MTR: The health ministry’s challenge of insufficient health workers and placing them in the remote dzongkhag is likely to continue into the next five-year-plan, threatening the government’s pledge of providing three doctors, including a specialist in all the dzongkhag hospitals.

The ministry raised the issue at the midterm review yesterday. The ministry is struggling to meet the demand of doctors even for the national referral hospital.

Eight dzongkhag hospitals have less than three doctors.

There is acute shortage of specialists and the low salary for the expatriates is further worsening the problem.

The health secretary Dr Dorji Wangchuk proposed to increase the salary to USD 2,500 from USD 1,500 for specialists from abroad.

“There are other factors, including workload and having to work alone without another expert opinion that deters people from coming here,” the secretary said.

Against the target of deploying three health workers in all grade-II basic health units, the ministry had to reduce it to 40 percent.

Dr Dorji Wangchuk said that while the ministry does not have plans to deploy doctors in the grade-II basic health units, it foresees an eminent need to do it because the BHUs are in industrial areas where the workload is increasing.

He proposed to increase MBBS scholarship slots to 30 in the next five years to ease the shortage.

“Only then will be in a position to get doctors of speciality and send them for post graduate and other specialised training,” he said.

The ministry has to fill a gap of about 379 general doctors and 111 specialists. The problem worsens with staff dropping out at the rate of 1.2 percent annually.

At a health conference in September last year, the ministry reported a shortage of 1,900 health workers.

“We’re in the process of working with the Royal University if they could increase the intake of the trainees,” Dr Dorji Wangchuk said.

According to annual health report 2014, there are 4,688 health workers, of which 244 are doctors, 957 nurses, 514 health assistants and 46 drungtshos, among others.

There are 3.3 doctors for every 10,000 people in the country, an increase from 2.8 in 2013 and 2.7 in 2010. The nurse to bed ratio was 1:9 in 2012 improved to 1:7 in 2015.

The ministry has finalised financial incentives for health workers in the rural areas and will soon discuss it with the finance ministry.

Private selective diagnostics services centres jumped to 11 in 2015 from three in 2012.

The online health information system will reach all health units by next year, improving the deployment of staff and performance.

Prime Minister Tshering Tobgay said that before increasing the scholarship slots it is crucial to study the trend of demand over the years.

Prime Minister suggested the ministry to discuss recruiting retired health workers with the Royal Civil Service Commission.

He said mandating new recruits with rural posting could solve the problem of deploying health workers to rural areas.

The ministry’s reprioritization of its human resource development budget from Nu 300 million to Nu 325 million was approved in principle at the review meeting.

The reprioritized budget is for 12 specialisation slots for chest medicine, dermatology, orthopaedic, pathology, psychiatry, radiation oncology, medical oncology, radio diagnosis, transfusion medicine, and anesthesia. Of that, Nu 5 million is to train the drungtsho and menpas.

Construction of the Gyaltsuen Jetsun Pema Mother and Child Hospital will begin from April after the ministry completes its drawings and designs.

Tshering Palden