J&K has vibrant public health sector, will ensure it gets stronger: ACS Vivek Bhardwaj

Financial Commissioner (Additional Chief Secretary) Health and Medical Education Department, Vivek Bhardwaj says that the health infrastructure in J&K doesn’t necessarily need more buildings and concretisation but overall strengthening of the healthcare service delivery system as he vowed to make it stronger. In an interview with Greater Kashmir’s Senior Editor, Nazir Ganaie, the ACS spoke on a wide-range of issues.
File photo of Additional Chief Secretary Health and Medical Education Vivek Bhardwaj
File photo of Additional Chief Secretary Health and Medical Education Vivek BhardwajFile: PHD Chamber/YouTube

Greater Kashmir (GK): What key initiatives are being taken to prevent coronavirus in J&K?

Vivek Bhardwaj (VB): We have made a systematic and robust responsive system in order to deal with the novel coronavirus in Jammu and Kashmir. And I must credit my doctors and paramedics who ensure that all goes well at every level with no further loss of life. It is entirely our collective effort; the government, doctors can’t do anything without the active support of the general public. It is also essential for us at the administrative level to keep reviewing the situation and preparedness for a full-blown and vibrant response system. In the recent case of Omicron variant, we undertook the review with the help of health experts as well as those from the field of our preparedness as well as tenacity of our response mechanisms to manage the cases. I am also of the opinion that we need to keep reviewing and monitoring the preparedness, identify the gaps and strengthen core capacities in surveillance, laboratory support, infection prevention and control, logistics, risk communication and in particular, hospital preparedness in terms of isolation and ventilator management of critically ill patients.

GK: Are J&K hospitals prepared to tackle the Omicron wave?

VB: Omicron has been identified as a widespread variant engulfing the the world; it has become the dominant variant in many countries, and the world is experiencing the highest daily new COVID-19, so is the case in Jammu and Kashmir since the start of the novel coronavirus pandemic. We have directed the Deputy Commissioners and divisional level administrations to enhance the testing rate and contact tracing for positive patients to trace infection trajectory and establish micro-containment zones at an early stage. Our hospitals are very well equipped to tackle any kind of medical emergency…and importantly, the people must follow Covid Appropriate Behaviour in letter and spirit then only we will combat the virus successfully.

GK: Jammu and Kashmir was quick to reach the target of mass vaccination. How is it going across the twin regions now?

VB: Jammu and Kashmir has taken a lead in the mass vaccination programme. Now the vaccination drive for the teens in the age group of 15 to 18 years also started across the UT. Around 8.33 lakh children will be vaccinated at around 1640 sites across the Union Territory. I have already informed the press that there are 459 vaccination centres, including 340 in schools and 119 in Community Health Centres and Primary Health Centres, have been set up in the Jammu region, the remaining 561 sites have been established in Kashmir. I would send out an earnest appeal through your newspaper to my fellow citizens to come forward for getting fully vaccinated as vaccination is a shield against Covid-19 as well as a person has less chance of getting hospitalisation.

GK: Do you see any visible change in the health sector in Jammu and Kashmir?

VB: Jammu & Kashmir has witnessed some major breakthroughs in health sector through various interventions having significant effect on healthcare delivery system, including establishment of two AIIMS, New Medical Colleges, Health and Wellness Centres, operationalisation of 102-108 ambulance services, Pradhan Mantri Jan Arogya Yojana under Ayushman Bharat etc. This is helping us to make the healthcare sector more responsive and vibrant as far as the delivery system is concerned. The Union Territory has made substantial progress in improving health services delivery over the last few years with a committed approach by all stakeholders to provide quality and accessible healthcare services to everyone in our public health facilities. The Government is also creating value in public healthcare in J&K by implementing the National Quality Assurance Program in Public Health facilities. And, yes, all these interventions will definitely have a significant effect on the healthcare delivery system, with the ultimate aim of free Universal Health Coverage (UHC).

GK: You talked about the National Quality Assurance Programme. How is J&K being covered under the initiative?

VB: Ministry of Health and Family Welfare, launched National Quality Assurance Programme (NQAP) to support and facilitate a quality health care system in the public health facilities. The main focus of the programme is enhancing satisfaction level among the beneficiary and service providers of the government health facilities, reposing trust in the public health system. The National Quality Assurance Standards have been developed keeping in the specific requirements for public health facilities as well global best practises.

GK: How many districts in J&K are covered under NQAS currently?

VB: NQAS are currently available for district hospitals, CHCs, PHCs and Urban PHCs across Jammu and Kashmir. These standards are primarily meant for providers to assess their own quality for improvement through predefined standards and to bring up their facilities for certification. It is broadly arranged under 8 areas of concern– Service Provision, Patient Rights, Inputs, Support Services, Clinical Care, Infection Control, Quality Management and Outcome. These standards are ISQUA accredited and meets global benchmarks in terms of comprehensiveness, objectivity, evidence and rigour of development.

GK: Are there any future ambitious projects that are aimed to revamp the health sector?

VB: I believe Jammu and Kashmir has many buildings now. We have surplus infrastructure and all we need to focus on strengthening the service delivery system at every level as far as health strengthening of the health sector is concerned. We are focusing on streamlining and upgrading the healthcare system and that doesn’t include just the infrastructure.

GK: What is the government focused on with regard to the health sector in J&K?

VB: We have surplus infrastructure and all we need to focus on strengthening the service delivery system. We are focusing on strengthening the healthcare system and that doesn’t include just the infrastructure.

GK: Many stakeholders have desired to invest in Jammu and Kashmir in the health sector, however they complain that the government doesn’t seem to be cooperative, why?

VB: Why should we be creating a private health infrastructure when we are having a vibrant public health sector. Why do we need to give them a free hand so that the ordinary people in this region have to pay ten times more than what they pay today? Should we encourage people to pay huge sums of money for their treatment? Should that be my objective? Tell me. A common patient gets a surgery, delivery done for free while as for the same amount of treatment, they are forced to pay a huge amount in the private sector. Why will we encourage our people to go to private hospitals. I am not of that opinion.

GK: But if any well-known chain of hospitals wants to open hospitals in J&K. Why wouldn't the government cooperate and facilitate their efforts?

VB: They are businesses. They will do what they want to do. They are free to do that under the law. We will do what we have to do. Our interest is common man, while their interest is paying man. We won’t allow any private stakeholders to fleece our poor patients. The best healthcare service delivery should be a source of satisfaction for us and not just the awards and appreciations.

GK: How is SEHAT Health scheme and distribution of golden cards reaching out to the common man?

VB: Health Scheme is a great success. Over 60 per cent of the population (individuals) have been covered and given away the golden cards while over 70 per cent have been covered for the same scheme. Under this ambitious scheme, the government bears the expenses of treatment of the citizen up to 5 lakh. Under SEHAT Health scheme 229 government hospitals and 35 private hospitals of Jammu and Kashmir have registered who will provide benefits of the Scheme and the kind of response reflected by the Insurance companies shows that the scheme has reached out to the masses with immense support.

GK: Sher-e-Kashmir Institute of Medical Sciences (SKIMS), remains in news for many reasons? Healthcare, administration and leadership is always under scrutiny. Are there any further initiatives aimed to strengthen this tertiary healthcare institute?

VB: The basic objective and the goal of the government should be to put the right person in the right job. Now we have to support the leadership. I am sure everything will fall in line. Healthcare, administration and leadership will flourish once they have support from the government side.

GK: Is there sufficient staff including doctors and paramedics available as a lot of hospitals, PHCs and NTPHCs have been upgraded?

VB: We have a huge deficiency of doctors in Jammu and Kashmir. Despite advertising 800 doctor vacancies, only a very few could be filled. We are working on to advertise more posts and also streamlining the deficiency of doctors and paramedical staff.

GK: How is maternity health care being strengthened in Kashmir?

VB: In J&K, most of the complicated and critical maternity cases are referred from all the districts to two tertiary care hospitals, SMGS Hospital Jammu in Jammu division and LD Hospital Srinagar in Kashmir division. Some of these patients who require intensive care are referred to the General ICU of the Medical College Hospitals, which always remain full to their capacity and many maternal deaths occur because of non-availability of beds in ICU. Keeping in view, four bedded ICUs and eight bedded HDUs each at GMC Srinagar (LD Hospital, Srinagar) and GMC Jammu (SMGS Hospital Jammu) have been established and operationalized with the financial support under NHM.

GK: Is there any improvement in infant mortality?

VB: Jammu and Kashmir has witnessed a remarkable improvement in the number of infant deaths since the start of the National Health Mission. The IMR has decreased from 45 in 2009 to 22 in 2018 and it continues getting better day by day. We have achieved this target only after improving coverage of quality antenatal care, skilled care at birth, postnatal care for both mother and new-born and care of small and sick new-borns.

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