Crackdown on absenteeism sparks calls for systemic reforms in TN’s public health sector
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At the center of the ongoing debate over the unauthorized absence of 1,420 government doctors and calls for strict action is the larger question of the state of Tamil Nadu’s public health workforce.
Last week, the Ministry of Health said it had initiated disciplinary proceedings against 1,420 government doctors (postgraduates) for unauthorized absence and breach of service obligations. While it sparked debate, the controversy also brought to the fore long-standing concerns among government doctors about pay gaps, labor shortages, extended working hours and workplace safety.
The call for strict action against post-graduate doctors who secured posts through service quotas and then quit has reignited a long-simmering debate, a public health expert said. “The demand is a legitimate one. Public resources have been invested in the education of these doctors and accountability must follow. However, to continue with punitive actions and leave unaddressed the systemic failures that forced these doctors out would be an exercise in partial justice. The Tamil Nadu government health service is holding together thousands of doctors who remain, not because the system rewards their dedication, but despite repeated views that they don’t meet.” he said.
The first is the pay anomaly. A government doctor in Tamil Nadu earns 30 to 50% less than his counterpart employed by the central government or in neighboring states, he said, adding: “This is not a minor discrepancy. It represents years of lost income after more than a decade spent in medical training, often at significant financial sacrifice.”
The key problems are the personnel crisis and long working hours. The obstetrician-gynaecologist said, “Over the years, there has been a multifold increase in the number of women coming to government hospitals to give birth. But is the workforce in government hospitals sufficient? The answer is no. The disabled workforce has remained virtually unchanged for two decades,” she said.
“The airline industry has regulations that a pilot can only fly a certain number of hours in one shift. In the UK, a doctor’s shift cannot exceed 13 hours. In contrast, doctors in Tamil Nadu work 36-hour shifts due to staff shortages. Many of us are overworked and burnt out. There is no opportunity for career growth,” she said.
Another doctor said the government had not made any credible commitment to fill vacancies in bulk. The doctor said that the state governments have failed to increase the number of jobs according to the rising number of cases. “The health infrastructure has expanded but there has been no commensurate increase in manpower. Instead of increasing the sanctioned posts to match the increasing patient load, the sanctioned strength has been revised and reduced primarily to meet National Medical Commission norms,” he said.
Some felt that government doctors had been scapegoated for administrative failure. Successive governments have found it politically expedient to pit doctors against the public, the health official said. “Drug shortages, staff vacancies, inadequate infrastructure – failures rooted in procurement delays and budget neglect – are consistently blamed on the medical workforce in the field. This erodes public confidence in doctors, who are themselves victims of the same broken system, and absolves administrators of the responsibility they rightfully bear,” he added.
Published – 03 Jul 2026 19:39 IST