With reference to the call for indefinite strike by NIDA from 28th October 2022, it is brought to notice that government has issued OM NO.HFW(A)- 12/129/2021/526.dated 28th October 2022 wherein instructions have been issued to the Principal Director, DHFW, and the Chief Medical Officers and Medical Superintendents in the State, for not sanctioning any leave to any Government Medical Officer or health care professionals.
Further vide No. HFW(A) MISC- 12/38/16/524 dated 28th October 2022, it has been directed that no government medical doctors shall communicate with members of the press in matters not connected with discharge of official duty. Failure to comply with the instructions makes the officers liable to disciplinary action in addition to deduction of pay for the unauthorized absence on the principle of ‘no work no pay’.
In order to manage and mitigate the likely impact of such unauthorized absence by a large number of government medical doctors, and ensure that health services are not disrupted for the citizens following measures are to be activated at various levels:
A state level control room with dedicated helpline shall be set up for coordination and real time monitoring of the situation in the State. The Control Room shall be overseen by Principal Director, DHFW, who may draw officers from the Directorate to assist him. The Control Room shall, inter alia assist the Principal Director to enforce the instructions given in this and earlier Office Memorandum, and provide guidance to any individual needing access to health care facilities during the period.
At the District Level, following action and measures are to be undertaken;
i. A District Level Control Room under the chairmanship of an officer not below the level of ADC/SDO (Civil) and consisting of officers from Medical and other departments for coordination and real time monitoring of the situation in respective districts shall be set up. The control room shall be in constant touch with the State level control room and provide regular status updates for effective monitoring.
ii. The Control Room shall also provide guidance to any individual needing access to health care facilities during the period. A district level helpline shall be set-up and given wide publicity through media, hospitals etc.
iii. The attendance shall be monitored closely by the CMO and DC and daily report be furnished through the Principal Director and Commissioner, Nagaland respectively.
iv. The CMO in consultation with the Deputy Commissioner shall re-deploy all available contractual/temporary and AYUSH doctors or any other health care professional in various facilities in the district to fill the gap due to anticipated unauthorized absences, to ensure that all routine and essential services including OPT, IPD, Emergency services are not impacted Any officer who has been granted leave or left stationed should be recalled A list of contractual doctors appointed by Government is attached for reference, and would also be available with the CMOs and MSs.
v. The Deputy Commissioner’s shall hold a meeting with the available private hospitals/health care providers to worked out the modalities for management of OPD and referral cases from the government facilities as and when required. In case of Dimapur, the OPD and other referrals may be re-directed preferably to CIHSR In district with limited availability of private sector health facilities/clinics, arrangements shall be worked out with nearest such facility availability in other districts by the concerned Deputy Commissioners.
vi. The CMO /MS in consultation with the Deputy Commissioner shall establish facilitation centre at each health facilities till PHC level for the aid of the patients and management of cases requiring urgent attention like referral transport etc. For the centre, available Nurses and Paramedical Staff, in addition to the Contractual doctors and administrative officers may be used.
vii. It is to be ensured that functional referral transport like Ambulances should be readily available and deployed in an efficient manner across the District to provide timely transport for urgent medical cases in coordination with the district control room/facilitation centre.
viii. The Deputy Commissioner shall review the supplies of Medical consumable, Drugs etc at each of the Governments facilities in the Districts and communicate any exigencies to the State Control Room for quick replenishment.
ix. The CMO/MS are to ensure that all the healthcare professionals including Doctors, Ayush Doctors, CHOS, ANM/GNM, ASHAs are in their respective stations. Disciplinary action is to be initiated against those not available in their respective place of duty.
x. The Deputy Commissioners shall review the implementation of public health programs including TB elimination, Malaria program, AIDS control program, immunization etc with the CMO and District program managers in order to ensure that all services under the program are provided without any disruption.
The Deputy Commissioner shall be overall in charge of ensuring implementation of instructions at the District level and take all necessary measures to ensure smooth functioning of health services without disruption, and shall be assisted by the SP, CMO, MS and other officers as he may deem fit to assist him. The Deputy Commissioner is to ensure sufficient security deployment along with executive magistrates at health facilities to ensure peaceful and orderly conduct of affairs.
Principal Director (H&FW), shall be overall in charge for ensuring that the proposed strike called by NIDA has the minimum impact on provision of health services to public, including enforcement of the various instructions issued by the Government as far as these regard functioning of the Department and services provided and the programs implemented by it. Principal Director shall also, in coordination with MD, NHM ensure that facilities like Naga Tele health are fully operational during the period of agitation and all public health programs remain unaffected.
All steps undertaken by the concerned officers in accordance with the instructions contained in the office memorandum shall be well publicized so that public does not face any undue hardship.