Instilling Responsibility and Accountability in Healthcare

In J&K, there is an epidemic of hysterectomies. In most private settings, unnecessary surgeries of the reproductive system of a woman and gall bladders of both genders are the main source of revenue.
Instilling Responsibility and Accountability in Healthcare
"However, in a scenario when many of the private healthcare institutions are running on goodwill rather than their capacity and infrastructure, not much can be expected." [Image for representational purpose only.]Flickr

Over the past few months a number of orders and circulars have been issued by the J&K Government and Health and Medical Education in the direction of seeking answers for what seem to be chronic ailments in the healthcare department.

The recent noise around the lopsided Caesarean Sections and their percentage share in various hospitals, the referral audits, the manpower audit, the app for measuring performance of the healthcare settings and many others seem to indicate that someone may be taking a note of the cries that patients and populations have been making over the years.

Will there be a better referral system now, a more diligent approach towards child birthing practices, a system to register the grievances of patients, a more justified presence of doctors in hospitals in the peripheries and nodal centres.

In absence of any actions following the issue of such orders and circulars, one is forced to think that these measures are just cosmetic. Over the years, Governments, one after another, have spoken about better healthcare delivery and more responsive healthcare systems.

From the basic ‘Suggestion and Complaints’ boxes outside the offices of Medical Superintendents of the Hospitals, to the Grievance Cells of the administration, healthcare systems have had many moments of telling them to be more in tune with the patient's needs.

However, when no action follows these orders, the system comes across as an automated system where circulars and orders are issued from time to time with a disclaimer.

Years ago, a previous Government carried out an extensive exercise of manpower audit. It was found that there were pockets, mostly near the capital cities, where the availability of the doctors was much more than required.

It was also found that there were doctors who had served at the same place for decades and then there were those who found themselves tossed and transferred every now and then.

The arbitrary transfers and postings, promotions and assignments of responsibilities were recorded. Nothing followed.

Two years ago, J&K Government issued orders to set up a system to justify referrals. It was noted that many patients deteriorate or lose the battle in transit, especially if they had a medical or surgical emergency.

The critical care ambulances were made omnipresent by the Government. Manpower was also created. But what still lacks is the responsibility and the accountability from those running the show.

How many hospitals take regular mortality meetings and fix responsibility for a life lost. How many hospitals follow up on a patient they sent to another hospital? How many hospitals are in a position to claim that they are equipped to handle patients at all hours of the day?

In J&K, there is an epidemic of hysterectomies. In most private settings, unnecessary surgeries of the reproductive system of a woman and gall bladders of both genders are the main source of revenue.

The unjustified treatment protocols, the unaudited prescriptions and their burden on the pockets and health of people is a sore wound that would have soothed a bit with action.

However, in a scenario when many of the private healthcare institutions are running on goodwill rather than their capacity and infrastructure, not much can be expected. Patients in J&K await a real reprieve which to some extent also means lesser burden on their incomes.

In case of complaints and inquiries about negligence in medical practice, the patients pin their hopes on the system. These inquiries stretch over months and never fix responsibilities.

The members of committees mince words and ensure ambiguity as the running threads through the pages of the reports that they ink.

The Health and Medical Education Department, a few months ago, had ordered that all inquiries be completed within three months. This order too remained on papers and files.

Responsibility and Accountability are two pillars of any system, and in the health care system, the absence of these could mean a collapse and chaos.

It is time for the Government to follow up on the orders and circulars it issues. A follow-up that is followed up by action!

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.

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