Private Practice by Government Doctors: Legal Insights

Private Practice by Government Doctors continues to test the boundary between public duty and personal gain across India’s health system. Specifically, doctors who draw salary from from public exchequer must devote their full time to government service. Yet many still see patients privately on the side. As a result, this practice drains attention from public hospitals and quietly pushes patients toward private clinics instead. In Mirzapur, for example, a recent grievance against a government doctor working in a PPP-run MCH wing shows exactly how blurry this line has become. Therefore, vigilance committees now face real pressure to define what counts as private practice within hybrid public-private models. Ultimately, until officials enforce the existing ban consistently.  Private Practice by Government Doctors will keep eroding trust in public healthcare delivery.

🩺 The Conundrum of Private Practice by Government Doctors: A Challenge in Mirzapur and Beyond

Private Practice by Government Doctors remains a major challenge to public healthcare in India. Indeed, it creates a deep conflict between public service and personal profit. Meanwhile, recent legal directives and administrative action in Uttar Pradesh, especially in Mirzapur, show how hard this ban is to enforce. In fact, a recent grievance filing makes this struggle clear.

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⚖️ The Legal and Administrative Framework Around Private Practice by Government Doctors

Overall, the conflict rests on a clear legal position. In particular, officials do not criminalise private practice, but they strictly ban it for doctors who receive a Non-Practicing Allowance (NPA).

• Supreme Court’s Stance (2011): First, the apex court clarified that private practice by government doctors does not constitute a criminal offence under the Prevention of Corruption Act or Section 168 of the IPC, even where state policy prohibits it. However, it does violate service rules, and consequently, this violation mandates departmental action. As a result, this ruling confirms the State’s power to regulate or prohibit the practice administratively.
• Allahabad High Court’s Directive: Similarly, the High Court recently directed the Uttar Pradesh government to strictly enforce its 1983 government order, which bans private practice by doctors who accept NPA. Specifically, this directive followed widespread complaints about conflicts of interest and about patient referrals from government hospitals to private clinics.

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⚠️ The Mirzapur Enforcement: A Case Study in Accountability

For example, the administrative response in Mirzapur shows how officials are trying to operationalise the ban, particularly given one specific public grievance.

I. Formation of the Vigilance Committee

First, following the government directive (Letter No. 86/P.S. (Med. Health and Medical Education) / 2025), officials constituted a District Vigilance Committee in Mirzapur. Then, the District Magistrate approved it on 14.02.2025.

• Mandate: Under National Health Mission (NHM) guidelines, the committee must, above all, monitor health services, review complaints (including unauthorised private practice), and recommend corrective actions to ensure accountability.
• Composition: Typically, the District Magistrate (or a similarly senior official) chairs the committee. In addition, the Chief Medical Officer (CMO) serves as Member Secretary, alongside other health and law enforcement officials.

II. The Specific Grievance against Dr. Santosh Shukla

Notably, the public grievance (PMOPG/E/2025/0026174) explicitly names Dr. Santosh Shukla, a government doctor under the CMO, Mirzapur, and raises a crucial question:

• The MCH Wing Conflict: Does the doctor’s work at the MCH (Maternal and Child Health) Wing — which operates on a Public Private Partnership (PPP) model — amount to private practice?
• Logical Approach Required: Therefore, the grievance calls for a clear, explicit report on whether working in a PPP setup violates the spirit or letter of the ban for a government doctor who draws NPA, even though the setup is technically separate from a fully private clinic. In other words, this question hinges on the nature of the doctor’s employment and compensation within the MCH wing.

III. Call for Non-Practice Certificates

Furthermore, the Additional Director of Medical Health and Family Welfare, Vindhyachal Division, has reinforced this enforcement push further. Specifically, he directed all CMOs to immediately furnish a certificate confirming that doctors in their monitored hospitals do not engage in private practice and do not refer patients to private hospitals or nursing homes. In effect, this administrative step forces accountability and formal documentation.

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📉 The Deeper Issue: Corruption vs. Effective Governance

Ultimately, the core challenge, as the grievance notes, is not a lack of rules — rather, it’s a failure of enforcement.

For instance, when officials circumvent or ignore rules due to systemic failure and weak accountability, the ban loses its meaning. In fact, one description calls this a “deep-rooted systemic failure” where “rules exist but are not respected.” So, the newly formed Vigilance Committees carry real weight. Above all, their success will depend on whether they can:

1. Impartially investigate specific cases like that of Dr. Santosh Shukla.
2. Establish clear guidelines on what constitutes “private practice” within hybrid models like PPP.
3. Ensure swift and deterrent departmental action against confirmed violators.

Until administrative will matches the legal mandate, in short, this conflict of interest will continue to undermine public trust and the quality of essential government health services.

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🤝 Blurring the Lines: PPP and Private Practice by Government Doctors

Essentially, the core of the issue lies in how officials define “private practice” and how they classify a doctor’s employment in a facility like the MCH Wing, which operates on a PPP model. In fact, this is exactly the grey area that makes Private Practice by Government Doctors so hard to police in PPP-run facilities.

1. The Principle of Non-Practicing Allowance (NPA) vs. PPP

To begin with, service rules — like the Uttar Pradesh 1983 Government Order — legally bind a government doctor who receives a Non-Practicing Allowance (NPA) to devote their full time and energy exclusively to public duties. Specifically, officials pay the NPA in place of the doctor’s right to earn income from private practice.

• The Private Practice Ban: Accordingly, the ban covers any work that brings pecuniary gain outside the official government salary and duty hours, or any activity that creates a conflict of interest and leads to the neglect of public duties.

2. How the PPP Model Complicates the Issue

Generally, Public-Private Partnerships aim to leverage private sector efficiency, investment, and expertise to improve government services. In this context, the MCH Wing, which operates on a PPP model, involves a contract where a private entity manages or provides certain services, often using public infrastructure.

Element	Government Hospital Duty	PPP-Run MCH Wing Duty
Payer	Government (Taxpayer Funds)	Private Concessionaire/PPP Entity (may include user fee revenue)
Goal	Public Health Service (no-cost/low-cost)	Public health goal (with efficiency mandate)
The Crux Question	Can officials depute a doctor here?	Does the private partner pay the doctor additional remuneration?

The Conflict for Dr. Santosh Shukla

1. First, if officials formally depute Dr. Santosh Shukla to the MCH Wing as part of his government duty, the government pays his entire salary (including NPA). This work technically isn’t private practice. Instead, it’s a re-deployment within the public health system.
2. On the other hand, if Dr. Santosh Shukla receives any additional payment, honorarium, fee, or incentive directly or indirectly from the private entity managing the MCH Wing, it becomes tantamount to private practice. In that case, this extra payment counts as pecuniary gain outside the official government pay structure. This situation violates the NPA rule.
3. Conflict of Interest: Even without direct pay, if the doctor’s involvement in the PPP wing leads him to refer patients from the main government hospital (where service may be free), it creates a clear conflict of interest. Referring patients to the MCH wing (where fees may apply or run higher) constitutes an ethical breach.

3. The Logical Approach for the Vigilance Committee

Therefore, the Mirzapur District Vigilance Committee needs to focus its enquiry on the source of funding and terms of engagement:

• Source of Remuneration: First, the committee must confirm whether Dr. Shukla receives only his government salary and NPA, or whether the private concessionaire also pays him — even on a part-time basis — while he works at the MCH Wing.
• Terms of Deputation/Engagement: Next, if officials deputed him, the government order authorising this deputation must explicitly state that he will not receive any extra compensation from the private partner. In this way, it upholds the principle of the NPA.
• Documentation: Finally, the committee must review the concession agreement for the MCH PPP model to check whether it allows the private partner to use and compensate government doctors.

Above all, the ban’s core intent is to secure government doctors’ unfettered commitment to their public post.
Consequently, any arrangement that financially benefits a doctor for work performed outside the strict terms of public service amounts to a form of private practice.
Officials must address it.

In conclusion, until enforcement catches up with the law, Private Practice by Government Doctors will keep undermining public trust in India’s healthcare system.
This issue is a form of private practice.
It must be addressed.