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Both the autonomous hospitals offer world-class infrastructure, but suffer policy lacunae: the government has separate policies for the autonomous and government-run hospitals, according to the managements of the two hospitals.The Delhi government has three super speciality hospitals, with two of them being autonomous and G.B. Pant Hospital being run by the city government.According to Deputy Medical Superintendent Chhavi Gupta, the Rajiv Gandhi Super Speciality Hospital (RGSSH) is a 180-bed high-end super tertiary care hospital in East Delhi dealing with cardiology, pulmonology, gastroenterology, GI surgery, urology, radiology and having CPVS, ICU, CCU, blood bank, pain clinic and a sleep lab."We have two medical officers, one blood bank officer, and faculty doctors. About 50 to 60 per cent posts of doctors are vacant. The doctors are being recruited regularly."When visited the hospital, the OPD was flooded with people, while the remaining blocks of the hospital, spread on a 13-acre plot, wore a deserted look."With the existing strength, I think we are doing well. We are treating 1,500-2,000 patients in the OPD on a regular basis. The doctors here are happily working more and are putting in more efforts. Per day, the hospital takes at least 25 patients in the cath lab," Gupta said.The hospital is providing Out Patient Consultation (OPD) services in cardiology, gastroenterology, pulmonology, GI surgery, cardiac surgery, clinical hematology and rheumatology."It will be wrong to compare any hospital with a super speciality hospital. We deal with only super speciality branches."Gupta said while the hospital has all the equipment and infrastructure, it is now keeping its focus on the doctors' recruitment."The hospitals deal with about five to eight minor and major surgeries per day," she added.While the plan is to make the hospital 650-bed, the first phase has the 250-bed sanction of which 180 are already in existence, Gupta added.The picture was no different for the Janakpuri Super Speciality Hospital (JSSH). According to known sources, the footfall in the JSSH is about 1,800 patients in the OPD per day, but the hospital too has huge vacancies of doctors, with over 70 per cent posts of faculty doctors and specialists being vacant and no surgical doctors in the hospital.According to Ashok Kumar, Medical Superintendent, JSSH, the hospital has forwarded the file for surgical doctors' appointment to the Delhi government. For the huge vacancy, he said the hospital is giving advertisements, but they are not able to find doctors."We consider the number good in terms of the patient inflow. We are not able to get doctors for faculty positions. The government's pay structure of the society hospitals is less than that of the government doctors or private doctors," Kumar said.The 100-bed hospital also sees a high inflow of patients, who were given long waiting time for treatment.Explaining the difference between the autonomous and government hospital, he said: "In autonomous class, autonomy is given in terms of purchase, recruitment and functioning."He said the government gives a little freer hand to the autonomous hospitals for management. "For filling a vacancy, we advertise the post. The government does not have a role in recruitments in autonomous hospitals.""We are issuing advertisement for filling the post, but we are not getting any response. If we issue an advertisement for, say, nursing staff and there are 100 posts, we will get close to 20,000 applications. But for faculty doctors or professors, even if there is just one vacancy, at times there is one applicant or not even that."He said the same issue is faced by the Rajiv Gandhi Hospital, as the two have the same by-laws and same rules and regulations. "We face similar issues. We have the autonomy, but we have to follow the financial rules and regulations of the government. The doctors will get government benefits if they go for government hospitals and not for an autonomous one."Explaining it further, B.L Sherwal, Director, RGSSH, said the hospital is a society or autonomous hospital."There are issues and the number one is human resources. Also, we have to understand a number of things before we say that the posts are vacant."Sherwal said they have analysed that a hospital is not going to grow until they find super specialists who can work and spend some period of life in the institute."So, for that, we need to work on doctor's terms and conditions. When we issue advertisements, there are times when we get one or two applications or sometimes not even that," he said.He also said the two hospitals cannot hire doctors for more than five years. "We will have to sign a contract for five years. Although they (the doctors) can continue for longer, the joining is different from other hospitals which are government and private as there will be no promotion."Sherwal added that the government in 2013 has fixed a salary for the doctors in autonomous hospitals."There has been no change in the salary structure. We pay Rs 1.25 lakh to Assistant Professor and pay Rs 1.65 lakh to Associate Professors. We have to pay Rs two lakh to the professor. This was fixed in 2013 and is still the same."He said the peer groups not only get hike but promotions as well. "So, the job of the faculty doctors is not permanent and is contractual. A promotion is absent."Sherwal said the doctors come to the hospital for work, but it is difficult to hold them."We have told the government about our issues and the file has also moved. We got an in-principal approval for changing the policy for these issues."He also said the government has given some liberty for doctors' appointment."Also, I have sought for some liberty in the appointment as at times I get the doctors who are interested in joining. But they need to wait for the advertisement, which may take one to six months to come out. I can issue a short notice interview for them. The appointment will be for only three months."Appreciating the efforts of his doctors, he said, the doctors are doing their work. "We have long waiting for patients. We are giving quality care. Outstation patients are also high."He said the hospital is running well. "The people we have are working hard. I hope as soon as the promotion and salary issues are resolved, we will get more doctors."According to sources in the Rajiv Gandhi Hospital, the patients are even asked to wait for a year, however, Sherwal said the doctors are doing all they can. "We are expecting some improvement in a few months."(Nivedita Singh can be contacted at nivedita.singh@.in)( With inputs from IANS )

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