'People In Villages Also Must Get Services Of Specialists': Madras High Court Refuses To Interfere With Rural Posting Of PG Doctors

Justice Anand Venkatesh noted that the 19 doctors, who were before the court, had opted for UPHC and APHC at the time of counselling and cannot be allowed to wriggle out by stating that they do not have the necessary facilities in those PHCs.

The court said there are various instances where doctors with specialization have rendered their services in remote villages and rural areas without any facilities and they have paved the way for creating new facilities for the poor people.

"This is the attitude with which the doctors are expected to render their services. The patients look at doctors who treat them like god when a precious life is saved and this Court expects doctors to maintain that standard and render service. The PG doctors cannot be heard to say that they will work only if all the facilities are available. 'Let not Gods waste their time in litigation'."

The doctors had argued that the State had previously given an undertaking to the court that the services of super speciality doctors would be utilized "in commensurate with their qualification either in the headquarter hospital or in the hospital attached with the Medical College in the State of Tamil Nadu run by the State Government." 

It was also contended by them that there was discrimination between in-service doctors and non-service doctors as the in-service doctors are never posted to PHC, UPHC or APHC. The petitioners further submitted that they are not averse to working in PHCs provided that facilities which are commensurate with their qualifications and specialisation are available.

On the other hand, the State submitted that even in-service doctors are sent to UPHC and APHC and thus there is no discrimination. The State also said the petitioners have themselves opted for UPHC and APHC at the time of counselling.

The court said the petitioners, who have completed post-graduation in various disciplines. have also executed a bond and undertaken to render service for two years.

"The State Government has spent a lot of money towards these doctors and these doctors must necessarily give back something to the society during the bond period by taking up appointments/postings in the places allotted and opted by those doctors at the time of counselling. These doctors are not going to render their service free of cost and they are going to be paid salary every month on par with the fresh recruits coming under the Tamil Nadu Medical Services," said the bench.

The court added that if the authorities fail to utilize the services of the petitioners within the bond period, they will lose the chance of making use of the specialization that has been gained by these doctors.

Observing that State Government is very serious about providing best facilities to poor patients belonging to those areas, the court, however, said the attempt to upgrade the health centres is a slow process since it involves huge investments in procuring specialized equipment.

"The facilities that are presently available may not cater to all the specializations attained by the petitioners. However, a PG doctor cannot be permitted to state that he will work in a UPHC and / or APHC only if the specialization achieved by him is available. The PG doctors must bear in mind that the State Government has spent a lot of money on them and their services are attempted to be utilized. These doctors, can always join the concerned UPHCSs/ APHCs and can help the Government/Health Department by giving their suggestions and increasing the facilities available in the concerned PHCs," said the court.

The court further said that a poor person in a village or a rural area must also get the services of a specialist.

"Even though the petitioners have completed their course, that does not mean that they have become specialist doctors and it takes a long period of practice to achieve specialization. In fact that is the case with all professions. These doctors getting exposed at the PHCs can gain a lot of experience to hone their skills. Even to perform well in the chosen field of specialisation, an overall experience in handling patients in distress during the initial period of practise helps the doctor grow with a strong foundation."

The court further stated that it is the moral duty and legal obligation of non-service PG doctors to render their services during the bond period. 

The court added that instead of finding excuses and engaging in litigation, the doctors should be proactive in rendering their services and helping the poor and needy people in the village and rural areas.

"For further up-gradation of PHCs and APHCs, the State Government as well as the Medical Department require the inputs from the PG doctors to understand the type of facilities that should be enhanced in the concerned PHC," it said further.

The court also said the PG doctors cannot take the stand that they will only work in the hospitals with all facilities. "If this stand is to be sustained, the services of most of the non-service PG doctors cannot be utilized during the bond period," it added.

Case Title: Dr Sri Hari Vignesh R v. State of Tamil Nadu and others

Citation: 2023 LiveLaw (Mad) 44