Arunachal: Govt Enforces NPA Surrender for TRIHMS Doctors, Sparks Debate Amid Healthcare Strain
But in a state where healthcare is a lifeline, critics call for comprehensive reforms, not piecemeal relief.
ITANAGAR- The Arunachal Pradesh government has formally directed doctors at the Tomo Riba Institute of Health and Medical Sciences (TRIHMS) to surrender their Non-Practicing Allowance (NPA) if they wish to engage in private practice — a move officials say will empower doctors financially but which critics warn may deepen the state’s fragile healthcare crisis.
The policy, floated in 2022 under CM Pema Khandu, has now been enforced across all government medical facilities. Doctors must choose between retaining the meagre NPA — a central allowance meant to bar private practice — or relinquishing it to legally moonlight at private clinics.
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Health Minister Biyuram Wahge defended the step, saying: “This is a pragmatic solution. Many were already practicing unofficially due to financial pressures; now, we formalize it to boost morale and reduce attrition.” Compliance forms must be submitted by October 15, 2025.
The NPA, pegged to 6th Pay Commission rates, has long been a grievance among Arunachal doctors, who argue it barely offsets costs of living in the state’s remote terrain. The Arunachal Pradesh Doctors’ Association (APDA) says the policy may help, but insists salary hikes and better working conditions are essential to tackle overburdened shifts.
At TRIHMS, the state’s premier medical college and tertiary hospital, the directive coincides with mounting strain. As per information available, Only 8 of 33 GDMOs currently handle emergency duties, and a 48-hour statewide doctors’ strike last week exposed vulnerabilities in security, staffing, and public trust.
Impact on Services
Staffing pressure: Critics warn legalized dual practice could reduce on-call availability, worsening emergency care.
Retention vs. ethics: Supporters argue it may stem the exodus of doctors, but APDA cautions of conflicts of interest.
Rural access: With 80% of Arunachal’s population in villages, patients risk higher private costs and weaker public access.
The state’s MMR (150 per 100,000) and infant mortality rate (35 per 1,000) already exceed national averages, and TRIHMS handles 70% of complex referrals. Any diversion of staff attention could threaten maternal and child health gains.
The Road Ahead
Student and civil society groups demand 7th Pay Commission revisions, rural posting incentives, and security protocols alongside NPA reforms. Without systemic fixes, experts fear the policy will ease doctors’ earnings but strain a system already short 500 specialists.
The government insists the measure balances fairness with pragmatism. But in a state where healthcare is a lifeline, critics call for comprehensive reforms, not piecemeal relief.
