October 29, 2007

Medical science park planned near Chennai

Frontier Lifeline Hospitals plans to set up a Rs.500-crore medical science park at Elavoor in Tiruvallur district by the end of 2008.

Hospital chairman and CEO K. M. Cherian told a press conference on Thursday that the ‘Frontier Mediville,’ to be established on 1,00,000 sq ft, would focus on clinical studies in human and animal tissue, besides undertaking research and training.

Frontier Lifeline and SASTRA University in Thanjavur formalised a Memorandum of Understanding to develop clinical applications for basic research initiatives.

The agreement was signed by vice-chancellor R. Sethuraman and Dr. Cherian.

The Centre for Nanotechnology and Advanced Bio Materials at SASTRA University specialises in polymer synthesis and covers tissue engineering, nano-biosciences and photovoltaics. “The synergy of clinical research and the ongoing work on nano-scaffolds at the university has the potential to evolve commercially viable medical products,” dean S. Swaminathan said.

Sanjay Cherian, director, Frontier Lifeline, said the collaboration would help the research stay focussed on patient benefit and troubleshoot hitches that surfaced along the way.

October 24, 2007

Medical interns at highest risk to accidental HIV infection, finds study

At least 100 medical interns and resident doctors at the Sassoon government hospital had to pop anti-HIV pills for 28 days after they suffered needle stick injuries while working in the hospital.
Even as healthcare workers are known to get accidentally exposed, mainly through needle stick injuries, to blood from patients infected with HIV, the study at SGH, one of the first in the country, found that medical interns were at the highest risk.

The joint study sponsored by Johns Hopkins University was conducted over a period of three years and the findings were presented by Dr Amita Gupta at the Johns Hopkins University at the 46th annual conference of Infectious Diseases Society of America at San Diego, in October this year.

Principal investigator of the project Dr A L Kakrani, Head of the Department of Medicine at SGH and B J Medical College, said that more than 700 such needle stick injuries were recorded during the period. The group that was exposed most to the needle stick injuries was of medical interns.

At least 100 persons suffered needle stick injuries and half of them were medical interns, followed by resident doctors. While the risk of transmission of HIV from patient to doctor via needle stick injuries is .3 per cent, according to Kakrani, there are around 70-80 cases worldwide where doctors have turned HIV positive.

Needle stick injuries are wounds caused by needles that accidentally puncture the skin. If not disposed of properly, needles, concealed in linen or garbage, can injure other workers unexpectedly, says Kakrani.

Doctors with needle stick injury were given drugs for 28 days. Kakrani explained that the virus remains localised in the area of injury for a maximum of three days.

Drugs given within three hours of the needle injury is effective and kills the virus before it multiplies. A combination of two drugs —lamivudine and stavudine— were given to most doctors and a three-drug combination of lamivudine, stavudine and indinavir were given to some of the doctors. None of the doctors tested positive for HIV.

October 23, 2007

Centre plans to phase out `harmful` combo drugs

The Drugs Controller General of India (DCGI) is finalising a strategy to ensure total pullout of irrational combination medicines from the domestic market.

The DCGI has called a meeting of state drug controllers and representatives of the industry to understand the implementation issues related to its recent directive to withdraw the licences issued over the last 10 years for marketing 1,070 brands of 330 fixed-dose-combination (FDC) medicines worth about Rs 1,000 crore.

The three-day meeting, to be held at National Institute of Pharmaceutical Education and Research (NIPER), Chandigarh, from October 25, may lead to the preparation of draft guidelines on FDCs to be followed by all state drug authorities.

Till now, the DCGI’s directive has received only partial response from states. The main reason for this is that all these drugs are being manufactured with approvals from state drug authorities though the marketing approval of FDCs — which by Indian definition come under the new drug category and approval for which is supposed to be given only by the central authority, that is, the DCGI’s office.

A majority of the states, including Delhi, remain hesitant to take action as many of these FDCs are being marketed for over a decade now. The industry is also perturbed due to the fact that these medicines, like drugs for cold-fever-pain, are commonly prescibed by the doctors. The industry wants to weed away all harmful combination of drugs (if any) while keeping intact the marketing rights of effective and safe medicine combinations.

“We have asked the DCGI to legalise the safe FDCs available in the market and to develop specific rules for licensing such drugs. The DCGI’s office has in the past legalised many such drugs. If there are proven harmful combinations, we will support their withdrawal and the industry should be given adequate time for withdrawing such combinations,” said Daara Patel, secretary general of the Indian Drugs Manufacturers Association (IDMA).

Sources in the DCGI office said the apprehensions of good medicines going off the shelves were misplaced as the companies would be free to send fresh applications for marketing approvals to the central office. Given the current licence fees, the DCGI’s office, the Central Drugs Standard Control Organisation, may earn about Rs 3 crore if all the companies apply for central licences on these medicines.

All major domestic pharmaceutical companies, other than Indian arms of foreign multinational firms, have FDCs in the market.

Apollo Hospitals enters into tie-up with Jet Airways for providing a package offer to patients

Apollo Hospitals has joined hands with Jet Airways to come out with a package offer for patients at various places wanting to undergo treatment in Chennai.

The memorandum of understanding, signed a few days ago, would benefit those coming from Kolkata and north-eastern States to start with.George Eapen, Chief Executive Officer of the Apollo Hospitals Group, said here that the tie-up was an exclusive arrangement to facilitate patients get good medical care at the hospital’s headquarters in Chennai.

“We are trying to get a discounted tariff from Jet Airways for patients. Details would be announced in a few days. It will be a ‘special guaranteed rate’,” Mr. Eapen said.

Mr. Eapen was in the city to inaugurate the newly constructed ‘Dialysis Block’ at the Apollo Speciality Hospitals where six dialysis machines were acquired for treating renal diseases.

Chest pain clinics

According to Mr. Eapen, the hospital management has been giving importance to opening chest pain clinics across the country.

“The target is to have 1,000 such clinics where lifestyle diseases, heart problems and hypertension will be attended to immediately.”

They would be started at a few places in the southern districts and already Madurai has five clinics, he said.

The Apollo Pharmacy network would also be strengthened by having 1,000 outlets in the country, he said.

Nations with the best health

Health stories normally concentrate on AIDS epidemics and disease outbreaks. But Foreign Policy looks at the five healthiest nations in the world.

Japan has the highest life expectancy. Japanese women live till 86, and men, 79. The secret of their success is low cholesterol foods and exercise. Government-sponsored pre-work workouts have ensured trim physiques. But high-fat western foods are adding to a high rate of diabetes. Seven million Japanese suffer from the disease.

France has surprising low rates of heart disease, the world's No. 1 killer. This is because of their emphasis on slow dining and a daily glass of wine. The French diet is high in fat, but scientists speculate their penchant for smaller portions and longer meals help keep heart disease at bay. However obesity rates are rising and there is worry heart disease could shoot up.

Iceland has world class natal care which ensures it has the lowest infant mortality rate in the world. It has just 2 deaths (US has 7) before the age of 5 for 1,000 live births. Extensive pre-and post-birth medical care offered by the state explains why. There is three months guaranteed professional leave for each parent. However, love of carbonated sodas by kids is increasing obesity rates.

Sweden has the highest cancer survival rates and nearly 100 per child immunization. This is because nearly 14% of government spending goes into healthcare. This covers 85% of medical bills in the country. The country also has some of the world’s best hospitals and coupled with that Swedes believe in holistic care. From happier professional lives to better street lights, everything possible is done to make their citizens happy. The lack of privatization in the health sector is a worry though with long queues being the norm.

Cuba has a lower infant mortality rate than the US and similar life expectancies. One of the reasons is better access to doctors. There are more doctors per capita—7 for every 1,000 Cubans— more than in any other country. This keeps health indicators at a level which rivals most developed countries. But early detection is a must. For when Cubans fall ill medicines and equipment are often in short supply. Nutrition and treatable diseases have also been on the rise thanks to shortages.

Insurers offer cover for treating poor

Poor patients could soon avail of emergency treatment at the best private hospitals in the city if a proposal by an insurance company gets the nod. The government-owned Oriental Insurance Company Ltd has submitted a proposal to the Bombay High Court offering to cater to the needs of poor patients under a group medical scheme. The hospitals would pay premiums and be covered for treating the poor.

Legal experts said that if the scheme delivers what it promises, it could soon put an end to the practice of private hospitals turning away emergency cases in which patients cannot afford to pay a deposit. A division bench of Chief Justice Swatanter Kumar and Justice Dhananjay Chandrachud, which is hearing a public interest litigation on providing treatment free to poor patients, has asked the Association of Private Hospitals and the Maharashtra government for feedback on the proposal. The court is scheduled to hear the issue on October 25.

"A comprehensive group insurance policy could take care of the many problems that ail the private medical care sector," said advocate Jamshed Mistry, who was appointed as amicus curiae (friend of the court) in the PIL and who submitted the proposal to the court. The insurance policy, drawn up by K M Dastur Reinsurance Brokers (KMDRB) Pvt Ltd, is a first-of-its-kind and could help 319 private charitable hospitals in the state—70 of which are in Mumbai—meet guidelines set last year by the HC on treating the poor. The court had ordered the hospitals to reserve 20% of beds for poor patients who should get free or concessional treatment. The order had also directed each hospital to transfer 2% of its income obtained via patients’ fees to a separate fund called the Indigent Patients Fund (IPF).

As per Oriental’s plan, IPF money would be paid as an annual premium to the insurance firm, which would reimburse 100% hospitalisation expenses and 90 days post-hospitalisation expenses for patients with an annual income below Rs 25,000. A 50% reimbursement would be made for patients with an annual income below Rs 50,000.

"Its a win-win situation for everyone," affirmed Maneck Dastur, general manager, KMDRB. "While the poor can avail of free treatment, the hospital would get every rupee it spends." For the insurance company, such a scheme would also allow it to fulfil a mandate to frame policies for rural areas and the poor.

October 21, 2007

Reliance enters Phama & wellness format

Reliance Retail, which began its retail initiative here by launching the Fresh outlet last year, has chosen the city again for kicking off its wellness format, a ‘one-stop-shop’ for all health and wellness needs.

The company, however, chose to keep it a low-key event, though the top brass of Reliance Retail’s Wellness vertical, including its Chief Executive Officer, was in the city on Friday as it unveiled the first Reliance Wellness outlet in the country, on Rajbhavan Road here.

As it did in other retail formats, Reliance has come out with a very attractive interior design, which will be replicated in other parts of the country in the next few months.

Sources said the company would launch about 20 stores in the next few weeks in top cities such as Delhi, Jaipur and Mumbai.

The Wellness outlet is home to some 5,000 products in different categories, including general nutrition, sports nutrition, skin and personal care, books, music and pharmaceuticals.

Besides, it houses an optical shop backed by a qualified ophthalmologist to test and prescribe lenses. The store, which comprises a pharmacy, offers medicines and remedies in allopathic, ayurvedic and homeo medical systems.

To attract customers, it introduces a ‘Medical Compliance Program’ for customers who are on long-term medication. “They would get reminders and alerts on the use and replenishments, if any,” a company executive said.

Health insurance

Some of the freebies include a free health insurance cover under RelianceOne, the customer loyalty programme. Reliance Retail has tied up with ICICI Lombard General Insurance Company to offer group personal accident insurance policy.

“If a customer buys products worth Rs 3,000 in the first three months, he would get a cashless hospitalisation benefit up to Rs 25,000. If he purchases an additional Rs 5,000 worth products in the 4-6 months period, the cover goes up to Rs 50,000,” the executive said.


Sankara Nethralaya Eye Hospitals: The story Behind

“With your permission, may I call in some of my colleagues,” the tall, well-built and greying gentleman asked us. After getting a surprised nod, the 67-year-old doctor called out a couple of names, ever so courteously, to an assistant. As we waited for his colleagues to join, he turned towards us and said, “It has always been team work at Sankara Nethralaya.”

Dr SS Badrinath, founder and chairman emeritus of the premier eye hospital and ET’s Corporate Citizen of the Year, is famously modest. He tends to downplay his own contribution to the institution that eminent jurist Nani A Palkhivala once described as “the best-managed charitable organisation in India.” (Later, Mr Palkhivala bequeathed his property to the institution.)

But, talk to his colleagues in his absence and they will speak volumes about what Dr Badrinath has done to the organisation. Dr Lingam Gopal, who has been with Sankara Nethralaya (SN) since its fourth year, and is its present chairman, says, “This organisation started with just three consultants, and now we have over 80, all working for a salary (that keeps costs low). It’s difficult to keep such a team together. His leadership and vision has made all the difference.”

But Dr Badrinath himself would rather talk about Sankara Nethralaya and about the work it does in clinical care, research and teaching. As we sat in the conference hall, on the seventh floor of one of its buildings at Chennai campus, Dr Badrinath explained why eye care is so important for the country. In the corridors and wards below, doctors, optometrists, paramedics and nurses scurried around to take care of a seemingly endless stream of patients.

India is still a poor country and a third of all blind people in the world are Indians, he said. The country also has the largest number of diabetics, which makes eye care even more difficult. So, India needs the best of talent and equipment. At the same time, in some cases, solution could just be a pair of spectacles. Around 6-7% of blind people in India are that way because they do not use corrective glasses.

The inspiration to start a hospital came from Kanchi Sankaracharya Sri Jayendra Saraswathi. “He gave a clarion call for doctors to come together and start a hospital at a meeting in 1976,” says Dr Badrinath. That explains why a photograph of Sri Chandrasekhara Saraswathi, the previous pontiff of the mutt, dominates the doctor’s room.

But then, he found it difficult to mobilise doctors to start a general hospital and decided to start an eye hospital instead. “We did not have money. We started the hospital without money,” he recalls. He took the plunge in 1978 and SN was set up as a unit of the Medical Research Foundation, a registered, not-for-profit charitable organisation.

Today, SN is a self-sustaining institution, and does not depend on donations. Revenues from paying patients take care of all its working capital needs while all surplus is ploughed back. But, it still depends on donation for capital investments — especially equipment which is costly and has to be imported.

It employs over 1,200 people and has spread to Assam, Bangalore, Jalna and Kolkata through its affiliates. Around 1,500 patients walk in everyday. Doctors perform over 125 surgeries a day. About 50% of the consultations and 40% of the surgeries are done free of cost. The organisation itself was founded to provide affordable eye care to people.

For a man with credentials as impressive as Dr Badrinath’s, surely a loan would not have been a problem. Here’s some insight from his wife, Dr Vasanthi Iyengar, “He reasoned, if you take a loan, the focus would turn to money, as you would be under the pressure to repay it.”

The first donation came from another Sankaracharya of Sringeri. Soon support from corporates and donors followed and continues to flow. In fact, among the first to call up Dr Badrinath after the ET Awards were announced were Rahul Bajaj, AM Naik and Brij Mohan Munjal.

“We are happy to get the recognition from ET. Such recognitions and accolades go a long way in inspiring our employees. We understood the significance of the award when congratulatory calls and messages started pouring in from Friday.”
Dr Badrinath graduated from Madras Medical College in 1963.

His subsequent years were spent in the US honing his skills. He had stints with Glasslands Hospital, New York, New York University Post Graduate Medical School, Brooklyn Eye and Ear Infirmary, and Massachusetts Eye and Ear Infirmary, Boston. He became a Fellow of the Royal College of Surgeons of Canada in 1969 and Diplomate of the American Board of Ophthalmology in 1970.

Again, it was in the US that he met Dr Vasanthi Iyengar, a paediatrician and haematologist. They met at Brooklyn New York in 1966 and got married a year later. Their elder son, Seshu, is a photo editor at ESPN in the US, with younger son Ananth a molecular biologist.

The Badrinaths returned to India in 1970 with probable plans of returning to the US. “We found it difficult to settle in Chennai in the initial years in early 70s,” says Dr Vasanthi. “In 1973, at the first year celebrations of HM Hospital, where Badri was practising, MS Amma (renowned musician MS Subbalakshmi) walked up to me with a request. Badri must practice here, she said,” adds Dr Vasanthi.

May 15, 1973 turned out to be the important day when the Badrinaths decided that their return to India was irreversible. “We were preparing to leave for the US. We already had our visas. Badri also had a job in the US. At 4 am that morning he said we are not going back,” recalls Dr Vasanthi.

Today, SN’s works on solutions through focus on and striking a balance between clinical care, training and research. In clinical care, it has done some pioneering work: it was the first to introduce PRK (photo refractive keratectomy) and later Lasik, which uses laser to improve vision; the first to perform a long and complex surgery OOKP (Osteo Odonto Kerato Prosthesis) where it uses a patient’s tooth to restore vision.

Its teleophthalmology (which uses telecom), mobile teleophthalmology (which uses a mobile hospital) projects literally takes eye care to the door steps of the poor. It is also serious about training. The institution not only trains doctors and ophthalmologists for PhDs and fellowships, but also offers courses in optometry, medical lab technology and ophthalmic assistance.

“India is a huge country. We need a lot of people. In many cases, you don’t need to be trained as a doctor to treat patients,” Dr Badrinath said. Another key area that SN focuses on is research. It’s one area where hospitals in general do not focus.

In many cases, India’s problems are unique, and demands solutions designed for the country. The institution has published over 400 scientific papers in peer reviewed journal. Almost one-third of papers that go from India in this field are from Sankara Nethralaya.

Its research also has a direct impact on its operations. The latest is a vision chip a team of its scientists, led by Prof HN Madhavan, designed to detect micro-organisms, virus, bacteria, fungus or parasite that cause infection in the eyes — very fast. “Our problems must be looked at and solved by us, not by some American company,” Dr Badrinath said.

Originaly from the Economic Times

Firms doing drug trials may tie up with Hospitals

The government is planning to make it mandatory for companies doing clinical trails to tie up with hospitals equipped with trained medical professionals.

This provision may feature in the new legislation to enforce ethical practices for clinical trails which is set to tabled in Parliament by the year-end. The is expected to prevent the exploitation of people who volunteer to have new drugs tested on them.

“We want to ensure data integrity by introducing ethical practices in laboratories and data compilation to prevent tampering of essential medical records. Besides this, the proposed law will have detailed guidelines on how to deal with clinical trial volunteers,” the DCGI M Venkateswarulu told ET on the sidelines of the ISB Pharma Summit here on Wednesday.

India’s clinical trials is estimated at $200 million and is expected to grow to $1 billion by 2010. The market has grown at almost 400% in the past two years and is pegged to grow even more by 2010. This means that the regulation is necessary not only to protect individual interests but also provide a quality benchmark for global pharma majors to outsource this function to India, he said.

Companies are realising the value of 80% reduction in costs and hence outsourcing this business to India. Right now, the government does not allow phase III trials to protect patients from possible exploitation.

However, it may consider opening up market for such trials once the legislation is in place. Phase III trials are conducted at random yet controlled multi-centres on large patient groups (3003,000 or more depending upon the disease or medical condition studied).

October 13, 2007

National Family Health Survey-3 Summary

India is still struggling to properly feed its children even as its economy booms, according to a survey of its citizens' health and development on Thursday.

While many development indicators are improving, including literacy and child mortality rates, malnourishment is by some measures getting worse, according to the survey by the health ministry with the help of several multilateral aid agencies.

The wealthy, mostly urban Indian middle class enjoying the fruits of an economy growing annually at near double figures, seem all but invisible in the new data.

Instead, hundreds of millions of poor, undernourished, under-educated agricultural workers dominate the picture.

The same groups continue to be the worst off: girls and women, people born into the bottom of the Hindu caste system and those from tribal communities.

The two-thirds of Indians living in its villages are starkly worse off than those living in cities.

A representative sample of around 200,000 people were interviewed for the survey. Here are some of the main findings of the 2005-06 National Family Health Survey:


- Nearly a quarter of infants are wasting (have low weight for their height), up from a fifth of all infants found by the last survey in 1998/99. Nearly half of all children under 3 years have stunted growth, a sign of prolonged undernourishment. That figure was 51 percent in 1998/99.

- Nearly 80 percent of infants now have anaemia, up from 74 percent in 1998/99. The condition can damage mental development in young children. More than half of all women are anaemic.

- Three percent of all women are obese, as are one percent of all men -- most of them live in cities.


- Nearly sixty percent of women were married -- illegally -- before their 18th birthday. However the median age of marriage is creeping up -- among India's latest generation of young women, those now aged 20 to 24 years, the median age was just over 18. Less than 12 percent of these young women were already married on their 15th birthday.

- The average women has 2.7 children in her lifetime, down a little from 2.9 in 1998/99.

- Seventy-four in every 1,000 children die before their fifth birthday, down from 95 children in 1998/99.


- Just under half of all women -- 45 percent -- cannot read. Among women aged 20 to 24 years, illiteracy drops to a third.

- Around 83 percent of children aged 6 to 10 years are going to school. Most children leave school by the time they are 15.

- Fifteen percent of boys and 18 percent of girls between 12 and 14 years are child labourers, either working for their family or outside the household.


- More than half of all Indians are forced to use a field or other outdoor space as a toilet.

- A third of all households have no electricity. Around 60 percent use wood or animal dung for cooking fuel.


- A little over half of all Indian men think hitting or beating their wives is acceptable in certain circumstances, particularly if she disrespects the in-laws. A smaller number think bad cooking or refusing sex are reasons enough. Nearly 55 percent of women think wife-beating is sometimes acceptable.

- Just over a third of married women said they had been pushed, slapped, shaken or otherwise attacked by their husband at least once. One wife in ten said her husband had forced her into sex on at least one occasion.

Further decline in sex ratio: Family Health Survey

There has been a further decline in the sex ratio in the past five years.

The National Family Health Survey-3, released here on Thursday, says that the sex ratio has declined to 918 girls to 1,000 boys in the 0-6 age groups. The 2001 census found a sex ratio of 927 per 1,000 boys.

The under seven ratio in urban areas is the same in the NFHS-3 as in the 2001 census, however, in the rural areas, NFHS-3 finds a sex ratio for this population of 921, lower than 934 in the census.

The ray of hope for girls is that there has been a marginal increase in the acceptance of daughters also. This preference for girls is directly linked to the adoption of two-child norm by the couples, according to survey. About 61 per cent couples in the country have two girls, as against 47 per cent in the NFHS-2 (1998-99) and 37 per cent in the NFHS-1 (1992-93).

Indian doctors in US tell lawmakers about healthcare

Leaders of the Association of American Physicians of Indian Origin deliberated with 30 members of US Congress to put across their views on the reforms required in the US health system, the association's national president Hemant Patel said.

"We offered our support, guidance and advice to the lawmakers as they look for new ideas on reforming the US health system with the 2008 elections round the corner," he said.

Patel gave details of the daylong meeting with Congressmen while addressing the annual convention of the Federation of American Association of Physicians of Indian Origin of New York, New Jersey and Pennsylvania held in Jersey City, from Oct 5 to 7.

Leaders of the associations, hundreds of physicians of the Tri-State area and some state health officials and politicians attended the convention.

Patel said the association team briefed Congressmen on the issues impacting not only Indian-American physicians but also all physicians across the US. The issues include health coverage for the uninsured, access to physicians, medicare reimbursement, doctors' right to make decisions in the interests of patients and medical liability.

He pointed out that the association, now financially stronger than before, also plans to get into legislative advocacy.

Senator Robert Menendez of New Jersey in his keynote address assured the doctors that "We share your goal of seeing that the 47 million uninsured Americans do not go to sleep without any medical insurance whatsoever".

Menendez added: "We need to ensure that we do not have gatekeepers - those in insurance companies who have no medical background telling doctors what kind of treatment they can or cannot provide for their patients and guarantee that physicians are not squeezed by the federal government by having their reimbursements reduced."

Headquartered in Chicago, the association is a 20-year-old umbrella organisation representing 130 member groups nationwide with a constituency of 42,000 physicians, which is almost 17 per cent of the total number of doctors in the US.

October 10, 2007

Steps to curb overseas doctors in Britain

Indian doctors should think several times before coming to Britain for jobs - the employment situation has been difficult for non-European Union doctors, and new proposals have been drawn to guarantee jobs to doctors trained in Britain.

An increase in fresh graduates turned out by British medical schools and the availability of a large number of doctors from an expanded European Union have made it difficult for non-EU doctors to gain employment in the National Health Service (NHS).

The health minister, Ben Bradshaw, has drawn up proposals to slash the number of junior doctors from overseas coming to Britain to train. The idea behind the proposals is to preserve jobs for the rising number of British medical graduates.

During the recent round of recruitment in the Medical Training Application Service (MTAS), non-EU doctors could not be excluded from consideration under court orders. During the MTAS rounds earlier this year, several hundred Indian doctors gained employment in the NHS.

However, the situation is likely to change if the new proposals are implemented. A court hearing is due later this month on the case brought by the British Association of Physicians of Indian origin (BAPIO), which challenged changes to immigration rules for non-EU doctors who had entered Britain under the highly skilled migrants permit.

Putting forth his new proposals, Bradshaw said that if overseas applicants were preventing those educated here from getting specialist training places, "then it is only right that we should consider what needs to be done".

The government is proposing that doctors from countries outside the EU should not be considered for a job unless there are no qualified applicants from Britain or from elsewhere in Europe. This is an unlikely scenario given the popularity of medical training in Britain and the EU.

According to Bradshaw, Britain now has 6,451 medical school places, compared with 3,749 in 1997, and each student can cost up to 250,000 pounds to train. During the MTAS rounds, several British doctors who could not find employment left the country as the issue snowballed into a major public controversy through demonstrations and petitions.

There is also a proposal that fresh British medical graduates would automatically get a first-year hospital training place on graduation, which would give them a head start over even other European candidates.

Meanwhile, representatives of BAPIO met officials of the Conference of Postgraduate Medical Deans (COPMed) after a BAPIO study raised concerns that non-white British graduates as well as those who had received their primary qualification overseas were more likely (as compared to white British graduates) to be found to be not making adequate progress with their training and referred for remedial training.

BAPIO sources told IANS that during the meeting, both groups affirmed their strong commitment to equality of opportunity within medical education. The discussions included plans to monitor educational outcomes and address areas of concern where these were identified.

Ramesh Mehta, president of BAPIO, said: "We are pleased to note that COPMeD chairman Elisabeth Paice was very receptive of our concerns. We look forward to the approval of the draft plan by the CoPMeD."

Elizabeth Paice said: "It was very useful to exchange viewpoints with Mehta, and to discuss how we could move from concern and evidence to appropriate action."

October 09, 2007

Star Health Insurance goes direct

Star Health & Allied Insurance, one of the two standalone health insurance companies in the country, has adopted a new model of managed healthcare that does not need the intervention of third party administrators (TPAs), which otherwise is an integral system of mediclaim services.

“Star Health has a direct tie-up with over 3000 hospitals across the country and the list is growing everyday. The customer gets an end-to-end service from Star Health without having to depend on a third party and the hospitals are also happy to deal directly with an insurance company. This has been a major boon for us”, Anand Roy, assistant vice-president, marketing, Star Health, said.

Chennai-based Star Health, the first operative health insurance company in the country — Apollo, DKV Insurance is the other player in the space — is aiming at Rs 200 crore premium income this fiscal and is lining up a long-term, high-end health policy.

“Being the first off the block has given us a headstart. We plan to increase out network to 125 branches by this year-end. Having acquired approximately Rs 100 crore of premium income in the first five months, we are now looking at Rs 200 crore in 2007-08”, Roy said.

Although health insurance, at Rs 3,500 crore premium, is set to emerge as the second biggest portfolio in general insurance (after motor insurance), it has been a relatively small business segment characterised by low profit margins and high volume losses.

October 07, 2007

Tailored herbal medicines under the scanner in UK

Scientists in Britain are warning that there is no evidence to suggest herbal medicines "tailored" to the individual do actually work; they also say such concoctions may even be harmful.

According to a study by a team from the Peninsula Medical School, a partnership between Exeter and Plymouth universities and the National Health Service in Devon and Cornwall, they found no convincing evidence that suggested herbal medicines "tailored" to the individual are effective.

The team arrived at this conclusion after a wide search for randomised clinical trials of tailored treatments across the world, in any language; they looked at 1,300 published articles on the subject and analysed the only three randomised clinical trials in existence.

They also contacted 15 professional bodies but were still only able to find the three trials. The team are also dubious as to the skills of practitioners in Britain who offer treatments specially formulated for individuals.

Practitioners generally offer a wide variety of treatments for conditions ranging from minor skin ailments to cancer, using a multitude of herbs, drawn from different cultures. Chinese, Ayurvedic and Western herbal medicine, have all become increasingly popular over the past 20 years where practitioners mix different combinations of plant extracts to treat ailments such as asthma and arthritis.

The team say while there were many herbs which have health benefits, studies on these tend to involve standard preparations or single herb extracts.

The researchers say herbs may be contaminated or even toxic, and their strength misunderstood by the practitioner and there are many issues regarding expertise such as a practitioner being able to make a proper judgement and knowing when a client is displaying symptoms that really should be assessed by a doctor.

The National Institute of Medical Herbalists says it is impossible to draw conclusions from three small studies with "questionable methodology", and herbalists often found themselves unable to obtain the funding necessary to carry out rigorous trials. They say people often resort to herbalists having tried the orthodox approach with no success.

India, US to cooperate in developing medical technology

India and the United States on Thursday agreed to enhance cooperation in development of low-cost diagnostic and therapeutic medical technologies.

At the India-US Summit on Translational Health Sciences, the National Institutes of Health (NIH) of the US and the Department of Biotechnology issued a joint statement to expand collaborative research, particularly in the medical research cluster in the vicinity of the national capital.

"The focus will be on infectious diseases, trauma, maternal and child health and chronic diseases like diabetes, hypertension and cardiovascular diseases," Roderic Pettigrew, Director of the National Institute of Biomedical Imaging and Bioengineering, told reporters here.

The Ministry of Science and Technology is setting up the country's first-ever Translational Health Science and Technology Institute to facilitate development, optimisation and evaluation of technologies for public health.

"We have been developing drugs to cure diseases and the translational health research initiatives are aimed at developing efficient drug delivery systems," a senior official of the Department of Biotechnology said here.

The collaboration will include organisation of workshops and meetings to share experiences and scientific information, direct links between appropriate centres of excellence, institutes and institutions in both countries.

"The two sides also signed a Letter of Intent on Translational Research expressing interest for cooperation," NIH Director Elias A Zerhouni said.

Microsoft Raises the Bar for Privacy in Electronic Health Record Solutions

Microsoft Raises the Bar for Privacy in Electronic Health Record Solutions

PatientPrivacyRights.Org, a national consumer watchdog group, works with technology giant Microsoft to put consumers in control of their electronic health records.

Austin, TX - Earlier this year Microsoft sought advice from PatientPrivacyRights.Org about building privacy protections into their new consumer health platform, HealthVault. Today Microsoft’s HealthVault system goes “live” and proves that technology can give consumers complete control over who can see or use the information in their health accounts. HealthVault proves that privacy is not an obstacle to building useful and safe technology to improve health.

Fifty years ago today, the Soviets launched Sputnik in space and provided a wake up call for Americans, changing what we thought was possible and jolting industry. The privacy protection in HealthVault is Health IT’s Sputnik. Microsoft proves that privacy works in real-world electronic health systems and it cannot be ignored. “Consent is essential for consumer trust and participation in digital health systems,” says PatientPrivacyRights.Org’s founder, Dr. Deborah Peel. HealthVault requires consumers to give informed consent before any use or disclosure of personal health information.

“Corporate claims to offer privacy mean nothing unless they are willing to take the same steps Microsoft has taken in building HealthVault,” says Peel. Microsoft has committed to independent third party audits to verify their pledge to protect privacy. “Audits are essential,” says Peel. “Technology companies have got to do better than telling consumers to just ‘trust us.’ Consumers shouldn’t trust anyone but themselves to decide who can see and use their sensitive health information.”

Microsoft was very receptive to concerns about the unchecked loss of consumer control of personal health information and the abuse of Americans’ rights to health privacy. Microsoft is the first major multinational technology corporation to collaborate with PatientPrivacyRights.Org and use the 2007 Privacy Principles created by the bi-partisan Coalition for Patient Privacy as the basis for the consumer controls of the health data stored in HealthVault.

Microsoft’s use of the Coalition’s strong principles ensures that consumers alone control the personal health information they store in HealthVault accounts. No one: not insurers, employers, hospitals, application partners, advertisers, data miners, or even Microsoft will access consumers’ electronic health accounts without consent. Microsoft’s application partners are held to the same privacy standards as HealthVault. Partners are prohibited from data mining or data aggregation contractually and by technical design, and no onward transfer of data is permitted without explicit informed consent. Advertisers are contractually required to protect any data transferred from HealthVault, and HealthVault’s privacy policies are simple and easy to understand.

In advance of the launch, Microsoft presented the security and privacy features of HealthVault to the Coalition for Patient Privacy. A number of issues were raised, and Microsoft pledged to continue to improve HealthVault’s protections and features and address new concerns as they emerge with the Coalition going forward.

Finally, Microsoft’s new health search engine allows people to search for health information anonymously. Search information may be saved to your Health Vault account where your searches are kept private and secure. Today, virtually all health sites data mine whatever you read and study, and sell that along with your identifying information. So at last it’s possible to search without fear that someone will know about what your concerns are.

PatientPrivacyRights.Org founder, Dr. Deborah C. Peel, will stand with Microsoft in Washington, D.C today at a press conference to announce the launch of HealthVault. PatientPrivacyRights.Org applauds Microsoft’s implementation of the most stringent existing standards for privacy in HealthVault. Microsoft’s willingness to incorporate the Coalition’s strictest privacy standards is truly revolutionary and sets a new, very high bar for the entire industry.

Microsoft’s HealthVault gives Americans a private, secure, trusted place for collecting and storing their personal health information. No consumer should trust any digital health system or technology product that does not follow the same best practices for privacy and security that HealthVault has put into action. PatientPrivacyRights.Org looks forward to standing with other technology corporations as they step up and employ best practices for privacy and security.

A.P. govt. chooses Star Health Insurance again

For the second year in a row, the Andhra Pradesh government has chosen the city-based Star Health and Allied Insurance Company, a stand-alone health insurance firm, to provide accident cover to BPL (below poverty line) families in the State.

Star Health has collected a premium of around Rs. 13 crores to provide one-year accident cover to 7.87crore people in the age group of 18-69 falling under the category of BPL families, which are given white ration cards.

V. Jagannathan, Managing Director, said Star Health had landed this order against some stiff competition. The country's first stand-alone health insurance company had also collected the second instalment of premium worth Rs. 33 crores for providing surgical intervention cover for five specified diseases to BPL families in three districts of Andhra Pradesh. The company had already collected a similar amount as first instalment, he added. The Andhra Pradesh Government was planning to bring five more districts under the insurance cover, he said.

Mr. Jagannathan said Star Health was also in talks with the Puducheery Government for replicating similar insurance schemes for BPL families in at least two districts of the Union Territory. Answering a range of questions, he said Star Health was now toying with the idea of creating an independent vertical for Government business.

The Managing Director said the company had collected premium income worth Rs. 99 crore up to September this year. He was hopeful of collecting premium income of Rs. 200 cores this year. Star Health, he said, had a pan-India presence now, with the opening of a number of branches in the North. Star Health today has 104 offices across the country with staff strength of around 1,500. The company has tie-ups with about 2,900 hospitals.

Mr. Jagannathan said Star Health had raised the capital to Rs. 108 crores from Rs. 105 crores earlier. He said the capital was adequate to support growth in business up to Rs. 500 crores.

October 03, 2007

Indian doctors can work in Singapore without exams

Doctors and nurses from 29 Indian medical colleges and nursing institutes will be able to work in Singapore without any examination, under the Comprehensive Economic Cooperation Agreement between India and the South East Asian economic powerhouse.

The government has identified nine medical colleges and 20 nursing institutes to be recognised by Singapore authorities.

“Doctors and nurses will be able to go and work in Singapore without any tests,” commerce secretary Mr GK Pillai said.

He said Singapore has agreed to extend this facility to India under CECA which has been in implementation for the last two years and covers investment, trade in services and merchandise goods.
Link: Original Article

BSNL to provide telemedicine service among hospitals

Bhartiya Sanchar Nigam Ltd (BSNL) is all set to provide telemedicine services through its network between the Indira Gandhi Medical College (IGMC) hospital and other hospitals including PGI Chandigarh and some in the remote areas of the State. T his was disclosed by the chief general manager of Himachal Pradesh circle of BSNL, Anil Kaushal at a press conference on the occasion of its seventh anniversary. He said 17 hospitals have already been connected under the plan and telemedicine service co uld be started anytime.

The work to connect three more hospitals of the State with the IGMC would be completed in near future. Mr Kaushal said telemedicine would help the people of the State in getting medical advice of specialists of IGMC in their local jurisdiction.

October 02, 2007

Health insurance scheme for poor announced

The government today announced another ambitious programme for the common man, the Rashtriya Swasthya Bima Yojana, which aims to provide health insurance worth Rs 30,000 annually to families of unorganised workers falling below the poverty line.

The government is also announcing the Aam Admi Bima Yojana on October 2 and the National Old Age Pension scheme on November 19, the late Prime Minister Indira Gandhi’s birthday. The first scheme would provide death and disability benefits to the rural landless poor.

While the Rashtriya Swasthya Bima Yojana is meant exclusively for all BPL families in the unorganised sector, the Ministry of Labour and Employment, which has formulated this scheme, is clueless about the actual number of BPL families falling in the sector, which restricts the benficiary number to six crore families.

“The number of BPL families in unorganised sector is a debatable issue but our programme will cover at least six crore BPL families in the sector and this is expected to benefit 30 crore people,” said a senior official of the ministry.

The scheme to be implemented from April 2008 would stretch over five years and cover 1.2 crore families in 2008-09 with an estimated allocation of Rs 751 crore (2008-09 fiscal).

Another problem the programme faces is the fact that the Centre does not have the complete data on BPL families in the country.

Labour ministry officials admitted that the data were not available. Union Rural Development Ministry which has been compiling the data still has to collect them from several states.

“We are aware of this fact but we may devise an altenative in six months’ time (by April 2008) when the schemes would be formulated by the states. Insurance and health services provider would be identified apart from selection of the beneficiaries in this time,” the official said.

The timeline of the scheme stretches over five years with just 1.2 crore families covered in the first year and culminating in six crore families in the fifth year. The total strength of the unorganised sector in the country is 39.35 crore .

Ministry officials admit that BPL numbers in the sector could be much more. This is taking into account the fact that around 30 crore people in the country are below BPL (assumed to be in the unorganised setor) and the sector constitutes 97 per cent of the total workforce.

“The scheme will be implemented from April 2008 and in the first year it would cover 1.2 crore unorganised BPL families. We would allocate Rs 751 crore for this purpose in 2008-09,” Minister of Finance P Chidambaram, said at the launch of the scheme today.

While government of India would contribute 75 per cent of the estimated annual premium of Rs 750 (subject to a maximum of Rs 565 per family per annum), contribution by the respective State governments would be 25 per cent (as well as any additional premium). The beneficiary has to pay Rs 30 per annum as registration/renewel fee.

Total sum insured for the unorganised sector worker and his family (unit of five) would be Rs 30,000 per annum. The insurance cover will take care of all hospital expenses and cover all pre existing diseases. The smart card provided by the authorities will take care of the cashless attendance for all covered ailments.

Releasing the guidelines for the states based on which proper programmes will be formulated by them, Chidambaram said, “Till now, there is no structured security scheme for the unorganised workers in the country. The Unorganised Sector Workers Social Security Bill provides the foundation on which we are buidling these schemes.”

He further said that the scheme might follow the path of NREGP which was spread to all districts much ahead of schedule.

Technical cells would be set up by the Centre to assist the State governments in preparation of the projects. Officials informed that 18 states have indicated their willingness to implement the programme.

“Now it is for the states to formulate their specific schemes in line with these guidelines. Chief Minister of Maharashtra has already given his consent for the guidelines proposed by the Ministry,” they said.

Chidambaram said the government would launch the Aam Admi Bhima Yojana tomomrrow in Shimla.

Now pay your medical bills in EMI

You’ve bought your car on equated monthly installment (EMI), the brand new apartment on EMI, even the plasma TV on EMI. So why not take the EMI route if you go under the knife too?

In an innovative move to make payments easier, the city’s Manipal Health Systems has tied up with HDFC Bank to make this offer to patients.

To begin with, the EMI payment method can be availed of by anyone undergoing the Laser Assisted In Situ Keratomileusis (LASIK) surgery for correcting eyesight. “A lot of youngsters are going in for the LASIK surgery.

So, if you give them some assistance in payment, it will enable more people to opt for this,” says Manipal Health Systems managing director R Basil. The surgery costs around Rs 35,000 and since the EMI option was launched in August, the hospital has done over 200 LASIK procedures.

“Typically, procedures like LASIK, which are cosmetic surgeries are not covered under medical insurance (mediclaim) policies. The EMI is an option provided to patients,” says HDFC Bank SVP and head (product & portfolio-credit card) Mr Parag Rao.

The EMI option is available for all credit cardholders of the bank. The cardholder can avail of this facility for either a 6, 12 or 24 month time-frame.

Says Manipal Health Systems VP (marketing) Bikram Sehgal, “We had several youngsters coming for evaluation , but very few of them would actually get the procedure done. On enquiring, we realised that many found the price too high. After the tie-up with HDFC Bank for the EMI was introduced, we have seen tremendous response. The number of procedures have increased by nearly four times.”

Incidentally, while the HDFC Bank and Manipal Hospital tieup for this product is the first one in the country, such EMI facilities are provided to card holders in developed markets like US and UK. So does it mean that other surgical procedures would also be brought under the ambit of EMIs? Mr Parag Rao was unwilling to hazard a guess given that most of the major surgeries are covered under mediclaim policies.

“The EMI option, you would have to understand, complements the existing payment systems like accepting credit card,” he adds. As for the hospital, Mr Sehgal says that depending on the feedback, they may look at extending the option to other procedures as well.

October 01, 2007

TamilNadu MGR Medical University will conduct job fairs

Tamil Nadu MGR Medical University is planning to organise job fairs for students passing out of its affiliated colleges, Vice-Chancellor Meer Mustafa Hussain has said.

The idea emerged at a meeting of the first students’ union of the university held on Thursday.

While some colleges were organising campus placements, the students felt that they would gain from a similar arrangement. The suggestion was to conduct a job fair with the participation of employers from several medical specialities, nursing and pharmaceutical concerns.

“We decided to act on it immediately because it seemed a good idea. There is rich potential with foreign universities and employers who want to hire researchers, doctors, nurses and pharmacologists,” he said.

“These institutions and companies are more likely to respond to the invitation of a university rather than to a college,” Dr. Hussain said.

One student from each affiliated college had been chosen to represent its interests in the newly formed union which, he said, was aimed at opening up a channel for interaction between students and the university on academic and administrative matters.

For the first time since its inception, the university has applied for grants from the University Grants Commission.

Hitherto it could not apply for want of the requisite staff strength. However, that situation was rectified.

Under the Medical Tamil project, the textbooks for Anatomy, Physiology and Bio-Chemistry would be ready by December-end.

This would be followed by training for professors in teaching the subjects in Tamil. Professors were also working on standardising the vocabulary, he said.



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