PATNA, Jan. 5 -- Bihar's health secretary Lokesh Kumar Singh on Saturday cautioned government doctors, hospital administrators and clerks that negligence and complacency will not be tolerated anymore. Chairing an online review meeting with civil surgeons from across the state, Singh issued a blunt ultimatum, saying doctors and staff unwilling to perform their duties should resign, as the era of merely passing time in government service was over. Emphasising that government service cannot be treated as a formality, he said negligence would not be tolerated under any circumstances and non-performing personnel must either be proceeded against or asked to step aside so that young doctors could be recruited. The secretary expressed serious concern over widespread irregularities in duty rosters and biometric attendance, noting that in several districts doctors were neither adhering to assigned rosters nor taking biometric attendance seriously. He directed superintendents, in-charges and officers to carry out regular rounds and surprise inspections to ensure staff presence and compliance. Singh, who focused on enforcing discipline, accountability and tighter monitoring across the healthcare system, also instructed civil surgeons to closely monitor data uploaded on 'Bhavya', a healthcare monitoring portal, warning that mismatched or incorrect reporting would attract strict action. A major focus of the meeting was the alleged operation of 'tout' (middlemen) networks within health institutions. The secretary said complaints had been received from multiple districts about private ambulance drivers diverting patients from government hospitals to private nursing homes. Questioning the lack of effective action so far, he asked civil surgeons to develop and implement concrete plans to dismantle these networks, making it clear that decisions taken in the meeting must translate into action on the ground and not remain confined to files. The review also exposed serious shortcomings in the health management information system (HMIS) and duty postings. It emerged that duty postings had not been updated in many districts, while HMIS was either poorly updated or completely non-functional in several blocks, a situation the secretary described as alarming. Singh expressed strong displeasure over the role of senior clerks, particularly those posted for years in civil surgeon offices. He said clerks were running the system according to their own whims in many places, harming the department's image. Ordering an immediate transfer drive, he said clerks who had been stationed at the same place for long periods would be shifted, beginning with Patna civil surgeon's office, where staff from other districts would be brought in. He also warned that repeated complaints of misbehaviour by clerks would not be tolerated. Raising concern over viral images and videos of dead bodies from government hospitals, the secretary said such incidents were damaging the image of both the department and the government. Pointing to internal involvement in the circulation of such content, he directed all hospitals to form media cells, fix clear accountability for media-related activities and ensure dignified handling of bodies. He also stressed the need to ensure adequate availability of ambulances and stretchers, underlining that humane and responsible functioning of hospitals was non-negotiable. Singh asked civil surgeons, superintendents and medical officers in-charge to use their financial powers up to Rs 5 lakh to ensure availability of adequate stretchers and wheelchairs at health facilities and to provide mortuary vans and even ambulances, in emergency cases, to ferry dead bodies....