Mananthavady District hospital
There is a discussion going on about upgradation of this hospital. My personal 2 cents;
The author is a resident of Mananthavady, studied and worked in Calicut Medical college for 10 years,worked in all Govt. Hospitals in Wayanad,including DH Mananthavady, and worked in superficiality PVT hospitals in Calicut.
Upgrading to a Medical College will make only negative impact on health scenario in Wayanad. strange? I will explain.
The Negatives
1. Tons of investment for infrastructure. Highly uneconomic to plan and execute.
2.Huge amount of running cost,compared to return. We need at least 10 specialities and 2-3 superspecialities. Each Department will hold at least one Professor.,2 or 3-Asst professors and 3-4 lectures.Now think about salary.One lac to 1.5 lac is spent for each doctor as salary and benefits.. When taking an average, (200 X one lac)=Rupees two crore will be spent for salary for one month for doctors only. Nurses,Paramedicals, Administrative and others will be paid around the same figures in total. Reserve 4 crore for salary only.
3.Medial College is designed for teaching. But unfortunately they are notorious for patient care and most importanly delay of service. Take examples of Medical Colleges of Thrissur,Alleppy and Kottayam. Patients are considered only as student's subjects. They will not get proper attention and care,but will get experiments from young house surgeons and medical students, even from Nursing students. None of the real and qualified doctors will be available after 1 pm for anything. In case of any failure in treatment,they can hide any malpractice in within the shield of Academic Teaching. But in the other side, teaching quality is too poor. Literally none of the so called Professors will teach correctly and perfectly. No researches or presentation of papers is taking place. Students are gained knowledge from their books and experiments from poor patients. The patients will suffer ultimately with delays or negligence. Only thing will correctly occurs may be "Private Practice" of doctors.
5. Do you think this Goverment Medical colleges will provide good opportunities for admission for middle and poor class? No. Our system is like that. Thrissur based tution institutions control the admission. Outstanding students are exemptions, MBBS entrance is a distant dream to an average studentin Kerala. 90% of existing MBBS students are from financially well families. Thanks for the Entrance system and coaching malpractices.
4.Already Kerala is saturated with Medical Doctors. Proliferated self financing colleges producing more and more graduates. About 2000 freshers are coming out from Kerala and another 2000 from outside. Where they will work? within 5 years they will be surplus and unemployment will prevail. Remember, only less than 3000 post are there in entire Kerala. They will go out side country or go to private hospitals.
5. Estimated that about Rs.36 lac been spending by government for each MBBS student to make him as a doctor. Govt Medical colleges will become only a producer without any return or benefit. Only 50 or 100 MBBS doctors in an year will come out of from this proposed medical college.They will not work in govt service. There will be no vacancies too. Private sector will be happy as they will get good and free supply of young doctors without any cost or worry.
7.So this FACTORY will not give anything in return to general public who given their share as taxes.
Poor man will suffer more, Govt will shed millions of money in sea.
8. Presently,in District hospital we are getting a qualified and EXPERIENCED Care from doctor freely. Medical College will destroy this two factors too.
9. Medical Colleges are no more considered as the highest care giving institutions. It was before 20 years ago. Now Corporate hospitals and private hospitals in cities has all facilities and top class patient care. If anybody having some money in pocket will definitely prefer private hospitals than a Medical college.
9. Medical Colleges are no more considered as the highest care giving institutions. It was before 20 years ago. Now Corporate hospitals and private hospitals in cities has all facilities and top class patient care. If anybody having some money in pocket will definitely prefer private hospitals than a Medical college.
Need to improve the system. Then how?
1.Develop the infrastructure and facilities of the District hospital. Make like RCC and Sree Chitra Institute where we will get excellent care under Govt.
2.There is an impression that Govt Hospitls are only for poor peoples and economically and sociologically backward classes. Here is the problem. Its for general public. But upper class people will not come to the hospital for treatment. If asked they will say about lack of service or medicines, unhygienic and smelling wards etc. So better to stay in a private hospital. Okay, Its a fact but they are not bothering about other poor people who is suffering all those things. We have to come forward to question and find a solution. The comfort which we expect in private hospitals should be bring to the government sector. politicians, Government employees and business men in Mananhavady should use the service of government sector. Then only we know what is required more and when real questioning happens, authorities will allow sufficient funds.
2.There is an impression that Govt Hospitls are only for poor peoples and economically and sociologically backward classes. Here is the problem. Its for general public. But upper class people will not come to the hospital for treatment. If asked they will say about lack of service or medicines, unhygienic and smelling wards etc. So better to stay in a private hospital. Okay, Its a fact but they are not bothering about other poor people who is suffering all those things. We have to come forward to question and find a solution. The comfort which we expect in private hospitals should be bring to the government sector. politicians, Government employees and business men in Mananhavady should use the service of government sector. Then only we know what is required more and when real questioning happens, authorities will allow sufficient funds.
4. with good administration,We have good example of a Government hospital working properly as a model. Eranakulam General Hospital, It is like almost a private hospital. All facilities available,neat and clean good administration. Punalur Taluk Hospital is another example.
5 Allow more specialities and superspecialities. As salary(and designation as a doctor in Govt) is attractive we will get enough doctors. Number posts of doctors and other staffs should doubled or tripled so that there should be 2 shifts for Outpatient's Clinic.OP should work in evening up to 9 pm in night. Number of Nurses and Technicians should increased as per workload. Peripheral hospitals, PHCs ams CHCs should be modernised. Extra care for Mobile units in Tribal areas with all facilities should be strengthened.
6. More facilities and equipments should be installed. All services can be connected to a Hospital Information system(HIS).Computerised patient registration and HIS will provide correct and updated patient history of all details with one or two mouse clicks. Radiology and lab services will be better and fast. The overall cost is less (= a doctors salary), but benefit is huge. Digital Xray,CT, MRI,US , Auto analysers, daily monitoring in ICU or in ward,patient record library etc ..all should connected. Workload will be very less in this system. Aadar number and health insurance card also connected to this system so that It can be used for other government schemes and projects.
7. Surrounding area of District hospital should be developed. Attach the land of Govt.UP school,(As it already destroyed by wrong policies)village office, sub registrar office, Vet hospital, RDO office, PWD office,IB, DYSP office,DMO office and build good quality buildings with parking facility. These offices can be moved to Mini civil station. The vast area behind DMO office and Pazhassi tomb Can be used for modern buildings.
8.Hygiene and sterility Is very important in hospital and Govt workers Cannot achieve his level due to various reasons. Cleaning should be outsourced to a modern Firm using completely by machinery.Half of the all salary to the present workers( calculate 100 attenders X 20000 average= 20 Lacs per month ) is enough for this
9. Nursing service also should have some revamp.More staff and training in modern equipment.
10. Digitised queue for OP and and online reservation system in Pay wards and consultation/surgery etc. Can be archive by making a website with nominal Initial cost.
11. I think we can achieve all these with a quarter of fund otherwise used for a medical college.And this is the practical way implemented easily by a economy like Kerala.
In short I tried to explain we need a good Tertiary care hospital under government, but not a medical college.
Thank you
Other posts related to Wayanad in this blog
Your observations are true. The situation of teaching hospitals are same everywhere be it government or private run.As you said it is necessary to strengthen existing district hospitals in India.This will help a lot not only in improvement of treatment of patients, But also avoid burden of going to super speciality hospitals for not serious conditions.
ReplyDeleteHi I am fm Mananthavady...ur posts about wayanad is highly appreciable
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