Bhutan

Health and nation building

Jan 13, 2018
Nation building efforts cannot be successful if adequate attention is not paid to the population’s health. The Constitution mandates free basic health care services to the people because for Bhutan its people are its most important wealth.
 
At the core of this mandate are our health workers who give care to the sick so that they are able to work and care for their families. We saw their services being recognised​ during the national day celebrations in Haa and reforms that the Royal Civil Service Commission initiated in the doctors’ career path is progressive and commendable.
 
The change indicates the importance of health professionals in the country’s socioeconomic development. It is ​in response to the needs of the health ministry that continues to struggle in retaining doctors as it is in public interest. The reform is expected to make up for the seniority lost and to attract, retain​,​ and motivate doctors who are in critical shortage in the civil service.
 
The changes are meritorious promotion for senior doctors, entry level at P3 for doctors with masters, more than two years study to be considered active service for promotion of doctors, and first promotion after three years plus one year of probation.
 
Health officials have welcomed the move.
 
Retention and recruitment go together because the features that tend to retain physicians also attract new doctors. But having good policies is not enough​.​
 
Health ministry must work towards enhancing the working environment for its professionals. For it to retain its professionals, it must make efforts to understand and empathise with the professionals’ mind-set. It is time agencies with high turnover accept​ed​ that there could be a bigger push factor in the working environment that is causing them to leave the profession than the pull factor.
 
It is claimed that 61 physicians have already benefitted from this change since it was instituted in 2015. But between 2015 and 2017, the health ministry has also lost 10 doctors and efforts made to retain specialists ended up getting politicised.
 
It has been observed that when senior doctors decide to leave, no agency makes an effort to understand their reason for leaving. While no one is indispensible, parent agencies and the civil service commission must take the initiative to know what have caused senior physicians to give up practice. Scheduling exit interviews to gain an insight into what policies and procedures may need further adjustment would be a professional way to relieve professionals.
 
It is not uncommon to see many blaming the system when they decide to quit. But a system is made up of professionals and it is often the working culture that pushes people to leave. These reforms in the doctors’ career path are likely to provoke comparisons from other sectors where specialists and professionals are as valued.  It is hoped that the other sectors, as important as they are​, do not indulge in such practices.
 
For the quality of health sector determines the quality of life for country’s population.
 
Kuensel, January 13, 2018

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