The Directorate of Health Services Kashmir has halted an "ill-conceived initiative" by Sher-e-Kashmir Institute of Medical Sciences (SKIMS) Surgical Oncology Department to perform surgeries in peripheral institutes after condition of a patient had deteriorated during surgery in a district hospital forcing his referral back to the tertiary care Institute.
"Yes, we have stopped the programme," said a senior official of the Directorate of Health (Kashmir).On November 27, this correspondent reported that a cancer patient from south Kashmir's Kulgam district had a close shave with death after the SKIMS department performed his surgery for mouth cancer (squamous cell carcinoma in buccal mucosa) at Anantnag district hospital though he had been admitted for treatment at the institute.
However two hours after his surgery on November 14 in the district hospital, the patient was rushed back to the SKIMS for "further management" after his condition had deteriorated. "At 6:25 (2:10 hours after the surgery) patient has not gained consciousness… …therefore he is referred to SKIMS for further treatment," reads a referral note that was written by the authorities concerned at the district hospital before he was rushed to the SKIMS.
The SKIMS and Directorate of Health had signed MoU in 2014 for "collaborative cancer services" in peripheries "in an effort to reach out to the patients at the doorsteps for early detection and intervention of cancer. Under the program the Oncology Department would send teams to peripheries for intervention. While the doctors argue that there was a practice of reaching out to patients for primary and secondary healthcare and for early diagnosis of cancer, there has been opposition to the idea of performing critical surgeries in peripheral hospital which lack critical care infrastructure.
"The decision (to stop critical surgeries in peripheral hospitals) was taken after the case came to the fore," said the official. The Kulgam patient's case had also come into the notice of the government and Minister of Health for State Asiea Naqash had also questioned the move.