In 2011 union health ministry approved regional geriatric center (RGC) at Sher-e-Kashmir Institute of Medical Sciences (SKIMS) for treatment and care to state’s senior citizens. The institute was among eight hospitals picked up by then union health minister Ghulam Nabi Azad, across all states, for establishment of the centers. Subsequently, 12 more regional centers were announced. Today, most of these centers are operational in different states while others are at various stages of execution. However, seven years on, the SKIMS center is still a distant dream. Funded by union ministry under National Program for Health Care of Elderly (NPHCE), the center was meant to provide separate, specialized and comprehensive healthcare to senior citizens. Apart from running round-the-clock OPD services the center had to be equipped with 30 dedicated beds with requisite staff and equipment for healthcare of people aged 60 and above. The center was also expected to start postgraduate course in geriatric medicine with an intake capacity of two doctors annually. “The ever-increasing rushing of patients to the institute has an impact on management of ailments of elderly people. Often these elderly people are seen waiting in queues for long hours, in OPD, diagnostics and admissions. This category of patients often faces untold misery. Keeping it in view, the geriatric centers would have come as a big relief for treatment and care of senior citizens,” said a senior doctor. However, not only has the center been delayed for seven years now, the funds allocated for its construction has been diverted in violation of norms, as per an audit report by office of accounts general, audits and accounts department, government of India. In June this year the accountant general wrote to SKIMS authorities raising serious objections to the manner in which SKIMS has “handled” funds for the RGC project. The report underlines that the land for construction of separate 30-bedded RGC was to be provided by SKIMS. “However that was not done. Instead, the RGC was clubbed with state cancer institute (SCI),” reads the report. The decision to allot ground floor of under construction five-storey SCI to RGC, instead of setting up separate geriatric center as defined under the central program, was taken by SKIMS governing body in 2012. The report highlights that union health ministry had taken strong objections to merging of two projects and rejected the proposal. However, by then, SKIMS had diverted Rs 2.01 crore funds meant for constructing infrastructure for RGC to the SCI. Subsequently SKIMS authorities decided to use cancer wards at institutes’ regional cancer center for geriatrics once the new cancer institute gets completed. The SCI is far from completion, notes the report, and therefore it would take a “very long time” till existing cancer wards of SKIMS are made available for geriatrics. “As a result geriatric ward and OPD for establishment of 30-bedded RGC as envisaged under NPHCE guidelines cannot be created despite passing of seven years,” the report highlights. Now, since the SKIMS is unable to submit utility certificate (UC) for funds already allotted to it for the RGC, the union health ministry has not released further funding under the project. Talking to Greater Kashmir, Inder Prakash advisor to union health ministry on NPHCE said: “Initially it was promised (by SKIMS) that a separate building will be set up as geriatrics center. The funds were allocated, used and then suddenly we heard that the building has been dedicated to something else,” he said. Prakash said implementation of the project was responsibility of state government and only funds had to be provided by union ministry. “We are not in a position to help the situation. It is the state government that needs to come up with a solution to this grave issue,” he said. He said the SKIMS needs to set up a separate building for RGC as was initially decided. “If they constructed something with funds meant for RGC, they need to find a way for setting up setting up the center,” he said. According to Prakash it was a matter of concern that the first geriatric center in the country was yet to see light of day. “By now we were expecting it to have started functioning and provide care and treatment to elderly population of the state,” he said adding that he was “personally saddened” by the delay. A senior official said the ministry hasn’t released remaining funds for the project. “These will be released to SKIMS only when we submit utilisation certificates for Rs 5.83 crore allocated to for the center,” the official said. Apart from funds for construction of the RGC, Rs 1.2 crore was also released to SKIMS for establishment of video-conferencing unit to be utilized for capacity building and mentoring. However, the report states that even this center has not been started and therefore no capacity building of staff was taking place at SKIMS. The RGC guidelines lay stress on capacity building of doctors and para medics working in peripheral hospitals for management of elderly patients. The RGC SKIMS has sanctioned posts for a professor, two assistant professors, four senior residents, 16 nurses, two physiotherapists, an occupational therapist, a social worker, and other staff. Recently, a memorandum submitted by heads of over 20 departments of SKIMS to Raj Bhavan sought Governor’s attention towards the delay in construction of the geriatric center.
7 YEARS ON, GERIATRIC CENTER AT SKIMS A DISTANT DREAM
