Health Care delivery Services is essential essence for every living soul in the Society as such it is not only social obligation and responsibility of every citizen of the society but also to all social related groups and organization, besides particularly premier responsibility of the Government of the people to provide Health Care delivery services to all of its citizens and every Government or every World or Country incurring maximum expenditure on this vital Sector for the welfare and well being of their people and the Government of India or UT of J&K has no exception, But, this vital Sector lacking various issues which mainly affects the functioning of this sector despite availability of Infrastructure created for the sector, therefore all these issues and policies and decisions needs to be revisited for proper and better health care delivery services in general and particularly in our UT of J&K and I am inviting attention of the Government of UT of J&K towards the issues delineated hereinbelow as under :-
1)Producing Efficient Doctors
There is need to produce efficient and
skilled doctors for
for which the Government should have not only revisit the policy while formulating the process of selection of doctors but also to improve the quality of teaching Medical standards of the institutions where such doctors were under-going such trainings. There is no clear cut policy of the State/UT Government regarding selection of doctors for under-going graduate and PG degrees every year as per the actual requirement such doctors with the result every parents desires to send their in-eligible wards out-side the State & Country for imparting Medical Education training on monetary donations, who have not only qualified NEET Examination here but have qualified in low merit after a many attempts in 10+2 examinations, and some have even not interest in the said field, but undergone due to compulsions of their Parents. As and when, these doctors came with the degrees and practising in the private sector and subsequently got Government in the public sector. The percentage of such doctors are very high and mushroom growth of these doctors are raising day by day which is becoming concerns for proper and better health care delivery Services in the UT of J&K. It can be imagine and analysed, a medical candidate who have no worth of efficiency have undergone under-graduate and post-graduate degree out-side the State or Country on Monetrary donations will not certainly cater the requirement for our proper health care delivery services efficiently, but almost tries to treat this noble profession as a business to get back their investment (invested on donations, fees etc, during their training out-side) returned by any means through this noble medical profession. It is also been witnessed that the State/UT Government have started recently number of Medical Colleges in this State/UT, but all such Colleges have not been properly equipped in respect of Infrastructure and manpower as per laid down norms laid down by NMC of India. Under these circumstances, it will also impact on the efficiency and quality doctors to be produced in future for our health care delivery services in the State/UT. It would be appropriate that Government should have establish new Medical Colleges in this State/UT in a phased manner by providing adequate infrastructure and manpower subject to availability of funds so as to poduce efficient and quality doctors for proper Health Care Delivery Services in the State/UT.
With a view to ensure efficient and quality Doctors for Health Care Delivery System, the State Government shall work-out Annual actual requirement of Graduate & Post-graduate Doctors in the State/UT of J&K for deputing them in such Medical Colleges of the State or Out-side where stands of Medical Education are at par with the available guidelines prescribed by the NMC, Government of India. However, the State Government shall equip all such newly Established Medical Colleges in respect of Infrastructure and manpower in a phased manner and student shall be deputed to such Colleges accordingly. Moreover, the State Government/UT of J&K shall issue blanket ban for under-going Graduate and Post-graduate Medical training admissions out-side the State/Country. However, the State Government shall devise policy for deputing such adequate number of candidates to these recognized Colleges out-side the State/Country on the basis of Selection/Merit in the Examination to be conducted for the purpose subject to requirement to be determined after deputing candidates within the State/UT, so that efficient and quality doctors are produced in this State/UT for our proper health care delivery services.
2. Mushroom Growth of Private Hospitals/Clinics in the State/UT
It has been witnessed that Private Hospitals/Clinics in the State/UT are increasing day by day. No doubt, it is the need of the hour to have more and more such Hospitals/Clinics to cater the requirement of the people, but the same shall have good standard of quality in respect of infrastructure and manpower, besides shall have completely regulated as per the available guidelines/ norms to be prescribed by the State Government.
It has been seen that retired doctors/businessman doctors are going to establish such Private Hospitals/Clinics in the state/UT especially in the twin Cities of Srinagar/Jammu in order to get hefty amount of Rupees from poor patients where mostly in-service doctors are practising and Government doctors working in Government Hospitals are pushing such patients in these Private Hospitals for Surgeries/treatment. Most of the Private Hospitals in the Cities of Srinagar/Jammu stands established in the congested area of residential locality where traffic stands almost jammed and most of them have even not proper vehicle parking facilities.
It would be appropriate if the State Government shall issue blanket ban on private practise of doctors. However, the State Government shall formulate guidelines/norms for opening of Private Hospitals and Clinics, Poly Clinics, Evening Clinics where un-employed doctors can be adjusted by the Government on the pay & allowances, and terms & conditions to be determined by the Government and services of in-service doctors can be utilised in such Evening Clinics on the rates, terms & conditions to be determined by the Government. It would not only provide quality and efficient doctors available at Private Hospitals in the State for proper health care delivery services to the people on Government rates, but also provide jobs to un-employed Medical Youths in the Private Sector on the terms, conditions, pay & allowances to be determined by the Government. It will also facilitate Private Practise to the doctors but as per the terms, conditions & honorarium to be fixed by the Government after working hours/duty of the doctor.
In view of the above, the State/UT Government is requested to formulate and enact the law for Establishment of Private Hospital, Clinics, Poly Evening Clinics in the State/UT as per the available guidelines of NMC Government of India in respect of Infrastructure & Manpower and recruit/appoint the un-employed doctors in all such Hospitals/Clinics (along-with in-service experienced and qualified doctors after working hours/duty) after proper selection on the pay, allowances, terms & conditions to be determined by the State Government. This will not only ease the rush of Patients in the Government Hospitals, but people especially poor will get services of efficient doctors including tests on Government rates with the result health care delivery services shall improve in the State/UT at large extent.
3. Availability of Senior Doctors in the Hospitals
It has been observed in all the Government Hospitals in the State/UT that no Senior Doctors are available in Emergencies and only Internees or Junior or Senior Resident doctors are available for treatment in Emergencies which is great concern especially during odd and nights. However, Senior Doctors are being called “On Call”, but it does not suffice the purpose as it is not alternate for availability of full time Senior doctors of all Departments/Specialities to remain available to meet the requirement of the Emergency Patients. Due to this policy of the Hospitals, patients mostly died in the Hospital after reaching the Hospital within 48 hours in absence to availability of Senior Doctors of all disciplines. The Emergency patients as and when reaches to the Hospital would have almost multiple problems and needs Consultation, treatment and decision of various Senior Doctors of different Departments/Specialities, as such availability of internee, or Junior/Senior Resident doctor or even on call any single Senior Doctor in one Specialities could not suffice the purpose of treating such Emergency patient having Multiple diseases and problems with the result he expired.
The doctors after working hours might have not interesting to work in their Hospitals during late hours or on Holidays and Sundays, because they almost indulging in private practise, so were eager to leave from their place of postings immediately for their private clinics for private practise.
In view of the above, I request the Government that all the Government doctors working in the Public Sector shall be banned for
doing Private Practise and for improving health care delivery services in the Government Hospitals, all doctors, Senior doctors including HoDs shall be put on roaster duty. However after banning the Private Practise, all such doctors shall be given Non Practising Allowance (NPA) as admissible under rules.
4. Avoiding of rush of Patients in Health Institutions/Hospitals
A very chaos in Government Hospitals has been Witnessing for the last so many decades despite opening of new health centres/ PHC’s/Sub-District Hospitals/District hospitals/Government Medical Colleges in the State. The fact of the matter is that opening of more and more Health Institution either it may be Medical College or District Hospital or Sub-District Hospital or Primary Health Centre at State, District. Tehsil or at Block level respectively does not fulfil the demand of the requirement arisen day by day with regard to Patient care and does not overcome the rush of patients. You have seen as nothing has been happened on ground due to opening of such more and more institutions in the State for the last so many decades as witnessed and reported with regard to avoid rush of patients and proper health care delivery services to the ailing community at their door steps.
Therefore, this methodology for proper health care delivery services
has not proved futile, as such the same has ben taken up without proper formulating viable policy and has been executed without application of mind. It would be proper and viable if District Hospitals in the State should have been strengthened and upgraded in such a way that Super Specialized treatment with sophisticated machines and Specialized doctors would have been made available to the people in their own District with the result these people should have not gone to SKIMS Soura or in Srinagar Government or Private Hospitals in the twin Cities of Srinagar and Jammu for their treatment in order to increase the rush the load and chaos in these Hospitals as even for minor treatment People came to twin Cities of Srinagar and Jammu for their treatment. It will also not only involves traffic jamps in all the Districts of the State, but also in the Hospitals also.
In view of the above, the State/UT Government shall
Put blanket ban for opening of new Health Institutions in the State till existing Institutions including District Hospitals are fully equipped and Strengthened in respect of Manpower and Equipment’s at par with Super Specialized Hospitals of Srinagar/Jammu in a phased manner , so that people shall not move out-side their home district for treatment and no Institution or District Hospital shall entertain patients of other districts and no patient shall be referred out-side the District as when there would be availability of all Specialized facilities and doctors in their home district.
5. Utilization of services of Senior HoD’s for Patient Care
It is astonished to say that a Senior HoD of any stream/discipline who shall be available in the Hospital or Operation Theatre for patient Care has been witnessing and found in the official meetings or dealing official business of the Government when he may be elevated or given charge of the post of Principal or Director in Health & Medical Education Department. I think it is very strange that such qualified and senior doctor having much experienced in their relevant field of doctrine or Surgery would have been a better choice to remain available for patient care in the Hospital or Operation Theatre rather than discharging the duties of an administrative head of the institution.
I am not against the growth and promotion of Senior HoD working in Health & Medical Education Department, but I am of the view that Senior HoDs be given higher promotion as Director of their respective Departments with next higher pay scale but shall exclusively given the responsibilities for the patient care in the Hospital and the posts of Principals and Directors shall be filled from the administrative cadre of IAS/JKAS which will be assisted by the concerned Directors/HoDs of the respective Departments to carry the administrative work in all the institutions of Health & Medical Education Department in the interest of patient care.
In view of the above, I request the Government to revisit the issue concerning patient care for formulating the proposal for filling all posts of Principals of Medical Colleges and Directors of Health Services from IAS/JKAS by providing alternate higher promotions to the HoDs of Health & Medical Education Department as Directors of their concerned department subject to the condition that they will continue to work exclusively for the Patient Care in the Hospital and assist Principals and Directors of Health Services in the administration as and where required with regard to their concerned Department for smooth functioning of the administrative work in the interest of administration/patient care.
6. Collaboration among various wings /sectors of Health & Medical Education Department and adoption of Research mechanism thereof to improve the professional skills for the betterment of patient care.
Various wings in Health Sector are working for health care delivery services under their respective Heads of Departments like Principals of their Medical Colleges and Similarly under Block Medical Officer at Block Level, Chief Medical Officers at District Level and under Director Health Services at District Level. No doubt all such wings/organization working in their areas for health care delivery services, but there are no coordination between these wings with regard to sharing their professional expertise or referral system to each other for the better and qualitative medical services and treatment for the patients. It has been observed that funds sanctioned by the Government to Hospitals for Research activity purpose were utilized for purchase of Computers and other electronic gadgets and these practice should be stopped and Research wings needs to be Established in all Hospitals to facilitate their doctors to research on various diseases for the patient care and such research needs to be got acknowledged from the concerned reputed institutions of the Country, so that utilization of doctors in these endeavour are properly utilized for the patient care from this State as well.
In view of the above, I request that referral system shall be explored in all health institutions in the State and proper c0ordination, consultation with all senior faculty in the relevant discipline available physically as well as through virtual mode to guide and discuss the issues for treating the patient in a better way , besides exploring establishment of Research Centres in all; hospitals linked and connected with all reputed health institutions within and outside the State.
7. Utilization of Retired Senior and Experienced Faculty doctors in Hospitals for Patient Care.
It is to inform that our Senior and experienced doctors prepared by in our Government Medical Colleges of the State and Country were seen in the private sector after retirement for doing excellent business in health sector and there is no policy of the Government to utilise their services after retirement for patient care.
Our Hospital lacks experienced and qualified doctors for the patient care and vacuum would also arise when Senior Faculty doctor or HoD retires from Government services. No such Senior doctor or HoD shall made available in the concerned Department, but his junior will get the charge of him after his retirement and resultant vacancy will filled up from un-employed junior doctor through selection process or sometimes academic/temporary arrangements are being made by the Government. But it has been seen that only un-employed doctors are interested on such temporary or academic arrangement basis and our retired senior experienced doctors/HoDs are not interested and mostly prefer in private Sector within and outside the State on monetary financial benefits and there should be no consideration of their responsibility towards their society as the society has given such rise to these doctors to become such experienced qualified doctor through various Government Medical Colleges/ of the State/Country.
In view of the above, I am of the view that the Government shall come out with enactment of Law that every doctor of the Government Medical Colleges of the State/Country shall be made available for the Society after retirement to serve the ailing and patient community and the Government is bound to pay them legitimate honorarium/salaries. This will facilitate the Government to utilize the services of an experienced, qualified and senior doctor/HoD after retirement for the Patient Care if and where required on monthly remuneration/salary to meet the requirement/deficiency in one hand and other hand we will in a position to utilise the services of any doctor for the society for the patient care.
8. Establishment of full fledged Control Room in all Hospitals of the State
There are CMO (Causality Medical Officers in all the State hospitals, but it cannot suffice the purpose in a big way for proper health care delivery services for the patient care. A full fledged Control Room having requisite manpower and infrastructure including latest digital and electronic gadgets needs to be established in all the Hospitals who will co-ordinate between various Sections/Departments/
9. Reviewing and strengthening of AYUSH Sector in the State- regarding.
The Indian Systems of Medicine & Homoeopathy, now AYUSH sector is an important and vital sector of the Health Sector from Centuries as it is an old traditional system of treatment of India. This systems being very effective in various ailments and known for without side effects and is not only system of treatment, but providing complete healthy life of treatment to the populace with free from all diseases. However due to casual and ambiguity approach of the Government, this Sector has not been properly utilized for the health care delivery Services in the State of J&K in the interest of patient care/Society.
The State Government mostly appoints Heads of Departments in this Sector either from deputation from other streams of the Health Department or sometimes Junior most doctors within and outside the Department, as it would reflects the poor functioning of the Department as only senior capable and experienced doctor from AYUSH Sector could lead the Department to the expected levels in the interest of patient care.
It is need of the hour that diseases and ailments which are mostly treated by these doctors efficiently through their tested medicines recognized by the Government needs to brought to the limelight and referral systems shall be explored of such patients from all Hospitals to these Ayush doctors/Ayush centres for treatment by exploring proper co-ordinations and relations for the patient care by identifying such areas of disease, treatment and way of treatment. The Professional discussions programmes needs to be arranged not only between AYUSH doctors and allopathic doctors, but it should be arranged among various reputed Government, private and retired doctors of different Hospitals of the State for the patient care for proper and improving of health care delivery services in the State.
Besides, a vital and important component of this Ayush Sector has been almost neglected by not patronaging a viable comprehensive policy for its successful implementation on the ground which component is called “Medicinal Plants”. It is not a component or Sector but a big Industry which not only augment Ayush Sector but also Health Sector and all various sectors in the State. This sector has been ordered to look after some portion of it to Forest Department, some of which by Ayush Department , but all in shabby and without any objective action plan and proper policy for its successful implementation 0n the ground
It is inform that our farmers cultivate Fruits and Vegetables in their Farms and Lands and in case these farmers shall cultivate the Medicinal Plants in their fields, it will boost the economy of our State manifold and shall not only provide employment to our youths but also generate revenue in a big way to the State and there is no need of funds for Ayush Sector but Health Sector as a whole as well in the State.
In view of the above, I request the Government that Senior and experienced Ayush doctor may be appointed as HoD and Principal of Ayush Department/College for its proper promotion & development in right direction, besides Medicinal plants sector may be declared as an Industry in the State like Fruit Industry and Department of Agriculture and Horticulture may be entrusted the responsibility to cultivate the Medicinal Plants in the State on commercial basis. However, experts from Department of Ayush, Forest and Regional Research Laboratories, Jammu/Srinagar and from other State/Central government/Private organizations shall be provided to them for the purpose to accelerate the opportunity of un- employment and generation of revenue and economy of the State through this vital Sector after making proper, realistic policy.
In the last, I appeal to the Hon’ble Lieutenant Governor, Hon’ble Chief Minister, Hon’ble Minister for Health & Medical Education and other officers of Health & Medical Education Department to have a look on my suggestions on merits for improving an important and vital Health Sector of the UT for Health Care Delivery Services in the UT of J&K in a proper and planned manner.
Thank You.
—The writer can be reached on Email id:- [email protected]
