On 10 December 2025, over 3,000 government doctors across Haryana went on an indefinite strike despite the state formally invoking the Essential Services Maintenance Act (ESMA) to prohibit any such action. The ESMA order, valid for six months, was meant to ensure uninterrupted healthcare, but the Haryana Civil Medical Services Association decided to escalate anyway after months of unresolved negotiations. Their core anger centres on the government’s decision to allow direct recruitment of specialist medical officers instead of promoting existing doctors, and delays in notifying an assured career progression (ACP) structure that was reportedly approved in 2024. Outpatient care has been heavily disrupted in several districts, even as emergency services limp on with skeletal staff and around 1,500 doctors redeployed from other facilities to plug gaps.
The Times of India
For doctors on the ground, the conflict is not just about pay; it is about dignity, recognition and the fear of being permanently side-lined in their own system. Many describe feeling betrayed that after years of service in understaffed hospitals, promotions are being opened to outsiders while their own ACP benefits remain stuck in files. ESMA’s shadow adds another layer of emotional strain: they are acutely aware that they could face disciplinary action, charge sheets or even prosecution, yet also feel they have exhausted polite channels. Patients, meanwhile, turn up to find cancelled OPDs and long queues at the few functioning services, fuelling public frustration that can easily turn against frontline staff. HR professionals in health systems will recognise the psychological cocktail here — pride in service, anger at perceived injustice, guilt about patient impact, and a deep worry that speaking up can be punished rather than heard.
The Times of India
From a compliance and leadership perspective, this standoff illustrates the hard edge of using ESMA as a labour-relations tool in essential services. Legally, the state can demand that doctors return to work, maintain attendance lists and initiate proceedings against those who remain absent, but that does not resolve underlying issues around career pathways, staffing norms and promotion frameworks. For health-department HR and administrators, the ACP dispute is a reminder that service conditions must be transparently codified, notified on time and implemented consistently; vague promises are no longer enough when professional futures are at stake. Leadership needs structured dialogue mechanisms with associations, early-warning systems for discontent, and clear communication on how recruitment and promotion align with long-term workforce planning. Without that, every change in recruitment policy risks triggering strikes, ESMA orders and damage to public trust in government hospitals.
What would a fair and transparent promotion and ACP framework for government doctors look like in practice?
How can governments use ESMA without destroying the trust they need from essential professionals during crises?
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7The Times of India
For doctors on the ground, the conflict is not just about pay; it is about dignity, recognition and the fear of being permanently side-lined in their own system. Many describe feeling betrayed that after years of service in understaffed hospitals, promotions are being opened to outsiders while their own ACP benefits remain stuck in files. ESMA’s shadow adds another layer of emotional strain: they are acutely aware that they could face disciplinary action, charge sheets or even prosecution, yet also feel they have exhausted polite channels. Patients, meanwhile, turn up to find cancelled OPDs and long queues at the few functioning services, fuelling public frustration that can easily turn against frontline staff. HR professionals in health systems will recognise the psychological cocktail here — pride in service, anger at perceived injustice, guilt about patient impact, and a deep worry that speaking up can be punished rather than heard.
The Times of India
From a compliance and leadership perspective, this standoff illustrates the hard edge of using ESMA as a labour-relations tool in essential services. Legally, the state can demand that doctors return to work, maintain attendance lists and initiate proceedings against those who remain absent, but that does not resolve underlying issues around career pathways, staffing norms and promotion frameworks. For health-department HR and administrators, the ACP dispute is a reminder that service conditions must be transparently codified, notified on time and implemented consistently; vague promises are no longer enough when professional futures are at stake. Leadership needs structured dialogue mechanisms with associations, early-warning systems for discontent, and clear communication on how recruitment and promotion align with long-term workforce planning. Without that, every change in recruitment policy risks triggering strikes, ESMA orders and damage to public trust in government hospitals.
What would a fair and transparent promotion and ACP framework for government doctors look like in practice?
How can governments use ESMA without destroying the trust they need from essential professionals during crises?
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A fair and transparent promotion and ACP (Assured Career Progression) framework for government doctors would involve clear guidelines and criteria for promotion. This could include years of service, performance evaluations, and professional development activities. The framework should be communicated to all doctors and implemented consistently.
For example, the framework could state that after a certain number of years of service, a doctor is eligible for promotion to a higher position. This promotion would be based on performance evaluations and any additional qualifications or professional development activities the doctor has undertaken. The framework should also include provisions for doctors who wish to specialize in a particular area.
As for the use of ESMA (Essential Services Maintenance Act), it is a powerful tool that can be used to ensure essential services like healthcare continue during crises. However, it should be used judiciously and as a last resort. Governments should first try to negotiate with the striking workers and address their concerns. If ESMA is invoked, it should be accompanied by a clear communication explaining why it was necessary and what steps are being taken to address the workers' concerns.
In this case, the government could have avoided invoking ESMA by negotiating with the doctors and addressing their concerns about the ACP framework and direct recruitment of specialist medical officers. They could have explained the reasons for the direct recruitment and assured the doctors that their career progression would not be affected.
In conclusion, a fair and transparent promotion and ACP framework, coupled with effective communication and negotiation, can help avoid strikes and ensure the smooth functioning of essential services. Governments should strive to maintain trust with essential professionals, as their cooperation is crucial during crises.
From India, Gurugram
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For example, the framework could state that after a certain number of years of service, a doctor is eligible for promotion to a higher position. This promotion would be based on performance evaluations and any additional qualifications or professional development activities the doctor has undertaken. The framework should also include provisions for doctors who wish to specialize in a particular area.
As for the use of ESMA (Essential Services Maintenance Act), it is a powerful tool that can be used to ensure essential services like healthcare continue during crises. However, it should be used judiciously and as a last resort. Governments should first try to negotiate with the striking workers and address their concerns. If ESMA is invoked, it should be accompanied by a clear communication explaining why it was necessary and what steps are being taken to address the workers' concerns.
In this case, the government could have avoided invoking ESMA by negotiating with the doctors and addressing their concerns about the ACP framework and direct recruitment of specialist medical officers. They could have explained the reasons for the direct recruitment and assured the doctors that their career progression would not be affected.
In conclusion, a fair and transparent promotion and ACP framework, coupled with effective communication and negotiation, can help avoid strikes and ensure the smooth functioning of essential services. Governments should strive to maintain trust with essential professionals, as their cooperation is crucial during crises.
From India, Gurugram
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