Revamping Public Health Care system

Not to speak of hospitals in towns and districts, the state of affairs in main city hospitals is beyond description

Dr Mohamad Amin Malik
Srinagar, Publish Date: Jan 23 2018 11:43PM | Updated Date: Jan 23 2018 11:43PM
Revamping Public Health Care system

There is no greater blessing on earth than having a good health. This is enunciated by the famous proverb “The greatest wealth is health”. Health is more important than learning, in view of the fact that once you are living well, you can learn things better and once you are sick, all your education is affected. Particularly in this part of the world, we may live without education but if a disease breaks out, it can wipe out the entire population. The public health care system in Kashmir has always remained in news headlines, mostly for bad reasons. Every now and then, there are controversies, attacks on doctors which are followed by protests and hartals. For the realization of demands, the patients become hostage.  The genesis of the problem lies in the fact that doctors' attention and time is directed more towards their private practice and they are unable to provide full time service in public hospitals.  Even the Doctors Association Kashmir (DAK) has accepted this fact that private practice by Govt. doctors is responsible for health care mess in Jammu and Kashmir.

Not to speak of hospitals in towns and districts, the state of affairs in main city hospitals is beyond description. The hospital workload is mainly run by junior doctors while the seniors remain busy with their private clinics. It has become virtually impossible to consult a specialist doctor in Govt hospitals for a problem. From scams in the supply of medicines/equipments to Govt. hospitals, the drug mafia, nursing-home-doctor-nexus and promotion of fake and costly branded drugs and sprouting up of diagnostic labs everywhere to unwanted prescriptions, investigations, procedures/operations has put a price-tag on our heath. Our huge population today is involved in the dreaded diseases like diabetes, heart, kidney and orthopedic ailments etc. An increasing proportion of people are using private health care facilities and many rely on compounders, self medication and some fly to different Indian hospitals for treatment. The primary reasons of this woeful situation is the absence of doctors in the hospitals, dissatisfaction with quality standards and the attitude of hospital staff.

 

Aftermath of recent sting operation on SKIMS doctors, the people on social media were really involved, conveying  the act was deplorable and conducted with certain ulterior motives to destabilize health sector in the valley. Some wrote that it was a conspiracy hatched at Nagpur to implant something in the SKIMS to serve their interests and many others said that it was sinister game to defame and discredit Kashmiri doctors and malign the reputation of SKIMS. While there is no doubt about the professional capabilities of our doctors and we still have doctors with impeccable ethical records and that too in SKIMS, many have carved a niche in their field of research at the international level,  nobody can condone the wrongdoing of some doctors. When reputed doctors are doing private practice it doesn’t remain hidden to any quarters. Then, the incident didn’t happen for the first time, just few years back a team of officers accompanied by police carried a raid on some clinics, the video footage is still being played by people on social media. If we have failed to control these evils ourselves and an agency comes forward to expose it, why blow things out of proportion and politicize it. It was a simple complaint against few doctors and not Kashmir bashing. 

We should form an unbiased and reasonable opinion about the evils present in our society and not endorse corruption and justify wrong doings of others. People may have relationship/receiving free treatment from concerned but we must think of the agony of general masses. Our population mainly depends upon Govt hospitals as they cannot afford expensive private care. Then, public healthcare is a fundamental right of every citizen. Wearing aprons may not be a big deal for doctors but it is their recognition, a privilege and important for maintaining discipline in an organization. The SKIMS is a tertiary care hospital and doctors are provided excellent service conditions to pursue research, academic activities besides hospital duties. The research needs quality time, energy and perseverance. It is not the case of surrendering NPA, doing private practice or taking NPA and also doing private practice. The NPA is a very small amount for people earning in lakhs. The simple reason follows, we least bother about our jobs, institutions where we get job-security, huge emoluments, retirement benefits and honor in the form of titles like professor, doctors and HODs on which we thrive on.

The private practice by doctors should not be seen as need of the hour or the birth right of people. While accepting the whole-time public employment the doctors have also accepted the basic condition governing all public employment-that they shall not undertake any private practice/any venture for monetary gains, which shall hamper their duties at the institution. A doctor who attends hundreds of patients at his/her clinic from 7-10AM must be stressed and fatigued and thus less productive, how can he justify his role for public hospital. No person on earth can do work beyond limitations. What history a doctor is supposed to collect in 1/2 minutes which is not sufficient to write a prescription? Patients need doctor’s time, eye contact and assurance that they care about their health. One need to investigate when and how the doctors find time to update themselves in the latest developments in their fields. If doctors would honestly engage in their duties and academic pursuits, they would surely have no time for private practice.

When health care has a profit making motive, we can never reap the benefits of excellent healthcare. The huge money spent to reorient and strengthen the public health systems doesn’t yield any measurable results. The time has come to chalk out a strategy to revamp the whole sector and streamline the working of medical practitioners. Instead of maintaining the option of allowing private practice, the authorities should strengthen the public hospitals with facilities and incentives for doctors and ban all Govt doctors from doing any kind of private practice. To cope with the increasing rush of patients, the hospitals need augmentation of infrastructure and filling vacant positions of doctors to increase doctor/patient ratio. The public health care will improve only if doctors put their foot down and dedicate their fulltime with the job in the hospitals.