A grave concern

Is our healthcare system crumbling?

In the absence of proper facilities most of our doctors avoid working in rural areas and for last seven decades, we are unable to provide a conducive working atmosphere for doctors and health workers in places other than big hospitals.

Last month I skipped a routine appointment with cardiology department at SKIMS because of the prevailing N1H1 virus scare. No doubt the situation of swine flu was not that bad then, but recent deaths and rising number patients have created a situation of alarm. Particularly, the recent death of a college warden due to the virus under mysterious circumstances has put a question mark on our preparedness and professionalism. Anyways, this is just one virus that has put our healthcare system to test for last several years. In real terms, the overall condition of the state’s healthcare system is not that healthy as is being projected by its managers.

Since Maharaja Hari Singh’s efforts to establish two hospitals SMHS hospital at Srinagar and SMGS hospital at Jammu it was only Sheikh Mohammad Abdullah who painstakingly ensured the establishment of a well-equipped healthcare infrastructure—SKIMS on the outskirts of Srinagar city. No other distinguishable healthcare infrastructure was established in the intervening period of more than half a century except few medical and health care teaching institutions and a handful of rural healthcare facilities. Presently state’s public healthcare sector with hundreds of dispensaries, primary health centers; scores of district and sub-district hospitals, several medical education institutions with associated hospitals having separate departments dedicated to different branches of medical sciences has one of the well-established health-related infrastructures. But most of this infrastructure and other facilities, particularly in the rural areas go waste for want of qualified technical human resource and resourceful management. During last, more than two decades, the private healthcare sector in the state has registered a visible growth and made an appreciable contribution in providing healthcare services to people. Many people, rightly raise fingers towards working in the private sector but for that, the regulating authorities are equally responsible for the mess. The authorities who control the state’s health and medical education sector also regulate the activities and all other operations of the private healthcare sector in the state.  

In the absence of proper facilities most of our doctors avoid working in rural areas and for last seven decades, we are unable to provide a conducive working atmosphere for doctors and health workers in places other than big hospitals. The biggest problem with our healthcare sector (both public and private) is that it has become urban-centric, thus depriving the vast rural population of quality specialised medical facilities.

The state’s maternity and cardiac emergency are the best areas to study and evaluate the shortfalls in our healthcare system. Not a single maternity and cardiology facility in the state is located outside the cities. Every emergency under these two medical exigencies can prove fatal for want of timely medical care, so the people living in the countryside are the worst sufferers. It is not a big deal to have these vital health-related facilities at a centrally located place within a cluster of panchayat jurisdictions. But lack of proper planning and the vital infrastructural backup has made every vital sector of our daily life city-centric. The private sector as usual always looks for greener pastures and private health sector is no different. Cashing on available human resource and other basic requirements readily available in cities the private healthcare players prefer to lure the patients to their urban centers than to deliver quality healthcare within their reach.

There is no dearth of infrastructure and other facilities with our public healthcare system but it lacks practical management. In a present-day era of technological advancement, every healthcare unit in the state could be connected with central control room through information technology to monitor the deployment of required human resource, their punctuality and other material and equipment requirement at the grassroot level. A simple version of global positioning system can be best used to track and utilize the services of doctors and other paramedic staff within a specific area to attend the emergencies at their convenience. Unfortunately, we have entangled the whole healthcare department in red tape wasting much of time in faulty human resource management, tedious procurements and indulgence in ‘licence Raj’ for the private health sector. Surprisingly, in our system non-professional at all connected with medical science and medical services management decides hiring and deployment of medical experts in the garb of political leadership and bureaucratic administration! Time has come that like few other vital areas medical sector requires to be revitalized by getting it exclusively under scientific command and control. Otherwise, it will crumble under the weight of unprofessionalism and mismanagement!