Though the country has been producing an ever-increasing number of medical doctors, public health in Nepal has not improved much; on the contrary, many believe it has gone down in government hospitals. The shortage of doctors as well as other medical staff in state-owned hospitals and health centres, along with a deterioration of service, makes one wonder if the situation is not partly due to the fact that private hospitals and nursing homes have mushroomed. Many of the government doctors also work in private hospitals or run private practice. To that extent, things may be tolerable. But when doctors’ private business interferes with their government duty during their paid time, the negligence becomes inexcusable.

This scarcity of medical services is much more acute outside the Kathmandu Valley. The report that the 50-bed Midwestern Regional Hospital in Surkhet has only seven general physicians, though it has 24 sanctioned positions for doctors, including specialists, illustrates the point. This situation exists for two reasons. First, most doctors do not want to go outside the capital, at least outside urban centres. Second, the government does not fill even the existing vacancies. To make matters worse,a number of health care centres remain without a doctor, in some of them, non medical staff including peons,fill in,putting the lives of patients at another great risk. The government needs to make the regulations governing the services of its medical employees stricter and also have the will to enforce them.