Jammu Healthcare Policy Care less, show busy, do nothing

 

Rajan Gandhi

Jammu Public Health system is a tiered structure designed to get innocent patients into web of PHCs, SDH, DH and finally GMC. Pursuant to COVID-19 situation and to prevent the spread of Corona virus all the OPD services at GMC and its associated hospitals Jammu were suspended on March 25. General public of Jammu division was advised to stop visits to OPD at GMC and its associated hospital. For 48 days OPD remained closed till 12 May 2020 except consultation on phone if patient was lucky enough. Nobody gave a second thought that during the closure of OPD and putting the surgeries on hold will add further miseries to the patients who have health issues other than Covid-19. How is it possible to treat critical ailments over a phone call, that too by a doctor who isn’t aware about medical history of the patient and with no inter district movement during lockdown patients faced lots of inconveniences in terms of getting passes, transport facility and other issues, due to which most patients just avoided critical check-ups and follow-ups which otherwise is very important for them. In between whole administration claimed best facilities for one and all but factually except few dedicated doctors it was a paid vacation type situation. Jammu healthcare has been crumbling for quite a long time but those at the helm of affairs just remained least bothered and ignored all warning signals as such least planning, no vision and the result is in front of everyone now. The same health administration which hogged the lime light with ‘Best Performing Large State Healthcare Award’ was just hiding behind excuses and passing on the buck to junior level staff. Transparency is the hallmark of any institution which helps to foresee the problems and helps in planning for future but this is not the case with Jammu Healthcare system. PGIMER, Chandigarh, an institute which came up in 1962 is a practical example how to raise the bar and no compromise while serving people. From computerization of labs to introduction of a token system at OPDs and placement of information kiosks in all buildings, the tertiary care institute of PGI, which receives about 10,000 patients daily, has adopted a hospital management system with integrated software modules, covering the general OPDs, specialties, super-specialties of about 80 wards. Under ADT (Admission, discharge and transfer) module, nurses in all 80 wards have been keeping an electronic tracking of patients from the point of admission, acceptance in the wards, transfer from one ward to another, until their discharge. An SMS facility for informing patients when their reports are ready to be accessed from the web is very much part of present day PGI. The institute has connected all radio-diagnosis machines to the network in order to give access to MRI and CT scan images in OPDs which is going to help doctors in better patient management. Now come to our own GMC, also established way back in 1973 and shifted to Bakshi Nagar building in 1993, right now five hospitals are associated with GMC Jammu. For last few years GMC website is depicting total bed capacity of 1700, 800 doctors including faculty and residents, 1000 paramedical staff including supervisory staff, 1500 Class-III and IV employees working in the college and its associated hospitals, no addition of staff for years! Hibernating administration was caught sleeping on files as usual shortage of staff on every front was the excuse. Ventilators in hundreds remain dumped for months together with no staff and no oxygen to operate them. Different wings of health and medical education seem to work in opposite directions. Director Health Services Jammu, National Health Mission, Jammu and Kashmir Medical Supplies Corporation all were caught on wrong foot and nobody seems to be in control of anything. Delay even in purchase of ambulances just speaks of rotten system prevalent in the different wings. Non operational oxygen plant with no backup, outdated machinery, almost nonexistent power backup, outdated operation theatres, delay in purchases of critical medicines, initially non availability of even PPE kits for doctors, you name the thing and criminal negligence will be the obvious reason. PHCs, Sub District Hospitals and District Hospitals have just become referral centres to GMC. NHM, SSB, JKPSC are just sitting on vacancies for years together and hospital administration is happy with backdoor SRO employments. What can be more criminal than the fact that pharmacists have been temporarily employed as security guards and are running even emergencies in the Jammu City Hospitals. On one hand thousands of unemployed medical graduates/diploma holders protesting for jobs and on other hand hospitals have hundreds of vacant vacancies. Coming to planning part, Super Speciality Jammu is without emergency since its inception despite all critical Heart and Neuro units operating from there. Instead of building emergency, the adjacent land has been assigned to build cancer institute. Similarly 200 plus bed Maternity Hospital coming under SMGS Hospital which in turns report to GMC but has been built in the premises of Gandhi Nagar Hospital which comes under DHS Jammu. Not only overlapping of interests but how a maternity ward will operate when paediatric ward and hospital is still at SMGS Shalamar. All these show that there is least practical planning in the whole process. Coming back to GMC, how a private CT Scan and Ultra Sound unit came up in hospital premises and if such extra space was available why hospital didn’t install its own equipment. For a simple Holter Test patient has to go two storeys down to chemist shop to get cells and electrodes for operating machine. Back to COVID, SOPs have been ignored as far as doctors are concerned. Even when positive tested patients got operated or child deliveries done, not all doctors and other staff members have been tested nor quarantined. Even positive tested doctors are made to work on the plea that they are asymptomatic and shortage of staff. All these are against SOPs issued by HMO and MoHFW, why can’t doctors working outside GMC be assigned to overcome shortage of staff. There are 15 plus Urban Health Centres / Evening Clinics established in Jammu City some years ago which are nothing but the brain child of some of the politicians and bureaucrats for absorbing their kith and kin well within the city. Every UHC is having Medical Officers and other staff and government is unnecessary spending money for no use. Surprisingly majority of these doctors posted in these clinics are females and have remained within Jammu City for decades together. A peek into transfers just reveals the mafia of transfer industry of doctors. No transparency in transfers at all. Seriousness of the authorities can be gauged from the fact that there is no biometric attendance system right now in place due to Covid excuse with the result supporting staff busy with their own patients, technicians running their own laboratories and many senior doctors untraceable. With only private medical treatment option available in GMC, Col. Chopra Nursing home, closed way back public has no option except to rush to neighbouring Punjab for treatment in COVID also. GMC and associated hospitals can start evening paid OPD’s with retired and serving doctors and other staff at a reasonable fee but who cares. Such is the dire state of healthcare that leave alone politicians, IAS/IPS even Director Health Services went for private hospital treatment when tested positive for Covid. Even claim of Health Department substantiates miserable condition of Health services in Jammu as out of 59 lakh non Covid OPD visits since April only 18 lakh in Jammu Division and 41 lakh in Kashmir, is there any comparison? Tesla Type 3 MRI Machine in GMC is waiting for installation for over three months and highly contagious bio medical hospital waste treatment agency’s payment also pending for more than three months. What happened to enquiry about death of two brothers who were made to wear PPE kits in June on Tawi river bed or drug store fires in which medicines worth crores were burnt or investigation of spurious drugs being supplied? What can be more self explanatory about the state of affairs at GMC when its own Principal writes for premature retirement? All these hue and cry resulted in another Commissioner being made Administrative Coordinator for all non-treatment related issues at Hospitals in Jammu in addition to existing Health and Medical Education Commis-sioner. After oxygen fiasco resulting death of patients ultimately in charge Advisor visited GMC for cosmetic round but got heckled by attendants of patients. Shoot the messenger itself seems to be the official policy as main gates of GMC were closed subsequently. Even LG paid a visit but nothing has changed on ground as practically administration is trying to treat a cancer patient with simple Paracetamol instead of major surgery. How can there be no Deputy Director Health Services Jammu or additional charge Medical Superintendent at GMC or Administrator without much power. It seems all these are meant to pass on the buck as the game of musical chairs goes on and on with public suffering. With no accountability fixed till now, no heads have rolled, why better known to higher ups. Care less, show busy and do nothing is the official health policy right now. feedbackexcelsior@