Quality healthcare in disarray

Kuldeep Chauhan

Himachal is ranked the second best state in the country in reducing neonatal mortality rate, which remains 28 per cent per 1,000 live births. Its other health indicators are also ranked among the top-ranking states of the country. But the reality on ground is different. 

Patients still cry for quality healthcare at tertiary level and basic healthcare at the primary level because the state lacks enough specialists and medical officers. 

The government is opening five more medical colleges (three already started) to make up for the shortage of doctors at both level, but it is still wrestling in holding back specialists who are looking for greener pastures.

The diseases burden has multiplied over the years. The state has been reeling under unprecedented outbreaks of dengue (4,041 cases) and scrub typhus (1,632 cases) mainly in Bilaspur, Solan, Mandi, Shimla, Hamirpur and Kangra, which have taken 24 lives (19 due to dengue and five due to scrub typhus) till October 16 this year.

Also, towns like Shimla, Mandi, Chamba, Bilaspur continues to report regular flow of hepatitis patients in hospitals, with two deaths out of 300 patients so far, though the outbreak season starts in winter months.

These outbreak together with the strike or protests by resident doctors, anganwadis and the staff of 108 national ambulance service for more pay and wages have pushed the health services to a corner that still remains a “priority number four” after education, PWD and irrigation, if one judges it by the budget allocation of the state government. 

Health got Rs 2,181 in 2018-19 budget, a 11.5 per cent hike as compared with last year, which is as good as 10.1 hike for the police.

After completing 10 months in office, the present government is struggling to cope up with the rush of patients at the two tertiary care hospitals in the state — the IGMC, Shimla, and Tanda medical college, and at zonal hospitals, too. The critically ill patients who need “super specialty care” continue to be referred to the PGIMER and AIIMS and other private hospitals in the region, as the state lacks specialists while quality care facilities remains deficient.

The super specialty block of the IGMC, which is under construction is yet to be completed, while the work on AIIMS at Bilaspur is yet to start due to a delay in land transfer. The 100-seat Ner Chowk Medical College in Mandi is starting its functioning from October 20, but it has no facilities like MRI and CT scan to provide quality healthcare to patients.

What to talk about the new medical colleges — Nahan, Chamba, Hamirpur and Ner Chowk — the old IGMC and Tanda medical college are still being run without holding the regular departmental promotion councils (DPCs) by the state bureaucracy, which rules the roost, say the member of the HP Medical Officers’ Association. 

As per the MCI guidelines, minimum 24 different faculties are needed to run a new medical college. But current practice is that the successive state governments are hiring faculties of the IGMC and Tanda by sending them on deputation for a few months to paint a rosy picture of faculty position in colleges during inspection by the MCI.

But even the MCI inspection was nullified by Union Health Minister JP Nadda under the new norms that has given a free run to medical colleges. While the Nahan college management hired “most of the retired doctors from a defunct medical college from Pathankot”, the Chamba medical college is being run by the retired and hired doctors from J&K, sources said. These colleges are being run in the district hospital buildings and provide a few diagnostic facilities for patients.