Doctors in the dock

HEALTH: Paid a pittance at home, Indian doctors could soon find that the doors to more lucrative overseas jobs have shut on them as well.

For Atul Malhotra, 39, it was a dream that had finally come true. After practising in a Delhi hospital for over five years, he was finding it difficult to make ends meet on his salary of Rs 20,000 a month. Then he got a job with a hospital in the United Kingdom, with a salary ten times what he got in India.

But the dream run didn't last for long. Malhotra, along with hundreds of other migrant doctors, found himself unable to renew his contract, due to the preference given to professionals from other European Union countries. He has come back to Delhi, and is working with a private hospital for a fraction of the salary. But he is nursing dreams of going back one day.

Events of the last few days have meant that it might remain just a dream. As it comes to light that doctors of Indian origin were involved in the latest London terror plot, doctors like Malhotra have another reason to worry. Britain is all set to tighten visa rules for immigrant doctors.

This is expected to trigger a chain reaction in Australia and New Zealand "" all attractive destinations for Indian doctors. (The United States does not recognise Indian medical degrees.)

The big draw has been better salaries. While a doctor in a government hospital starts his career with a meagre salary of Rs 12,000 per month, he can expect to get as much as £ 2,000 (over Rs 160,000) if he lands a job with the National Health Service (NHS) of the United Kingdom.

"The best brains of the country opt for medicine. Still, they are not offered the best salaries. While a 22-year old software engineer begins his career with a salary of Rs 50,000 a month, a post graduate doctor in government service can expect only Rs 35,000, that too after five years of service," says Delhi Medical Association president Ramesh Dutta.

The rapid corporatisation of the country's healthcare industry hasn't helped matters either. Doctors say that salaries in private hospitals are invariably worse than in government hospitals.

A look at the overall numbers suggests that there is actually a severe shortage of doctors in the country. According to official estimates, some 30,000 doctors pass out of the country's medical colleges every year. The demand, however, is for three times the number.

A recent study by the Federation of Indian Chambers of Commerce and Industry had found that there were 592,215 doctors in the country in 2005, with 22,000 more getting added every year. It has predicted that India will need at least 12,00,000 doctors by 2012.

Doctors say that while there might be an overall shortage, there is a glut in the cities where all doctors tend to flock.

"The migration of doctors to the metros has created a surplus in major cities. Even 20 km outside Delhi, there are no qualified doctors. Having spent over Rs 20 lakh on studies, doctors are not in a position to work in rural areas where the ability to pay is constrained," says one doctor.

As a result, Indian doctors have been looking abroad to improve their lot and the NHS was a big draw. An Indian doctor who recently returned from the UK to work with the Analjit Singh-controlled Max Healthcare says the NHS has stopped hiring, leaving few vacancies to be filled.

In addition, he says, more than half-a-dozen medical colleges had come up in the UK in the last few years, augmenting the supply of local doctors.

The involvement of some Bangalore-based doctors in the latest terrorist attacks could be the last straw.

Apart from the UK, Australia and New Zealand, West Asia too was an important destination for Indian doctors. Even there, governments now prefer local doctors to Indians. For Malhotra, it could only be a triple whammy.