Sc nursing after intermediate, are left out of the recruitment process,” he added.

The last batch of 4,997 nurses was recruited on August 16, against an advertisement last year to fill up 9,130 posts of staff nurse grade ‘A’.

Besides, the GNM recruitment rules also make it mandatory that diploma holders should be registered with the Bihar Nursing Registration Council (BNRC). Despite the huge vacancies, this eliminates the prospect of candidates from other states to apply in Bihar, unless they register with the BNRC.

Also somewhat skewed are the recruitment rules of pharmacists. Despite possessing higher degree, like B. Pharma after intermediate, they, too, need to possess the basic diploma in pharmacy to be eligible for recruitment in Bihar government service.

While B.Pharma is a four-year degree course, diploma in pharmacy is of two years.

“We have been requesting the government to allow candidates with higher degree after intermediate to be eligible for recruitment, but it has not agreed yet,” said Rajeev Kumar Sinha, general secretary of Bihar’s All India Pharmacist Association.

“We are also demanding relaxation in maximum age limit of candidates from 37 years to 45 years because the last regular recruitment was done this month, against an advertisement issued in 2006. During the intervening period, many candidates, who have completed B.Pharma, would have crossed the 37 years age limit,” said Sinha.

The pharmacist association is also demanding parity in wages, as those under the Rashtriya Bal Swasthya Karyakram under the National Health Mission, get a consolidated salary of Rs 12,000, while those on contract in Bihar government get Rs 37,000 monthly, he claimed.

Pramila Kumari, general secretary of the Bihar Grade A Nurses Association, and also a member of the BNRC, defended the government.

“The vacancies notwithstanding, candidates from Bihar should only be eligible to take up government positions in the state. Those who possess diploma or degree in nursing from private institutions in other states, obtain higher marks that our students who qualify from government institutions in Bihar, thus failing to make the cut,” said Kumari.

“We had to launch an agitation to force the government include a clause in our recruitment rules that candidates registered with the BNRC shall only be eligible to apply for staff nurse grade A position,” she recollected.

“We are examining the issues,” said Pratyaya Amrit, who was given charge as Bihar’s principal secretary, health, on July 27.

The state government was forced to change recruitment rules of general duty medical officers earlier this year after a lady doctor in the army won a verdict from the Supreme Court last December, allowing weightage in marks to doctors who worked in Bihar, but were not under state government setup.

The earlier rule had earlier prevented Central government doctors, like those in defence, railways and facilities under the Employees State Insurance Scheme, from getting credit points even if they had served in Bihar.