Indian health services are being either provided by government hospitals (public hospitals) or by the hospitals run by the private sector. In the last 20 years we have seen that there has been massive proliferation in private health services available in the country. Same has been the trend in the medical education sector. Almost 50% of the all the existing medical colleges have come up in the last decade or so. It is presumed that no new government medical college has opened during the same period. Private health services have become popular and wherever possible, an Indian patient prefers to get his/her treatment done in the private sector. This trend has been observed over the last decade or two.
The question to be addressed by people at helm is why has this happened! Health is a state subject, not much funding available for government hospitals, apathy of the politicians and bureaucrats, corruption in purchases of medical equipment and drugs, lack of maintenance and biomedical engineering departments in the hospitals, poor facilities, dirty wards, unhygienic facilities and many more reasons can be attributed to this malady. However, in my opinion, it is introduction of Non Practicing Allowance or what is popularly called NPA is the root cause of this problem.

NPA was introduced in the late 60s to stop government-employed doctors from doing private practice within the boundaries of a government hospital. Before its introduction, doctors were allowed private practice in special OPDs in evenings, thus helping them augment their incomes as well providing more income to the government. As time passed, the low total remuneration of a doctor started having affects on maintenance of academic standards for doctors. Continuing medical education in the form of books, journals, attending workshops and conferences is a part and parcel of a doctors life. However to do