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City’s Medical Network Needs Healing Touch

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Scores of illegal Nursing Homes Lack Even The Basic Infrastructure

By : Sandeep Singh

“Gentlemen, I urge you to engrave this on the templates of your memories that here are thousands of diseases in this world, but Medical Science only has an empirical cure for twenty – six of them. The rest is ……. guess work” ____________ Erich Segal, Doctor

For worst hygienic conditions and arrogant behaviour by the medical and para- medical staff, the people go to the private nursing homes. Here the stress is laid on operations to make the bills fatty.

“Women who can deliver the child in a natural way are operated just to charge Rs. 50,000/ – to Rs. 60,000/ – per case,” told the mother of a patient who had come from R.S. Pura to attend her daughter.

” If you want admission in the government hospital for proper treatment during admission period, see the doctor at home to pay his fee and other charges,” advised an agent of the reputed super specialist.

“All those who could not earn reputation have opened chemist shops and treating the Bhaiyas ( labour from other state),” said a chemist at Trikuta Nagar while telling the story of a couple doctor resident of Trikuta Nagar.

“What are you doing at the hardware store?” I asked my medical representative friend. ” O, Yaar, a doctor is constructing his house and I have come to pay his bills by the material purchased by him,” my Bakshi Nagar friend replied. “I could not get dear. A medical representative paying hardware items sound different,” I added. He Prescribes my company’s medicines and my company will pay it,” he confided

These are not isolated cases. For the proliferating centers of health, the money involved in the social service. And with the two-man nursing home cell of the government grappling to come to terms with the tough task of reining these places, there is no immediate relief is sight.

People admit that while nursing homes are a necessity, devising a foolproof system for the verification of the facilities offered and whether it had the necessary clearances, is still a problem.

A health official said: Scores of nursing homes in J&K are unregistered. A few applied for registration after notices, but many are still illegal. The punishment for running an illegal nursing home can be a fine or imprisonment.

The revision has so far not been implemented. “We have notice initiated prosecution proceedings against many nursing homes because we do not have the manpower to carry out the proceedings in court,” an official said.

So the most that government inspections teams do is to give the nursing homes time to pull up their socks – be it in terms of equipment or manpower. So, if an establishment is two doctors short, in the next inspection, it shows two more doctors on its staff and get the registration.

“Often doctors leave such establishments the very next day. But once the registration is obtained, it is valid for the next one year,” pointed out an official.

A survey is required to be conducted to ascertain the number of registered, unregistered nursing homes and review cases to meet the definition.

It is pertinent to mention that at Delhi, any place that has less than 30 beds is a health center and not a nursing home. For the government, any place providing 24- hour healthcare services is a nursing home, regardless of the number of beds. Apart from the NHR Act, medical establishments which have even one ultrasound machine have to register under the Pre – Natal Determination Techniques Act, 1994 (PNDT). The Act was brought in to stem rising incidents of female feticide. The Act was brought in to stem rising incidents of female feticide. The act has a more stringent punishment for violators which includes up to three years imprisonment and Rs. 10,000 as fine.

There is, on the one hand, the question of whether facilities on offer at nursing homes are commensurate with their claims. On the other, there is also the business aspect, which leads to the victimization of the patients.

Said a doctor at GMC Hospital: ” The kind of people who go to nursing homes, rarely come to government setups. So if anything goes wrong the only option they have is to go to a costly private hospital.

Most consultant pediatricians attached to nursing homes are also attached to these hospitals. In a way it is in their interest to refer patients to the hospitals at the smallest pretext.”

Another Menace : private practice in medical colleges has been eroding services and teaching. It is a well -known fact that the private practice of doctors in the state is hospital oriented and therefore, everyone aspires a job at medical colleges.

Postings in government medical colleges serve as commercial launch pads for such doctors. Medical teachers supposed to teach and train students remain largely engaged in private practice which leaves little time for the true purpose of their engagement. Additionally, it is difficult for enterprising unemployed doctors to establish themselves as fulltime private practitioners in our cities.

Many doctors working in government medical colleges attend their private clinics from 4 – 6 hours in the morning and/ or in the evening. Similarly, many surgeons employed in such institutions perform midnight and prolonged private surgeries after attending their private patients. Consequentially, physical and mental exhaustion gets in the way of regular hospital/ college duty. This acts to the following disadvantages :

1. Rushing through the OPD

2. Cursory rounds in the wards

3. Hasty examination and judgment

4. Confusion among trainees and students and

5. Lack of crucial training to learners.

6. Inadequate care of serious patients landing in emergency.

For example, if a patient starts bleeding from stomach veins at midnight and rushes to GMC Jammu as he requires emergency gastroenterology intervention (by a trained gastroenterologist ). Unfortunately, no one will intervene as the concerned doctor is already exhausted because of his 10 AM – 4 PM shift in the hospital and 5PM – 11PM private practice. The patient lands up in a private nursing home where also no full- time interventional doctor is available. As a last resort, the patient is advised to rush to Pathankot, Jalandhar or Ludhiana.

Therefore, the private practice of government doctors acts to the disadvantage of the public. Compromised emergency and OPD care render government medical college hospitals unable to deliver the requisite standard treatment. It is high time that private practitioners must be disengaged from government service to improve the functioning of medical college hospitals. It can be ensured by :

1. Providing round the clock supervision by the senior doctors.

2. Enhancing the teaching and training of medical students.

3. Granting reasonable time and conditions for research and

4. Making conditions favorable for doctors desiring full- time private service.

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