The Odisha government on Tuesday invoked the Odisha Essential Services (Maintenance) Act (ESMA) to curb strikes and work stoppages by doctors and other medical staff across state-run healthcare facilities. The move comes amid intensifying protests by medical personnel demanding pay parity with central government doctors, incremental incentives for super specialists and specialists, and proportional cadre restructuring across all grades.

According to an official order issued by the state home department (special), the ESMA directive applies to doctors, nursing officers, pharmacy officers, paramedics, technicians, and Class-III and Class-IV employees, including contractual staff, serving in government hospitals, medical colleges, and autonomous health institutions receiving state grants.

Under the ESMA notification, any cessation of work, strike, or protest action by the medical workforce in government healthcare facilities is now illegal for the next six months. This sweeping order covers a wide range of public health institutions, including district headquarters hospitals, sub-divisional hospitals, area hospitals, community health centres, primary health centres, municipal hospitals, medical colleges, the Ahalya Bai Regional Cancer Centre (AHRCC), Regional Spinal Injury Centre, jail hospitals, and police hospitals.

The government’s decision follows sustained protests by doctors under the banner of the Odisha Medical Service Association (OMSA). Since December 26, doctors in peripheral cadres have been observing two-hour-long work stoppages in outpatient departments, highlighting longstanding grievances regarding remuneration and career progression.

Demands of the Medical Staff

The protesting doctors have raised multiple issues regarding pay and working conditions. A central demand is remuneration parity with central government doctors, arguing that state pay scales lag significantly behind national standards. Additionally, doctors are calling for the abolition of Level-15 pay, which currently applies to Odisha’s Class-I officers, without preconditions.

The association has also demanded proportional cadre restructuring across all grades to ensure equitable career growth for doctors and medical personnel. They are pressing for incremental incentives for super specialists and specialists, postmortem allowances, and performance-based incentives to be implemented uniformly across the Odisha Medical and Health Services (OMHS) and Odisha Medical Education Services (OMES) cadres.

Another key demand concerns the working conditions and exit policy for doctors posted in challenging regions, specifically the Kalahandi-Balangir-Koraput (KBK) Plus areas and tribal sub-plan zones. Doctors with over three years of service in these regions are seeking a clear exit mechanism that recognizes the hardships of working in underserved and remote areas.

Government’s Response

The invocation of ESMA effectively criminalizes any form of strike or work stoppage in government healthcare facilities for six months. By doing so, the state administration aims to ensure uninterrupted delivery of medical services while negotiations and policy discussions take place. The order is also a warning to medical staff that non-compliance could result in legal consequences under the provisions of the Act.

ESMA has historically been invoked in situations where the government believes that a strike or work stoppage could affect essential services, potentially endangering public health and welfare. By extending the order to a wide array of healthcare institutions, the Odisha government has signaled its intent to maintain operational continuity and prevent disruption of critical medical services.

Potential Confrontation

The move to invoke ESMA sets the stage for a potential confrontation between the state administration and protesting doctors. While the government emphasizes the importance of uninterrupted healthcare delivery, the medical staff argue that their demands are justified and stem from systemic inequities in pay, allowances, and career progression.

Doctors, particularly those in peripheral and underserved regions, contend that their current pay scales and allowances do not reflect the level of responsibility and risk associated with their work. Many also highlight the need for incentives to retain talent in challenging postings, including remote KBK Plus districts and tribal sub-plan areas.

Implications for Healthcare Services

The ESMA notification aims to maintain continuity of patient care and prevent disruptions in outpatient and emergency services across government-run facilities. However, the ongoing tensions between the administration and medical staff may impact staff morale, potentially affecting service delivery indirectly. Healthcare experts note that prolonged dissatisfaction among medical personnel can have long-term repercussions on recruitment, retention, and overall efficiency in the state’s healthcare system.

Way Forward

While ESMA restricts the ability of doctors and medical staff to stage strikes, it does not resolve the underlying grievances that prompted the protests. Observers suggest that meaningful dialogue and engagement with the Odisha Medical Service Association and other stakeholders will be necessary to address issues related to pay parity, cadre restructuring, incentives, and working conditions.

The government’s immediate priority is to ensure uninterrupted patient care across all public health facilities. Simultaneously, policymakers face pressure to provide long-term solutions that balance the financial constraints of the state with the legitimate demands of medical personnel.

As the ESMA order takes effect, both sides are expected to monitor compliance closely. The coming weeks may see negotiations aimed at finding a middle ground, where healthcare services continue without disruption while addressing the concerns of doctors and allied medical staff.

In conclusion, the invocation of the Odisha Essential Services (Maintenance) Act marks a significant escalation in the ongoing standoff between the state government and medical personnel. While it legally prohibits strikes and work stoppages for six months, the resolution of pay parity and cadre-related grievances will require sustained dialogue and policy interventions. The state government must balance maintaining essential services with ensuring the satisfaction and retention of its medical workforce, whose cooperation is critical for delivering healthcare across Odisha, including remote and underserved regions.