Sanjay Kr Bhasin
Healthcare delivery system had been under watch of social groups, media, and commoners for quite sometimes now, in view of fast growing population, increased demand for healthcare and fast deteriorating infrastructure and depleting human resources in Government sector. India as a welfare nation has constitutional obligation to provide near free healthcare to its ailing population for another at least 50 years till India attains the status of “Developed Nation”. Every now and then, there are efforts from social groups, independent columnist and even media persons to pin point the shortcomings in the healthcare delivery system in the country. These suggestions get mixed response from the people at the helm of affairs. About a year back, the Division Bench of Hon’ble High Court of Jammu and Kashmir while hearing two PILs seeking improvement in medical facilities and infrastructure in JK UT observed, “Court is not an expert body which can advice on the issues as to how medical infrastructure available in the Union Territory of Jammu and Kashmir has to be improved and in what manner to bring it at par with the best medical facilities available in other parts of the country”. The Hon’ble Division Bench farmed a committee of experts from PGIMER Chandigarh and Retired Senior Faculty members from GMC Jammu/Srinagar, SKIMS, both Director Health Services and Principals of two GMCs to examine infrastructure, machinery and human resources in the hospitals and directed that wherever improvement is required, recommendations shall be made for the same. The court also said, “……..However, it is expected that whatever fair opinion or suggestion the doctors available in various hospitals can give to the members of the committee. The same will go in a long way to provide best medical facilities to the residents of Jammu and Kashmir”.
Now after about a year or so of pronouncement of the interim advice by the Hon’ble High Court, the expert committee has started its exercise as mandated by the court and visited GMCs and peripheral hospitals of Jammu Province in the first instance from 28th to 30th January. We hope that in addition to interacting with HoDs and other senior faculty members for better out puts, they might have physically visited all the vital areas of these hospitals like OTs, ICUs, Emergency Wings and so on to take stock of the situation directly for a comparison with other institutes of the same standing as well of higher standing to suggest best possible measures for making these health institutions, the “Centers of Excellence”.
As senior member from the profession, I would like to suggest that certain things should be kept in mind to improve overall health scenario in JKUT especially the medical institutions like GMCs.
Medical Education versus Health Care: Producing quality graduate (MBBS) and postgraduate (MD/MS and MCh/DM) doctors is the sole responsibility of Medical Institutions in addition to research and tertiary healthcare. Unfortunately in last two decades, the medical institutions have been relegated to the positions of healthcare delivery centers rather than becoming Institutions of Excellence for Medical Education. Lack of proper infrastructure and equipment, forced burden of patient care due to unnecessary referral from Sub-district and District hospitals, has directly affected the academics and research work. Overcrowding coupled with associated factors make doctors handicapped in providing quality services to the patients at Sub District and District hospitals, leading to more and more referrals to the Medical Colleges. Downhill course of Medical Education in India needs to be interrupted immediately to avoid collapse of medical education.
Lack of Qualified Faculty Versus Less Emoluments: Engaging best teaching faculty for Medical Colleges and even AIIMS/PGIMER has become a great challenge in the era of Corporatization of Health sector in India. The situation of faculty in all the GMCs is too grim. Less Pay/perks being offered to the medical/paramedical manpower also keep medical man power away from joining government sector. At contemporary posts/experience/qualifications there is huge gape of pay/perks between corporate hospitals and Government hospitals.
Medical Equipments: purchase of new and good quality medical equipment to cope up with the growing trends in medical science has always remained a great problem in already established GMC’s. Even repair of the equipments requiring very small amounts passes through tedious official process.
Suggestions:
Autonomy to the Medical Institutions: For smooth running of medical institutions, they should be given greater autonomy without much political and bureaucratic interference and influences. High powered Institution councils need to be established with medical persons of highest integrity and qualities as members of the council including Dean/Principals of all medical institutions and all HOD’s. The annual budgets should be kept at the disposal of the council with a well placed accounts and planning department whose head should preferably be an HOD of major specialty. Adhoscism at any level in medical institution should be discouraged and all Medical Colleges needs to be brought under the domain of a Medical University.
Establishing a Medical University: In view of fast expanding healthcare infrastructure both Government and private; the two universities of Jammu as well as Kashmir are facing difficulty to cope up with work load of deciding curriculums as well as exams related issues. Ex-Chief Minister of Jammu and Kashmir announced establishment of Medical University in the state on 18th December 2016; that has to see light of the day. Presently, all over India there are 30 Deemed Medical Universities and 14 Full Medical Universities, 10 being state controlled. Every endeavor should be put in by the J&K Government to get Medical University for JKUT.
Better and positive media reporting: Media hypes of trivial incidents in the hospitals create confusion and wrong impressions amongst the masses that the government doctors are not interested in work. Such narratives can easily be avoided as the same shall not help improving the system and rather have deleterious effects. Making Government sectors defunct and projecting the corporate shall not be in the larger interest of anybody as almost 90% of the JKUT population is dependent upon Government health sets ups. Media as a sympathizer to the poor general masses must resort to Positive Journalism.
Conclusion: New policies and announcements of schemes in democratic system are always welcomed and needs practical shape for overall welfare of the masses. Unfortunately, work on them either does not start or if it gets started by individual pursuance, it becomes so slow that completions crosses deadlines many a time. There are high hopes that the highly qualified and experience Expert Committee shall be submitting an excellent roadmap to the Hon’ble High Court for overall improvement of Healthcare system in JKUT on the basis of best outputs received from the HoDs and senior faculty as well as physical inspection of the infrastructure, machinery and human resources by the committee itself.
(The author is Hony. Secretary, JK Chapter of Association of Surgeons of India Member Secretary, Institutional Ethics Committee, GMC Jammu)
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