Sanjay 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 depletinghuman 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.Very often, social groups, independent columnist in the media pin point the shortcomings in the healthcare delivery system in the country getting mixed response from the people at the helm of affairs.In 2019, 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 court farmed a committee of experts from PGIMER Chandigarh and Retired Senior Faculty members from GMC Jammu/Srinagar, SKIMS, both Director HealthServices 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”.
The expert committee as mandated, after visiting the GMCs and peripheral hospitals of the State/UT, and if WhatsApp university has to be believed, the committee has submitted its report for Kashmir after about two years of its framing. The report for Jammu Division might also be ready and may be put to public domain separately. The delay in submitting the recommendations for improvement of Medical Facilities in Jammu Division is not known yet, in spite of the fact that there are already sharp existing dipartites between the two regions vis a vis Human resources, Infrastructure and Machinery and Equipments. We believe 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 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 had been sharing my views on the issues relating to Health & Medical Education in the State/ UT/ Country through my articles captioned, ‘What Ails Medical Profession?’; “Medical University: A Boon for Healthcare infrastructure in J&K”, ‘Mushrooming of GMCs’, Ban Private Practice of Government Doctors Avoid Mud Slinging and so on. I am happy that most of the suggestions given in my above titled articles have been directly or indirectly incorporated in the recommendations. Through this article would like to discuss the recommendations of the committee vis a vis giving my outputs to improve overall health scenario in JKUT especially the medical institutions like GMCs. Let us first discuss the recommendations of the committee given under three headings as (i) Issues related to Human Resources, (ii) Issues related to Infrastructure and (iii) Issues related to Bio-medical Equipments.
Issues Related to Human Resources: the committee has broadly recommended:
i) Tenure of Principal should be 4 to 5 years.
ii) Principal should be given substantial financial powers.
iii) Principal should be selected on the basis of seniority cum suitability taking into considerations; research, academics, credentials, team leadership and vision.
iv) High powered committee should choose the Principals consisting of eminent medical fraternity from inside and outside the UT/State.
v) Faculty deficit should be taken care of with abolition of post of Lecturer, making it three tier in GMCs: Assistant, Associate and Professor. Instead of PSC, the in house high powered committee to select the faculty at entry level.
vi) Higher Pay and desired allowances/incentives to the faculty.
vii) Ban on private practice by the teaching faculty and increase in working hours from 8am to 5pm with Saturday as half day.
viii) Better promotional avenues and regular skill upgradation of the clinical faculty including research methodology.
II. Issues Related to Infrastructures: the committee broadly recommended following:
a) Establishment of a Medical University.
b) Private wards @ 10% in each hospital.
c) Residential facilities for doctors and paramedics.
d) E-Hospital & IT initiatives.
e) Upgradation of OTs, ICUs and creation of Trauma Centre.
f) Low cost Pharmacy.
g) Auditing of referrals and back referrals.
h) Multiple Parking & Dharmshalas.
III. Issues Related to Equipments: wherein the committee opined that there is severe shortage of Equipments in almost all the departments and concerned departments and faculty should be involved in the technical specification and ample funds should be earmarked for the same.
All the observations and the suggestions given by the high-powered committee are of paramount importance in improving overall healthcare infrastructure in the GMCs of JKUT which is much needed in the larger interest of patient care, academics and research to produce better undergraduate and postgraduate doctors. Next I shall add on to the recommendations and try to give priority wise suggestions for consideration by the decision makers.
(The author is Hony. Secretary, JK Chapter of Association of Surgeons of India Member Secretary, Institutional Ethics Committee, GMC Jammu)
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