The state administration Monday ordered a slew of measures to ensure “greater accountability” with regard to referral of patients from Kashmir’s peripheral areas and their safe transit, days after the denial of admission to a pregnant woman at Srinagar’s Lal Ded hospital triggered a massive public outcry.
A top government authority held a video-conference with administrators of various health institutions of the state to discuss the circumstances that led to the shocking incident, where the woman from Moorie area of northern Kupwara district was forced to deliver a baby on road after being sent back from the LD hospital.
The video-conference was presided over by governor’s advisor K Vijay Kumar and attended by principal secretary, health and medical education department, Atal Dulloo, principal government medical college Srinagar/Jammu, director health services Kashmir, head of the department gynecology and obstetrics GMC Srinagar, medical superintendent LD hospital and other officials of the department.
Following the meeting, a number of decisions were taken to improve maternity healthcare in Jammu and Kashmir, while the GMC Srinagar was instructed to formulate guidelines and recommendations for referral of patients from districts to tertiary-care hospitals and submit the same within two days.
These guidelines, according to an official who was part of the meeting, will decide the conditions/ailments that would merit a referral from a peripheral health institution and those cases which could be “handled” in peripheries only.
“These guidelines, if adopted, should decrease unnecessary and irrational referrals from peripheral hospitals and reduce the unnecessary load on tertiary-care institutions,” the official said.
Moreover, the heads of directorates of health services in Jammu and Kashmir were instructed to prepare an inventory for referrals which should “justify” why the patients were referred.
A notification was also issued Monday making it mandatory for all healthcare professionals to record their names, designations, seal, registration numbers on all prescriptions, investigations and referrals.
Secretary health and medical education, Atal Dulloo, said the government was keen on ensuring rational referrals along with improved facilities in peripheries and today’s order was part of “our commitment towards this goal”.
“We have already issued posting orders of 921 medical officers in far-flung and rural areas to improve doctor-patient ratio there,” he said.
A referral from any institute would need to be “accounted for”, he said.
An official said the government was planning to institute “referral audit committees” for directorates of health in Jammu and Kashmir divisions, which were also instructed to make interventions to strengthen maternity services in the peripheries.
Director health services Kashmir Dr Kunzes Dolma said the government has decided to expedite steps to ensure 24×7 maternity services in district hospitals by way of adding staff there.
“We have a good maternity service in many of our district hospitals, but we do need more staff which we discussed with the government today,” she said.
The directorate has also been ordered to make sure that a healthcare provider accompanies a woman being referred to any tertiary-care hospital.
On Thursday afternoon, Surayya Begum of Moori village, who was 34-weeks pregnant, was rushed to primary health center Kalaroos by her relatives. The doctors at the PHC referred Begum to district hospital Kupwara, from where the doctors sent her to the Lal Ded hospital.
At LD ’emergency’, after preliminary investigations and examination, Begum was asked to go home at 8 pm by the doctor-on-duty, according to her relatives. Within half an hour of leaving the hospital, Begum delivered a baby on the road, outside Masjid Noor at Bemina here, her brother had said.
“The baby was born alive, but died moments later, while my sister wreathed in pain on the road.”
The incident triggered outcry in Kashmir and led to a demand for strict action against the doctors involved in the alleged negligence.
WON’T TOLERATE ANY LAPSES IN FUTURE: KUMAR
Taking a serious note of alleged mishandling of a pregnant lady from Kupwara at LD hospital, advisor to governor K Vijay Kumar Monday conveyed his sympathies with the affected family and assured a thorough enquiry into the unfortunate incident.
An official spokesman said chairing a high-level meeting, the advisor informed that the governor has instructed that hospital authorities across Jammu and Kashmir should strictly adhere to the standard operating procedures in the case of referrals to tertiary-care hospitals.
“No negligence in observing these SoPs would be tolerated in future,” he said.
Maintaining high standards of healthcare delivery to the citizens of the state should be observed at all costs and that the governor’s administration is committed to fill in all the existing gaps of manpower, equipment and infrastructure to strengthen the primary healthcare system across the state, Kumar said.
The advisor sought recommendations to identify the lapses and gaps so that such incidents do not take place in future.
He directed the principal GMC Srinagar and Jammu and director health services Kashmir/ Jammu to identify nodal officers who shall solely be responsible for streamlining the referrals from primary and secondary healthcare institutions to tertiary-care hospitals in the state.
He said that directions have been issued as part of the ‘auditing mechanism’ that doctors’ prescriptions shall be inscribed with seal/ stamp mentioning name and credentials of the prescribing and referring doctor so that responsibilities can be fixed in any eventuality.