TAMILNADU GOVERNMENT DOCTORS’ ASSOCIATION

Memorandum for

Revision of Pay and Allowances for Government Doctors

Office: 208, DAS Quarters, Govt. Rajaji Hospital, Madurai-625020Web: www.tngda.net mail: tngda_ss@yahoo.co.in

INTRODUCTION:• The health care delivery system in Tamilnadu is easily the best

• Govt. doctors can take the right- full pride

• Govt. doctors work for 54 hours to even 99 hours a week

• Promotion / pay structure - lowest in the country

• Working hours/ load - heaviest in country

• Increasing demands & specialists shortage

• Many types of recruitment process have failed

• So, make the job more lucrative

Important services in TN:-

• CEmONC

• Medical College in each district

• 1428 PHCs

• Trauma Care centers

• Ambulance services

The Burden:

Work place No required No. available No. shortage

CEmONC specialists: 800 (1300) 480 542

Medical colleges

Anatomy 122 48 74

Physiology 122 54 68

Biochemistry 61 28 33

Pharmacology 89 48 41

Pathology 152 84 68

Microbiology 78 37 41

Forensic 68 29 37

Community Medicine 126 54 72

Radiology 98 32 66

Psychiatry 38 28 10

Thoracic Medicine 38 24 14

Total 990 466 524

Trauma Center Orthopedician

40 13 27

What are our demands?

1. Rationalization of the work pattern of doctors

2. Pay and Promotion opportunities on par with central govt.

institutions

3. Allowances for additional work

4. Duty timings in PHCs on par with other states

5. VRS

Rationalisation - Salient features:

• Creation of Specialist Cadre

• Partial Compartmentalization of Education Side

• Working out Norms

• and Creation of Administrative Cadre

Specialist Cadre:• Similar to that in central govt.

• Specialist cadre – Public Health cadre – Teaching cadre should all be given same scale.

• Entry scale on par with public health specialist ie at Rs 9100 - 13500 or its equivalent in VI Pay Commission.

• Scale and time bound promotion on par with central scale (including that for public health specialist).

• Qualification: PG Degree or PG Diploma or a Super Specialitydegree.

• 1 or 2 or 4 advance increment to PG diploma, degree and super-speciality degree respectively.

• These specialists will be posted in specialist posts.

Administrative cadre:• To tone up the administration (as in Kerala).

• Common for DPH, DMS, DME

• Eligibility:– Should have minimum 5 years of experience– Can be from general, non-specialist, specialist or public health cadres– should have minimum 10 to 15 years left over service

• These cadres should be a “non-practising cadre”

• They should be given 12 months to 18 months residential administrative training

• Training should be in : Public Health/ Hospital Administration/ Finance/ Computer/ Gen. administration

• Entry posts should be identified: MHO/ BMO/ ARMO etc

• Certain post like Deputy Directors- Health, Medical, RAMO, RMO, Superintendents etc will be by administrative cadres

• JD/ ADMS/ ADPH/ ADME/ DMS/ DME/ DPH will be by both regular and administrative cadres on a fixed ratio.

Pay and Promotion on par with Central Services

Pay Structure and Promotional Avenues of CHS doctors:

Scale in Rs Gen Duty MO cadre (MBBS)

Public health cadre(Dip in Public Health)

Non teaching cadre(Dip & Master)

Teaching cadre

37400 – 67000GP 8900

Eligible IN 3 yr Eligible IN 3 yr Eligible IN 3 yr Eligible IN 3 yr

37400 – 67000GP 8700

IN 4 yrs IN 6 yrs IN 6 yrs IN 6 yrs

15600-39100GP 7600

IN 5 yrs IN 2 yrs IN 2 yrs IN 2 yrs

15600-39100GP 6700

IN 4 years Entry Entry Entryas Asst. Prof.

15600-39100GP 5600

Entry - - -

Comparative career progression of CHS vs TN doctors -Non Teaching side:

Cadres Entry Promotion 1

Promotion 2

Promotion 3

Entry In 4 y In total 9 yr

In total 13 yr

37400 –67000GP 8700

In total 8 yrCHS Non teaching specialist

- 15600-39100GP 6700Entry

15600-39100GP 7600

37400 –67000GP 8700

15600-39100GP 5400

37400 –67000GP 10000

15600-39100GP 6700

Entry

15600-39100GP 5400

15600-39100GP 7600 in 3 yr

15600-39100GP 7600

In 2 yr

15600-39100GP 5400

37400 –67000GP 8700

Gen Duty MO

15600-39100GP 5400

-

TN PHC / GH/ Non teaching specialist

15600-39100GP 5400

TN Public Health specialist

15600-39100GP 5700

Comparative career progression of AIIMS vs TN doctors -Teaching side:

Asst. Prof.Entry

Asso. Prof.In total 5 yr

Additional Prof.In total 4 yr

15600-39100GP 7600

37400 –67000GP 8700

Prof.Vacancy based

15600-39100GP 5700

15600-39100GP 7600

15600-39100GP 7600

Asso. Prof.Vacancy based

15600-39100GP 6700

Asst. Prof.Entry

Prof.Vacancy based

CHS Medical College Teachers

37400 –67000GP 10000

TN Medical College Teachers

-

Central Health Services

Indian Ordinance Factory Medical Service

Indian Railway Medical Service

All Indian Institute of Medical Sciences

Kerala

Karnataka

ANDHRA PRADESH

Puducherry:

Pay scale

Non teaching Side:All central scale of pay and promotion

Teaching Side:• JIPMER is a central institute• No state run medical colleges

Tamilnadu Arts College Teachers

SUMMARY: Non teaching cadres:

Pay scale & PromotionsInstitution

Entry

1 2 3

Andhra Asst Surg11250

Deputy Civil surg14300

Civil surg17035

JD18355

Karnataka GDMO14050 Sr MO/ Specialist 15200

in 6 years time bound

(Dy CMO)/ Sr Specialist)18150in 13 years time bound

23200JD

Pondichery(as in CHS)

8000GDMO

10000Specialist II Jr/ SMO in 4 years time bound

12000Specialist II Sr / CMO in 9 yr time bound

14300in 4 yr time bound

Kerala 11910-19350(Asst. Surg)

16650- 23200(civil surgeon)in 8 years time bound

23200 – 31150(DD)in 16 years time bound

25400 – 33100Addl DirectorVacancy based

Railway Medical Service

ADMO8000

DMO10000 in 4 yr time bound

JAG DMO12000 in 9 yr time bound

SelG DMO14300 in 14 yr timebound

Ordinance Factory medical service

Asst MO8000-13500

Sr. MO/ Splist Gr II jr10000-152004 yr time bound

DDHS (OG)/ Splist Gr II sr12300-152009 yr/ 8 yrs time bound

DDHS (SG)/ Splist GrI14300 – 1830014 yr / 11 yr time bound

Tamilnadu Asst Surg8000

Sr Asst surg9100 in average 17 years

Civil surg10000 in average 20 yr

Sr civil surg.12000 in average 22 yr

VI Paycommission (minimum)

Minimum 3 promotions in 4, 9 and 13 years

Conclusion:

•Central services, Kerala, Andhra, Karnataka, Pondichery all give better pay scales and timebound promotions

•Specialists with PG qualification enter at ahigher scale and have better promotionopportunities

•In Tamilnadu the Public Health Specialist enter a scale higher but not the other specialist.

Summary : Teaching cadres

Institution Tutor Asst. Prof. Reader Professor

AIIMS (central scale + time bound)

- 11625Entry level

14300 18400

Andhra (UGC scale)

8000 10000 12000 16400

Karnataka (AICTE scale)

8000 + 8000

12000 + 8000 16400 + 8000

18200 + 8000

Kerala(AICTE scale)

8000 + 150% DA

10000 12000 14300

TN Govt. Medical colleges

8000 9100 12000 12000

TN Govt. Arts colleges(UGC Scale)

8000 10000 12000 16400

TN Private Medical Colleges

15000 –20000

20000 – 50000 45000 –90000

90000 -125000

Medical Teachers vs Arts college teachers :

• one year less qualification (UG + PG + M.Phil+PhD)• have 10 weeks vacation every year• no treatment work • take 1 to 2 hours classes and rest preparation time • Medical teachers:

Treatment [ 4 to 6 hours/d ] + Teaching

Still medical teachers paid lower & have poor promotion

In Tamilnadu most medical teachers get only one promotion in their career and that too after 20 years

(ie from AP to Asso. Prof)

All teaching scales - Central scale / UGC/ AICTE scale have time bound promotion

Private Practice

• Restricted Private Practice is

allowed in Kerala, Karnataka

and Andhra

• NPA optional for private

practice in Karnataka (25% of

band pay + Grade Pay)

• Ban in Andhra withdrawn

• 12000 doctors is 1/3rd of

the total doctors in TN

• 60% of specialists

• Remote PHC/ GH

• 75% Rural availability

• cost of treatment low

• No benefit but expense

Rs 80 crore p.a.

Quality may go down as best doctors may opt out of govt. service

University Grants Commission (UGC)

UNIVERSITY GRANTS COMMISSION

3 October 2008

Prof. G.K. Chadha, Member, Economic Advisory Council to the

Prime Minister as Chairman.

Higher Pay at Entry Level than the civil services:

• Since the minimum qualifications at entry were higher.

• acquiring higher qualifications also meant that entry will be at older age.

• therefore given incentives by way of advance increments and higher grade pay to compensate them for higher qualifications at the entry point.

• both the corporate sector and foreign educational institutions are luring the young talented persons away with higher salaries and better pay packages.

Scales/ Career Advancement in UGC Scheme :SNo Designation Scale Promotion after

Assistant Professor1

PhD

PB 15600 – 39100 GP 6600

Entry (higher than IAS, Doctors)

15600 – 39100 2 Assistant Professor (Senior scale) 7200

After 4 years

15600 – 391003 Assistant Professor (Selection grade)/ Associate Professor

8000

After 5 years

37400 – 670004 Senior Associate Professor 8700

After 3 years

37400 – 670005 Professor.

11000

After 5 years

37400-670006 Senior Professor

12000

Only in University

7 Professor of Eminence

80000 fixed Only in University

Consultancy Assignments:• to accept consultancies, direct projects, register patents, R&D

Products and technology transfers as a part of their academic duties.

• this would help the society at large to benefit from the professional inputs by the academic community and contribute directly to societal development.

• besides it would help the individual teacher to augment his/her personal and institution resources.

• resources earned by a teacher through consultancy should be divided between the teacher and the institution

Consultancy Assignments: (contd)

Amount received up to 30% of the gross salary(basic salary+ grade pay+ DA+ Academic Allowance) :

– No sharing, entire amount to go the teacher concerned.

Amount received beyond 30% and up to the gross Salary:

- Sharing of the money beyond 30% in the ratio of 70:30 between the teacher and the institution respectively.

Amount received beyond the gross salary:

– To be shared in the ratio of 50:50 of the amount of the money received beyond the gross salary between the teacher and institution.

Academic Allowance (for preparation of teaching materials)

• Rs. 1500/- per month- Assistant Professor, Assistant Professor(Senior Scale), Assistant Professor(SelectionGrade)

• Rs. 1200/- per month for Associate Professor, Senior Associate Professor, Professor

Teaching Workload :

• Max 40 h a week• 5 h/ day• 5 days/ wk

• AP, Asso. Prof – 16 h /week class + preparatory time

• Sr Asso. Prof – 6 to 8 h / wk

• Prof = 2 h/wk

Details No. of weeks

Teaching 30Admission/ Exams 10

Vacation 10Public Holidays 2Total 52

Increments for Higher Qualifications/ on Promotion:

• Ph.d degree holder: 5 advance increments

• M.Phil degree holder: 3 advance increments

• M.Tech, M.D., M.S. L.L.M. degree :3 advance increments

• M.A./MSc./M.Com : 2 advance increments

• On being promoted as Associate Professor: 2 advance increments

• In-service teacher on completing Ph.D. degree: 3 advance increments

• In-service teacher on completing M.Phil degree: 2 advance increments

Superannuation:

• The age of superannuation of all college and university teachers throughout India to be 65 years.

• In the interest of students Individual teachers should however be allowed to continue as contract teachers till the end of academic session.

All India Council of Technical Education (AICTE) scale

Comptroller and Auditor General (CAG)Report

Performance Audit of TN Medical Education 2003 - 2007

VI Pay Commission : Central Govt. Gazette

What are our demands?

Non Teaching cadres:

• Same for Non specialist – time bound promotions at 4, 9, 13 years• Specialists should have one scale higher entry scale • Allowances for additional work

Sixth Central Pay Commission Report - Para 3.6.16:doctors will have Dynamic Assured Career Progression (DACP) at 4, 9, 13 years

Non Teaching cadres:

Non specialist demanded scale Specialist demanded scale

Designation Scale Designation Scale

Entry 15600-39100 GP 5400entry level

- -

Promotion 1 15600-39100 GP 6600in 4 years time bound

Entry 15600-39100GP 6600 entry level

Promotion 2 15600-39100 GP 7600 in 5 years time bound

Promotion 1

15600-39100 GP 7700 in 2 years time bound

Promotion 3(Existing JDHS cadre)

37400-67000 GP 8700in 4 years time bound

Promotion 2

37400-67000 GP 8700in 4 years time bound

Promotion 4District Medical Officer(Existing ADMS cadre)

37400-67000 GP 8900in 3 years eligible/ vacancy based/ CML seniority

ADMS / ADPH 37400-67000 GP 10000 (Vacancy based)

Directors 37400-67000 GP 12000

Teaching cadres:

UGC scales as for Arts and Science Teachers+

Treatment Allowance

Comptroller and Auditor General of India : in the performance audit report 2003-2007 of the medical education department in Tamilnadu

Para 3.2.11.2 : The emoluments of medical faculty are lower than that of their counterparts in arts and science colleges in Tamilnadu

Para 3.2.18 (Recommendations ): Govt. should consider University Grants Commission (UGC) scale for the medical teachers

Teaching cadres:

Designation Demanded scale

Tutor 15600-39100 GP 5400entry level

Assistant Professor 15600-39100 GP 6600Entry for specialist

Readers 15600-39100 GP 7600 in 5 years time bound

Additional Prof. 37400-67000 GP 8700in 4 years time bound

Professor 37400-67000 GP 8900in 3 years eligible/ vacancy based/ CML seniority

Dean/ ADME 37400-67000 GP 10000

DME 37400-67000 GP 12000

New Pay scales (VI Pay Commission)

Posts Demanded scale Demanded new scale

Assistant Surgeon

Civil surgeon/ Specialist GrII/ Assistant Professor

Senior civil surgeon / Specialist Gr I/ Reader

Chief civil surgeon/ Consultant/ Associate Professor

District Medical Officer/ Professor

Dean/ ADME/ ADMS/ ADPH

Directors

8000-275-13500 15600-39100 GP 5400

10000-325-15300 15600-39100GP 6600

12000-375-16500 15600-39100 GP 7600

14300-400-18300 37400-67000 GP 8700

16400-450-20000 37400-67000 GP 8900

18400-500-22400 37400-67000 GP 10000

22400 – 525 - 24500 37400-67000 GP 12000

Modified UGC Duty Timings

Arts College teachers: G.O. 111:Teaching days: 30 weeksAdmission, exams: 10 weeksVacation days: 10 weeksPublic holidays: 2 weeksWork load: not less than 40 hrs a week

Non Clinical Teachers: 10 am to 5 pm x 6 days a week= 42 hours10 weeks vacation

Clinical Teachers:9 am to 2 pm x 5 days a week+ 1 stay duty (24 hr)= 49 hoursNo vacation

Allowances

Why do we need extra allowances?

• In Tamilnadu unlike in central and other state institutions the doctors do many additional work on regular basis

• Have different work load

• Xtra duty timings in GH/ PHC side

• No renumeration for treatment work in medical colleges

Demanded Allowances:Name of the allowance

Existing allowance

Demanded allowance

Remarks

Non Practicing Allowance

Rs 900/- 25% of basic Optional

ORRestricted Practicing Allowance

Rs 150 –250 p.m.

20% of basic In lieu of restricted private practice. Based on option - NPA orRPA

PHC allowance Rs 900 – Rs1200

40% of basic To encourage rural service(PHC)

Multi specialityallowance

- 40% of basic To encourage rural service (GH)

Risk Allowance - Health insurance Rs 10 lakhs /

Year

In view of TB/ HIV, Hepatitis.

PG advance Increments

two increments for PG degree

1, 2 , 4 advance increments for diploma/ degree/ super speciality

specialist service to be encouraged

Academic Allowance - 1500 pm For preparation of materials

Treatment Allowance

- 40% of basic for UG teachers+ 20% to PG teachers

PG institutes teach both MBBS and Diploma/ PG degree

Weekly off 1 day 2 weekly off in PHC/ GH side

With heavy-duty hours 5 days a week is a must.

Rare SpecialityAllowance

- The allowance should vary from 75 to 100% of their basic pay depending on the rarity.

To attract essential but Rarer faculty as in Community Medicine, Forensic Medicine, Biochemistry, Anatomy and Radiology this allowance to be given to them.

Professional updating Allowance

- Rs 5000/ pa As a life saving service needto update knowledge. Pay commission allows this for scientists. Journal, CME, conference etc.

Special pay Rs400/-pm

Rs 1500/- pm An additional Medical Pay to be given

Personal pay Rs300/-pm

Rs 1500/- pm

Difficult Terrain Allowance

- 30% of basic Those PHCs and GHs interiorly placed and remains vacant.

Hill Allowance Rs300/-

30% of basic In compensation for lack of facilities

Mobile allowance

- Rs 500 p.m.

Conference Allowance

- 20 days special CL and TA/DA (for participating in the National Conference. The MCI insists all doctors to refresh and update knowledge.

Uniform allowance

Rs265/-p.a.

Rs 2000/- p.a. For 3 sets of overcoats and foot wear

Stay Duty Allowance

- Rs 1000/ duty - made to do 10 duties a month against 4 duties.

Post Mortem Allowance

Rs75/-per case

Rs 250 per case Difficult job. Have to attend court.

Administrative Allowance

Rs 0 to Rs300/-

20% of the basic Pay

CMO/ BMO & other cadres

Duty timings of PHCs on par with other states

Duty timings comparison:

Institutions Timings Remarks

Kerala 9 am to 1 pm / 2 to 3 pm

5 hours

Karnataka 9 am to 1 pm/ 2 to 4.30 pm

6 ½ hours

Tamilnadu 8 am to 5 pm/ 5 pm to 8 am (call duty)

9 hours + 15 hours call duty alternate days

Central govt. health institutions

Working hours same as for other central govt. offices

-

Other govt. servants

10 to 5.45 x 5 days -

Foreign health institutions

Weekly 36 hours to 40 hours

Out of duty allowance given

What do we need?

• Duty timings between 9 am to 2 pm and 3 pm to 4 pm

• Call duty after duty hours to be withdrawn

• Allowances for additional work

Withdrawal of ban on VRS

VRS:• Fundamental right of every govt. servant.

• Ban should be withdrawn and those willing can be re-employed on post- retirement

• Compensated by increase in the retirement age to 62 years

• Posts made attractive salaries/ perks.

• Legally not tenable

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