All specialist and super-specialist human resources are precious, yet internal dynamics seem more precious for the Ministry of Defence (MoD). It has been more than 14-months since the Prime Minister ordered to enhance the superannuation age of Non-teaching, Public Health Specialists and General Duty Medical Officers sub-cadres of Central Health Service (CHS) to 65-years with effect from May 31, 2016, but this has had no effect on the MoD. This is puzzling. The PM’s order issued under Rule 12 of the Transaction of Business Rules, 1961, is rarely invoked as Departure from Rules. The urgency can be seen from the Cabinet Secretariat most immediate ID dated May 31, 2016, which, while conveying enhancement of superannuation age with immediate effect, directed the Department of Health and Family Welfare (DoHFW) to seek ex-post facto approval of the Cabinet. The DoHFW implemented the PM’s directive immediately on May 31, 2016, as did the Ministry of Railways. Among other ministries, Ministry of Home Affairs with a sizeable number of doctors working in the Central police forces — CRPF, BSF, CISF, ITBP, NDRF-India, NSG, and SSB — too implemented the same from June 30, 2016. Bafflingly, the MoD hasn’t, yet.
Today Lieutenant Colonels (and equivalent in Air Force/Navy) in the AFMS retire at 56, Colonels (and equivalent) at 58, Brigadiers (and equivalent) at 59, Major Generals (and equivalent) at 60, Lieutenant Generals (and equivalent) at 61 (with 2-year tenure) and the Director General Armed Forces Medical Services (DGAFMS) at 62 (with 3-year tenure). Note the pensioning of the Lieutenant Colonels of specialist/super-specialist non-combatant at 56! And 99.5 per cent of AFMS doctors retire at the age of 59 or below — six years before their civilian counterparts! There is an acute shortage of doctors — 12–15 per cent — in the AFMS. The recruitment scenario is gloomy going by recent figures: of 2000 candidates who applied for 675 vacancies, 800 appeared in interviews, 300 were selected, and 175 joined — less than 26 per cent of the vacancies. Such is the dismal picture, yet such is MoD’s burden of silence.
Doctors are a rare human resource. Youngsters loathe joining medicine due to long gestation period and delayed employment, apart from the hard life it entails. Compare the medical graduates’ tuition fee with engineering and the 4x higher fee for the former over the latter will exemplify why doctors don’t fancy joining the AFMS. Not to speak of specialisation courses (MD/MS) or the super-specialisation courses (DM/MCh), which today costs a bomb, plus the 3+3 years consumed. The AFMS doctors can undertake the PG courses after 4 years of service, the time they serve in field areas. Medical science is stochastic; patients today bid fair to see specialists for their limbic and neural issues. The Internet and smart phones have wizened them. Given their regimented thinking, I can see the services headquarters sensing unease. How doctors serving under them, work beyond their — including service chiefs’ — superannuation age? This is old paradigm, long atrophied — passé today. It stems from the hoary perception that taking order from a junior in age, rank notwithstanding is improper.
The perception is invalid. Today in the services, younger officers of higher ranks supervise elders lower in pecking order, due to differentiated promotional timelines. It is endemic in organisations encompassing multifarious expertise. Levelled field is a mirage. The services’ retirement age had always varied with doctors retiring at a higher age vis-à-vis others. When services chiefs retired at 56, AFMS doctors retired at 60 — since 1936. The retirement age of Major/Lieutenant Generals in army and their equivalents in navy/air force has over the past years gone up to 60 with the three chiefs presently retiring at 62. In the AFMS, the retirement age at these two ranks has gone up from 60 to 61 with only the DGAFMS retiring at 62. The issue goes far beyond this disquiet over perception. AFMS is a specialised service — more healthcare than armed discipline. True, they’re part of the services set-up and important support arms, crucial for the Services wellness. But they belong to a different world — of patient care, empathy, curing, healing. This world demands different competencies/prescriptions, reason why the government has given them an extended run. With similar job profile, what’s applicable to the CHS is applicable to AFMS. What’s sauce for the goose is sauce for the gander! There can’t — and shouldn’t –be two different standards across ministries.
To retire AFMS officers at an age that’s lot younger than their civilian counterparts is both discriminatory and a cumulative loss; it inexorably haemorrhages precious resources. During a recent visit to two central universities as member of the UGC-appointed team, I was bemused to learn the vast difference in tuition fee (for all four-and-half-years) of a government-funded MBBS course and a private one. While the government-funded hugely subsidised course was Rs 1.5 lakh, the private institute’s was Rs 80 lakh. No mismatch for any professional course is more glaring than this. Not to say of specialist/super-specialist courses, where the mismatch is equally humongous.
Transfer to the pension establishment earlier than their counterparts paid from the same kitty is an irreparable loss of government spends for making them graduates/specialists/super-specialists; it tantamount to lateral brain drain of precious taxpayers’ human resources. Walk into corporate hospitals and you’ll likely bump into former AFMS doctors remunerated far higher than what they received in government. Public’s loss is corporate gain, feeding the latter’s billowing profit off taxpayers’ money.
I recall the lack of appreciation of AFMS doctors’ role even inside MoD conveyed in a letter from Rear Admiral A. A. Pawar, then Commandant, INHS Asvini, Mumbai. This was in 2015 when I was the Controller General of Defence Accounts. The new delegation of power had caused serious disquiet. His tone was one of exasperated injured pride. It was late evening when I read this letter. As a cancer survivor who had spent months in hospitals undergoing surgery after surgeries and associated treatments over an excruciating five-year period, I was scorched. I put myself in the patient’s shoes, visualising his pain and despair, and the rooted helplessness of treating doctors. I’m happy we rid these anomalies in the revised delegation of financial powers, 2016. Today’s issue too has the same ring of similarity: the lack of appreciation of AFMS doctors’ role, typecasting them under the armed forces overarching canopy and their cachet of regimentation. It’s time for course correction.
The Services must appreciate the changed — and ever-changing — dynamics of the specialised world we live in today, and introspect to change their perception; and the MoD must mull over the issue in a holistic vein and act — to stanch soundless, even relentless, haemorrhaging of rich human resource for the wellness of the armed forces and veterans who look up to the AFMS for medical succour.
(The writer is former Controller General of Defence Accounts and former Financial Advisor to Defence Services in the MoD. Views are strictly personal.)
(Reproduced from Millennium Post)