The Delhi government has launched a one-year service bond for all MBBS and postgraduate (PG) doctors, a policy meant to tackle the increasing shortage of healthcare professionals in the National Capital Territory (NCT). The new order, to be implemented from the next academic session, will cover all medical students graduating under both the All India Quota (AIQ) and the state quota.

The policy, initiated by the Directorate General of Health Services (DGHS), requires MBBS and PG doctors to serve one year in medical institutions under the Government of National Capital Territory (GNCT) after their education. The aim is to reduce the perennial shortage of healthcare professionals, especially in government hospitals and rural regions, where access to healthcare has traditionally been restricted. If these physicians refuse to abide by the service bond, they will have to pay hefty fines. MBBS students who opt out of the bond will have to pay a fine of Rs 15 lakh, whereas students who are pursuing MD and MS courses will have to pay a penalty of Rs 20 lakh.

The imposition of this service bond comes in the wake of a trend initiated by other states, most of which have already instituted such policies to remedy healthcare personnel shortages. States such as Maharashtra, Rajasthan, Gujarat, Madhya Pradesh, Uttar Pradesh, Chhattisgarh, Jharkhand, Haryana, Tamil Nadu, Karnataka, Andhra Pradesh, Telangana, Kerala, Goa, West Bengal, Assam, Andaman and Nicobar Islands, and Arunachal Pradesh have instituted service bond policies with differing terms and conditions. In these states, medical graduates have to work in government health institutions for a given period of time after finishing their studies.

The bond for service is considered a key measure to bridge the gap in health delivery, especially in under-served rural settings. Most of these areas fail to retain medical doctors, who prefer working in urban areas where facilities are superior, salaries higher, and career prospects greater. Through the service bond, the Delhi government seeks to provide a guarantee that the state’s healthcare system is well-staffed, particularly in its government hospitals, whose demand for healthcare services has skyrocketed over the past few years.

The bond also serves as an incentive for medical students to remain in the state after completing their education, providing them with an opportunity to gain practical experience while contributing to public health efforts. It is hoped that this will help alleviate the stress faced by Delhi’s public healthcare system, which has seen increasing pressure due to the rise in population and health concerns in recent years.

But the bond policy has been met with diverging responses. While many have hailed it as a move that is needed in order for medical personnel to be enough to tackle the increasing need for healthcare services, some have feared its impact on medical students. Detractors say the policy could restrict the autonomy of physicians since it compels them to remain in a specific geographical location for one year, which may affect their professional development. The draconian penalties for not taking the bond have also been a subject of concern, with some worried that it could unduly put a financial strain on individuals who cannot or do not want to comply with the conditions of the bond.

The bond policy further questions its efficiency in curbing the underlying causes of the shortage of healthcare workers. Though it may make sure that additional physicians practice in government facilities, it does not necessarily touch on factors like the conditions under which they work in the hospitals, which tend to be overcrowded and poorly equipped. Some argue that improving these conditions should be a priority, alongside the introduction of policies like the service bond, to ensure that doctors remain in government service after their bond period ends.

In response to these concerns, Delhi’s health authorities have assured that the service bond will be implemented with the goal of improving healthcare access in both urban and rural areas. They stressed that the policy is an interim arrangement to fill immediate staffing gaps and that measures are also being taken to enhance overall working conditions in state hospitals. This includes enhanced infrastructure, improved salaries for medical professionals, and greater support for doctors in rural areas.

All medical colleges in Delhi have to ensure now that students are well informed about the service bond policy and the obligations under it. The institutes will be responsible for monitoring compliance with the bond and making sure students are aware of the terms and conditions prior to graduation.

The Delhi government’s move to implement the one-year service bond for MBBS and PG doctors is part of an increasing trend across India to resolve the healthcare staffing shortage. It is a controversial step, but it is also viewed as a necessary move towards building the healthcare system and providing medical personnel to meet the population’s needs. Its success will be a function of how well it is implemented, along with the larger efforts to upgrade healthcare infrastructure and working conditions for doctors in the state.