The government’s attempts to provide 24×7 specialty care services in general and district hospitals is faltering, with the Health department barely able to run round-the-clock services in Punalur taluk hospital, where the initiative was piloted, despite concerns raised by stakeholders about the acute shortage of human resources in Health Services.
Health officials said that the idea had been to redeploy doctors with PG qualification, working in the periphery hospitals as assistant surgeons, at Punalur. However, this proposal has reportedly been met with stiff resistance from the local political leadership as well as the people.
Many PG doctors who had been pulled from institutions in Yeroor, Neendakara, Thevalakkara, Mayyanad, Kundara, Pathanapuram, Nedungolam, could not be retained at Punalur because of political interventions at the local level, who demanded their return.
It was last month that the Health Minister made the announcement that in the first phase, 24x7 services specialty services will be provided in General Medicine, General Surgery, Orthopaedics, Anaesthesia, Paediatrics, and Gynaecology.
The Kerala Government Medical College Officers’ Association (KGMOA) had pointed out that there are 799 vacancies of doctors in the Health Service — of which, 300 vacancies are in the specialty cadre — making it impractical that round-the-clock service provision can be made possible through just working arrangements, without post creation.
The government had, however, maintained that they had studied the patient load in various institutions and that judicious redeployment of specialist doctors from hospitals where patient load was much less, was enough for the time being to provide round-the-clock specialty services in many districts. It was pointed out that even some senior residents from Kollam Government Medical College could be utilised on working arrangement basis to provide specialty services at Punalur.
The government later placated the KGMOA that the plan was to provide specialty services from 8 a.m. to 8 p.m., and teleconsultation services from 8 p.m. to 8 a.m. It was also stated that a minimum of nine specialist doctors in each medical specialty will be ensured in all hospitals so that 24x7 specialty services can be run smoothly.
“We could run the scheme if at least six specialist doctors could be made available in every speciality. Even that has not happened and the pressure from local political leadership could not be overcome. As for doctors, none are keen on seeing this initiative work and are unwilling to step out of their comfort zone,” a Health department official said.
At present, Punalur has just two or three PG doctors in each specialty against the nine promised.
In Malappuram, the idea was that the 24x7 specialty services can be introduced at Tirur and Nilambur by redeploying doctors from Manjeri Medical College on a temporary basis but this has not happened reportedly due to non-cooperation from doctors.
KGMOA State president PK Sunil denied that government doctors were resisting the initiative as it would affect the private practice that they are legally allowed to do after work hours.
“Only about 30% of the government doctors have the so-called “lucrative” private practice. The basic issue is that unless the human resource shortage is resolved, this plan will not work. We are not resisting the initiative but when a specialist is moved from the periphery hospital, there will be local protest,” he said.
Post creation is not as straightforward as it is being made out, as the Finance department is is no position to approve such proposals. Even during the previous government’s term, the Health department secured only 202 posts out of the 1,520 positions it sought, and that result was achieved after prolonged negotiations.
The Health department has now pushed a proposal to the government for the creation of 1,120 posts of specialist doctors and that of 520 posts of casualty medical officers, sources said.
