December 19, 2010

MCI relief for integrated medicine practitioners in Maharashtra

The controversy over a letter purportedly written by the Medical Council of India (MCI) asking the state governments to take action under the anti-quackery provision against doctors, who offer integrated medicine, has finally been settled with the MCI clarifying that it never issued such a letter.

Integrated medicine refers to the treatment method that combines traditional Indian systems of medicine (ISM) like ayurveda, unani and siddha, with modern allopathy to cure patients. While ayurveda, unani and siddha fall under the Central Council of Indian Medicine (CCIM), allopathy practice is governed by the MCI.

Over 7 lakh integrated medicine practitioners in the country were up in arms over the MCI letter' (dated August 10, 2010) as some state governments, including the administrations in some districts of Maharashtra, had started acting on the letter and taking action against them.

The National Integrated Medical Association (NIMA), which is a body of ayurveda and unani practitioners, had taken up the cause of these doctors and was pursuing the matter with the MCI as well as the CCIM authorities in New Delhi.

The association's prime case was that ISM doctors are institutionally qualified graduates and post-graduates trained in all branches of medicine. The practice is well supported by government resolutions (GRs) issued in 1992 and 1999 under the acts governed by the central and the state councils.

The NIMA had challenged the veracity of the MCI letter' on the grounds that it was full of factual as well as grammatical errors. "It (the letter) appeared to be a case of gross misuse of the MCI letterhead by elements opposed to the Indian systems of medicine," NIMA secretary general V D Tembhurnikar told TOI.

The letter dated August 10 purportedly signed by MCI secretary Lt Col (Retd) A R N Setalvad and addressed to the health secretaries, health directors, district magistrates and superintendent of police of all the states referred to doctors offering integrated medicine as "quacks" and called for a check on them by way of steps like enlisting such medical practitioners, checking their qualifications, status of enrolment for practice of medical profession, etc.

"What was a matter of greater concern for us is that the administration in certain districts like Solapur, Beed, Parbhani and Hingoli had started acting on the basis of this dubious letter, without verifying whether it has indeed been issued by the MCI," said Tembhurnikar. Similar action was also reported by NIMA members from other states like Punjab, Uttar Pradesh and Chhattisgarh.

On Monday, NIMA officials called a press conference to release the MCI's letter clarifying its position on the issue. They also appealed to the state governments to take note of the MCI position and stop acting against integrated medicine practitioners.

In its letter addressed to the CCIM on November 16, MCI deputy secretary Reena Mayyar has stated: "I am to inform you (CCIM secretary) that as per record available, the Council has not issued circular no MCI/Circular/10/1116-31-32/Anti-Quackery/2010 dated August 10, 2010."

Consequently, the CCIM has issued a letter to the health secretaries as well as health directorates, district magistrates and district superintendents of police of all the state governments, appealing to them not to take note of the dubious MCI letter of August 10' and should not act against integrated medical practitioners.

Link: Original Article

December 18, 2010

Government to push doctors to prescribe generics

Given the huge price difference between branded drugs and their generic versions, the government is mulling a policy to push doctors to prescribe drugs by their generic names rather than brand names.

"Branded drugs are not innovative. The poor can ill afford them," said Srikant Jena, minister of state for chemicals and fertilisers.

Jena said the recommendations will be prepared and presented to a group of ministers (GoM) on Friday. He was speaking on the sidelines of the India Pharma Summit 2010 in Mumbai, organised by the Federation of Indian Chambers of Commerce and Industry in partnership with the Department of Pharmaceuticals.

Jena maintained that almost all common drugs, which were off patent, were available in their generic forms at almost all pharmacies and chemist stores in the country. "The state governments have been informed to ask doctors to prescribe generic drugs to cater to the needs of the poor who cannot afford the exorbitant prices of branded drugs," he added.

The government has been contemplating such a move for some time now. It is no secret that the cost of the branded versions of some widely used drugs are five to seven times the price of their generic counterparts. For example, Ciprofloxacin, a drug used for infections, is available for Rs 55 per tablet, five times the price of its generic version, which costs about Rs 11. Similarly, the generic version of Cetrizine, used to treat allergies, costs Rs 2.75 per tablet, compared to Rs 20 for the branded version.

The minister also said that the government is scrutinising and will review its essential drugs list, which currently includes 350 to 400 medications. These are drugs that are widely used and made easily available at affordable prices. He added that the government will soon regulate the prices of cancer drugs, which was a major point of discussion at a recent parliamentary meeting. Recently, the government is said to have been in talks with drug manufacturers for sourcing medicines to treat cancer at affordable rates. Jena explained that these drugs would be sold at its low-cost pharmacy chain Jan Aushadhi, which has stores across the country. Indian pharma major Cipla Ltd has also been in discussions with the Department of Pharmaceuticals to share the technological know-how for cancer drugs with state-owned companies.

Link: Original Article

December 17, 2010

Medical seats go waste at AIIMS

The All India Institute of Medical Sciences (AIIMS) allowed seats in its coveted postgraduate programmes to go waste this year, following an admission policy, which violates Supreme Court judgments, something that it could have avoided. AIIMS cancelled its open counselling scheduled for July 28 meant for vacant seats, even though at least nine seats were vacant as on that date, documents accessed by the Hindustan Times and an affidavit submitted by AIIIMS itself revealed.
Aspirants to those seats have challenged the AIIMS decision in the Supreme Court, where the institute, in its affidavit, has accepted that "some students did not pursue their course and so their seats became vacant".

At least seven seats fell vacant before the date of the scheduled open counselling, which was called off.

Contrary to its own admission now, AIIMS claimed that there were no vacant seats while cancelling the open counselling.

The institute has argued that the vacant seats will not go waste and it will fill up those seats next year during admissions. But its argument, clearly mentioned in its affidavit, violates two earlier SC judgments that bar medical colleges from carrying forward vacant seats to the next academic year.

AIIMS officials had no explanation as to why they did not hold the open counselling as was scheduled even when they knew seats had fallen vacant.

The prospectus of the institute clearly allows open counselling. AIIMS has, however, rejected the students' allegation that the seats were allowed to go waste to facilitate "back-door entries."

In the Medical Council of India vs Madhu Singh and Others, 2002 case, the SC has said that carrying forward vacant seats violates the MCI's own regulations. "As the definition of "admission capacity" shows it is the maximum number of students that could be fixed by the MCI from time to time for being admitted to the course and training."

"By carrying forward the unfilled seats from one year to the subsequent, there is necessarily increase in the number of seats, that is, admission capacity," the order by a bench of justices Arijit Pasayat and Ruma Pal said.

This order also quotes a number of other judgments against carrying forward the vacant seats.

Link: Original Article

December 16, 2010

TN plans to set up one medical college in each district

The Tamil Nadu Government has drawn up a plan to set up at least one medical college in each district of the state and to establish a State Medical Services Corporation and drug warehouses in all districts that provide quality drugs free of cost, a top official said.
"Tamil Nadu now has the highest number of medical colleges in government sector with 15 medical colleges, contributing to human resource development in medical, nursing and paramedical disciplines," State Health and Family Welfare Principal Secretary V K Subburaj told PTI.
He said the policy of one medical college per district proposed by the State Government is a milestone in the history of medicine in Tamil Nadu.
The State Government would encourage private trusts to start courses such as dental, BSc nursing and diploma in nursing courses in rural areas, he said.
"Government has given permission to start ten nursing schools and ten nursing colleges to conduct BSc nursing courses," he said.
Subburaj said government hospitals with medical colleges would be upgraded on par with international standards.
"Apart from this, all government hospitals will also be accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH), a constituent board of Quality Council of India (QCI), set up to establish and operate accreditation programme for healthcare organisations."
"Currently, two government hospitals in the state have been accredited by NABH," he said.
Stating that all Primary Health Centres in the state would also be accredited by NABH, he said at present 48 PHCs have applied for accreditation.
"NABH standards have more than 500 objective elements and about 70 per cent of these elements concern clinical practices and the rest focus on managerial functions," he said.
"The department is also encouraging public-private partnership to improve services of PHCs and government hospitals," he said.
In the last four years, 6,300 medical officers, 7,242 staff nurses, 1,282 village health nurses and more than 9,000 para medical staff had been appointed in various government hospitals, he said.

Link: Original Article

23 Haryana doctors convicted for gender tests

At least 23 doctors and other medical staff in Haryana have been convicted in recent months for illegally conducting sex determination tests, a minister said Wednesday.

'In a drive to curb the menace of female foeticide, the Haryana health department has got convicted 23 doctors and other persons and has carried out 10,618 inspections of various ultrasound clinics,' Haryana Health Minister Geeta Bhukkal said here.

'The department has seized and sealed 125 ultrasound machines for violation of various provisions of the Pre-Natal Diagnostic Techniques (PNDT) Act,'

She said that the ultrasound machines had been seized on account of being unregistered or for violation of various provisions of the PNDT Act.

Health authorities had also suspended or cancelled the registration of 262 ultrasound centres for violation of various provisions of the Act, she added.

Bhukkal said that a survey of all organisations and people using ultrasound machines had been completed.

Link: Original Article

December 15, 2010

Plan to add 8,000 PG seats, says MCI boss

There is a severe shortage of postgraduate medical seats in the country, said Prof Dr Shiv Kumar Sarin, chairperson of the Board of Governors of Medical Council of India here on Thursday at the first convocation of the Chettinad University.
“There are hardly 35,000 UG seats and 11,000 PG seats, while the need is 100 times more.” About 100 candidates vie for each PG seat in a medical university, which indicates the high demand and low supply, Sarin said.
In the US, there are more UG seats than PG seats: 24,000 PG and 16,000 UG.
There is a need to ramp up both PG and UG seats, and the MCI is working out ways to increase the number of medical universities, provided they don’t compromise on quality, excellence and competence, he added. For example, the number of applications to start new medical colleges this year has gone above 70, whereas it was just 19 last year. The target is to add 8,000 PG seats, he said.
Sarin said that reservation policy would go a long way in helping the not so privileged students access quality education. The Common Entrance Test would support all kinds of students, especially those who study under streetlamps, provided it is implemented in a transparent manner, he said.
Dr M A M Ramaswamy, chancellor, Chettinad University, handed over the degrees and diplomas to the students of the Faculty of Medicine and Allied Health Sciences.

Link: Original Article

Retirement age of faculty doctors to be raised: Azad

Union Health and Family Welfare Minister Gulam Nabi Azad on Wednesday announced that the Central Government is considering the possibility of raising the retirement age of faculty doctors of medical colleges from 65 to 70 years.

"In the last three years, the Centre has raised the number of MD seats in medical colleges up to 4700 per year as against 300 in previous years," said Azad, while highlighting the various steps taken by the government to augment the standards of medical education in the country.

"There is need for at least 600 medical colleges to cater to a population like that, whereas the country has just 314 at the moment (including 160 in the private sector) which are producing less than 10 doctors for per 10,000 people," he added, while addressing a public gathering after laying the foundation stone of a 150 crore super speciality hospital at Tanda near Dharamsala.

Gulam Nabi Azad further said one medical school at every district headquarters shall be opened from the next session, which shall prepare doctors in three years, adding that these doctors shall be appointed in rural areas after three months of internship.

"However, these doctors will not be entitled to perform any surgery," he said.

Further talking about the super speciality hospitals in medical colleges, Azad said that 13 of them were sanctioned last year for the entire country and six this year including the Tanda Medical College .

"This will include ecology, cardiology, cardiac surgery, nephrology, neuron surgery and other facilities besides 200-bed special wards. The project shall be completed in 18 months," he added.

Link: Original Article

December 14, 2010

Bangalore and Pune fast emerging as hubs for teleradiology

Call it an innovative solution to skilled manpower crunch or simply a new paradigm of seeking medical expertise.

The diagnosis that saves a patient's life in some remote areas of the country and abroad is being made by radiologists sitting in their consulting rooms in Pune.

The concept of teleradiology (knowledge process outsourcing) is fast picking up in the city. More and more experts are interpreting digital images of MRI, CT scans, X-rays, etc and sending their interpretations to doctors practising not only in various parts of the country but also the globe.

Radiologist Abhimanyu Kelkar, head of the Omega MRI Centre at Poona Hospital and Research Centre (PHRC), says, "Shortage of experts as well as advances in telecommunication are fuelling the trend of teleradiology in Pune. Besides dispensing radiology related work of my unit, I see around 10-12 MRI scans every day coming from various parts of the country. I charge Rs 400-700 per scan. The digital images are usually being sent by diagnostic centres and private hospitals which have sprung up in peripheral and remote parts of the country. It takes 15 to 20 minutes to interpret a report."

Besides helping patients in remote parts of the country, there are some who even work for hospitals in the US and West Asia. "I interpret around 30 to 40 reports every day. A large part of them mainly comes from hospitals in countries like Dubai, Jeddah and also in the US," says Kedar Athawale, faculty in radiology at Bharati Hospital and Medical College.

Confirming the trend, senior radiologist Amarjeet Singh, former vice-chancellor of the D Y Patil University and former dean of the D Y Patil Medical College, says, "It is a win-win situation for both the parties. I personally knew a few young radiologists in Pune who do teleradiology work for hospitals in the US and to some extent in the UK." "Doctors in western countries accept our expertise. The reporting of our radiologists is always appreciated for accuracy of diagnosis. Besides, we have the efficiency of delivering the report within half an hour — much earlier than any other hospital abroad," says Singh, currently CEO of D Y Patil Medical College. But how does the process of receiving the work begins? "Both the parties come to know about each other through websites or international conferences," says radiologist Amit Kharat.

"Once a US hospital or clinic decides to outsource its teleradiology work, it initially starts testing the reporting and interpreting skills of the group extensively. The group which has high degree of customisation or subspecialisation gets high preference as their reports are more evolved," says Kharat who is also the owner Cyberteleradiology private Ltd — a company involved in teleradiology work in Pune and especially deals with hospitals in the US and European countries.

Sharad Agarkhekar, president of the city chapter of Indian Medical Association, says, "Going by the number of private hospitals and diagnostic centres coming up across the country, the unprecedented number of scanners and X-ray machines being sold and the large number of people going for preventive health checks, the shortage of radiologists has started showing up. That is the reason for the trend fast picking up in Pune, after Bangalore."

Link: Original Article

Tamil Nadu preferred destination for medical tourism

Tamil Nadu has emerged as the preferred destination for medical tourism in the country, with the government prioritising the improvement of health care services in the State, said Health Minister M. R. K. Paneerselvam in Tiruchi on Thursday.

The State government has been upgrading facilities in government hospitals on par with private hospitals to extend top class health care. Expensive liver and heart transplant surgeries were now being performed at the Stanley and the Madras medical college hospitals free of cost.

Tamil Nadu is now being looked up to for its affordable and quality health care services and even foreigners were coming here for treatments, Mr. Paneerselvam observed, speaking at a function to mark the inauguration of a digital X-ray unit and the renovated neo natal ward at the Annal Gandhi Government Hospital attached to the K. A. P. Viswanatham Government Medical College in the city.

The government has sanctioned Rs. 600 crore for purchase of equipment in government hospitals. It has sanctioned the establishment of digital X-ray units in 40 medical college and government hospitals in the State. Ten have already been established and the remaining would start functioning soon.

The government has also decided to set up neo natal wards in all district headquarter hospitals and the first was opened in Tiruchi on Thursday. Construction was underway in the hospitals, and the wards would start functioning in 10 district hospitals next month. Similarly, all district headquarter government hospitals would also be provided with MRI scans and the equipment has been provided to government medical college hospitals already.

Prompt measures undertaken by the government to control the spread of diseases such as the AH1N1 influenza ensured that the State stood in the forefront in preventing loss of human lives due to such new diseases.

Appealing to government doctors and para-medics to discharge their duties sincerely and efficiently, Mr. Paneerselvam reminded the doctors that the DMK government had enacted the Hospital Protection Act to protect their interests. The salaries of government doctors and stipend of house surgeons have also been increased by the government, he said.

Transport Minister K. N. Nehru, District Collector Mahesan Kasirajan, MLAs Anbil Periyasamy, K. N. Sekaran and A. Soundarapandian, Mayor S. Sujatha, District Panchayat Council Chairperson V. Sangeetha, Corporation Commissioner T. T. Balsamy, and Dean of K. A. P. Viswanatham Government Medical College A.Karthikeyan were present.

Rs. 50 crore for Tiruchi medical college hospital

The Annal Gandhi Government Hospital would be upgraded soon and Rs. 50 crore would be sanctioned in the first phase for infrastructure development at the hospital, the Health Minister announced here on Thursday.

A new six-storey building would be built utilising the first instalment of funds. Ten super-speciality wards, each with 30 beds, would be established at the new building, which would have a total floor area of about 8,000 square metres, Mr. Paneerselvam said.

The Minister’s announcement comes in the wake of long pending demand from the city residents for upgrading the hospital, which turned into a public movement after a project to upgrade the hospital on par with the All India Institute of Medical Sciences by the Union government was mooted a few years back.

Transport Minister K. N. Nehru, who represents the Tiruchi II Assembly segment, indicated that the new building would be located in the medical college campus at Periya Milaguparai in the city.

Neo natal ward

The digital X-ray unit at the hospital has been set up at a cost of Rs.1 crore and Rs.12.12 lakhs has been spent for the renovated neo natal ward. About Rs. 25 lakhs worth of equipment are to be provided to the neo natal ward. The establishment of the 24x7 neo natal ward was intended to bring down the mortality rate of newborns.

Link: Original Article

December 13, 2010

IMA attacks MoH, MCI over suspension of top office-bearers

The Indian Medical Association today launched a frontal attack on the Health Ministry and the Medical Council of India for suspending its President and Secretary for endorsing products.
"The IMA is registered under the Societies'' Act. Only violation of any Section of Societies'' Act can invite action on IMA. There has been no violation of the provisions of this Act. MCI has no locus standi on IMA. IMA asserts its right to convey health information to the people," it said in a statement here.
The body said that the state medical councils are the competent authority to register as well as take any disciplinary action on any registered medical practitioner and MCI could only make recommendations to the state medical councils.
"The recommendation of MCI is not binding on the state Medical Councils," it added.
The IMA said that the "duly elected members of MCI have been removed and at present only an ad-hoc council appointed by the Government of India existed.
"At best this is a stop gap arrangement. This body has not been vested to perform duties of an ethics committee," it said.
On November 19, Union Health Minister Ghulam Nabi Azad in response to a written question in Rajya Sabha had said that the National President and Secretary General of IMA have been suspended from Indian Medical Register.

Link: Original Article

High medical bills push 100m into poverty every year: WHO

Illness and medical bills are pushing over 100 million people into poverty every year.

In some countries, 5% of the population is forced into poverty every year because they have to pay for health services. According to the World Health Organization (WHO), in countries like India, people who pay for their health care services suffer "catastrophic costs".

While millions suffer and die because they do not have money to pay for health care, others suffer because they end up paying through their noses.

Even countries where health services have traditionally been accessible and affordable are finding it harder to respond to people's needs, says WHO's annual World Health Report 2010.

The report estimated that between 20% and 40% of all health expenditures is wasted due to inefficiency. Overpaying is a form of waste. For instance, in some places medicine prices are up to 67 times more than the international average price, grossly affecting expenditures for other health services.

"No one in need of health care should risk financial ruin as a result of this," said Margaret Chan, direct of WHO.
The report cited a study by Harvard University in 2007, which showed that medical bills contributed to 62% of family bankruptcies.

"It's just not acceptable," said David Evans, director of health systems financing at WHO. According to the report, millions of people miss out on health care because they simply cannot afford to pay for it.

In some countries, women, who are among the 20% affluent in the society, are up to 20 times more likely to have birth of their babies attended by skilled health worker than her poor counterparts.

WHO suggests that a small change in the percentage of budget allocated to health would create a big increase in health resources.

If 49 of the world's poorest countries allocated 15% of their government spending for health, this could almost double their health expenditures. Cumulatively, this would represent an additional $15 billion annually for health expenditures.

Also, more efficient tax collection generates more government money for health. The report claimed, new or reinforced sources of revenue could boost health finances.

For example, a 50% increase in tobacco tax would yield $1.42 billion in 22 low-income countries — allowing health expenditures to increase by around 10%. India could raise $370 million annually by implementing a 0.005% levy on foreign exchange transactions.

Link: Original Article

December 12, 2010

Medical college''s pro-poor admission policy gets Supreme Court nod

Unaided private medical colleges can admit the poor and deserving students free of cost in its management quota even if that requires waving statutory regulations hindering such admissions, the Supreme Court has ruled. "If any college, out of charitable or philanthropic motive, wants to extend a helping hand to the economically weaker section of students by providing free admission to its ten per cent management quota seats, there is no need for the fee regulatory committee to fix the fees to be charged by the college for such seats," said a bench of Justices R V Raveendran and H R Gokhle.

"Nor will it be necessary for such a college to be the part of a consortium of unaided private colleges, which wants to charge the fee," held the bench, waiving two legal stipulations laid down by the apex court in some of its earlier judgements pertaining to admissions in professional unaided colleges. The court, however, struck a note of caution in granting such waivers to colleges, saying, "It will, however, be necessary to ensure that such a scheme (to admit poor students free of cost) is not a camouflage for making illegal or irregular admissions or for clandestinely charging capitation fee or for profiteering."

The bench gave its ruling on an appeal by a private unaided medical college of Gujarat, Pramukh Swami Medical College run by a civil society Charutar Arogya Mandal, seeking to admit and educate the poor and deserving students on its ten per cent management quota seats on a token annual fee of Rs 5,000. As per the relevant rules for admission to the private unaided medical colleges in the state, 75 per cent of the seats, dubbed as government seats, are reserved for admission to students successfully competing in a state-wide test for admission to various medical colleges. Out of remaining 25 per cent seats, 15 per cent seats are meant for non-resident Indians and ten per cent seats, called management quota seats, are for candidates selected by a consortium of all the unaided colleges.

The consortium prepares a merit list of students seeking admission to these colleges on their management quota seats against a higher fee. But Gujarat's Pramukh Swami Medical College scheme to admit poor students free of cost against its 10 per cent management quota seats ran aground for want of permission by the state government, which insisted upon it to stick to the relevant rules of joining the consortium of colleges to fill its management quota seats. The aggrieved medical college approached the Gujarat High Court seeking permission to allow its own methodology to admit the poor and deserving students. The high court, however, disposed of the college's plea by a vague order without examining its merits. It was against this order that the medical college came to the apex court and got the reprieve.

Link: Original Article

US doctors now open to sex with patients

Doctors in the US are now open to a romantic or even a sexual relationship with patients, a survey has revealed. Around 10,000 American physicians were asked 20 "ethically thorny" questions in a poll conducted by WebMD, an online medical consultancy, which found out that 11.7 per cent admitted they could become romantically or sexually involved with a patient.

But the doctors said they waited for at least six months after treatment, the New York Post reported.

"We shouldn't remotely entertain romantic thoughts when we see a patient," one doctor said. "But if you ran into that person outside the office at a later date and 'clicked', I see no problem."

But a whopping 83.1 per cent said mixing love and medicine was taboo - with one even calling it "totally exploitative".

The poll also found out that at least 23.2 per cent American doctors would prolong life-support, even if "futile", to appease the patient's family.

While 17 per cent said they would "falsify a patient's condition" to get insurance money, about five per cent said they might cover up a mistake even if it harmed the patient.

Link: Original Article

December 11, 2010

Nearly 1,000 more MBBS seats in Karnataka from next year

There's good news for aspiring doctors taking next year's Common Entrance Test (CET). The medical education department has given its nod to add 930 MBBS seats in nine colleges across the state starting 2011-12. Two government medical colleges — Bangalore Medical College and Research Institute — will add 150 seats next year and 100 more for Bellary-based Vijayanagara Institute of Medical Sciences.

"I have issued essentiality certificates to increase intake by 930 seats so far. Even in case of deemed universities, we have asked them to surrender 25% seats for government quota," medical education minister S A Ramadas told STOI. The Medical Council of India will take a final call.

Other institutions where an increase has been recommended include Rajarajeshwari Medical College, Bangalore (150); K S Hedge Medical Academy, Mangalore (50); Srinivasa Institute of Medical Sciences and Research Centre, Suratkal (150); Yenepoya Medical College, Mangalore (100); Navodaya Medical College, Raichur (100); Kempegowda Institute of Medical Sciences, Bangalore (80); Jawaharlal Nehru Medical College, Belgaum (50).

Currently, Karnataka has 10 government colleges with a combined intake of 1,100. In all, there are 39 institutions offering a total of 4,855 MBBS seats.

Link: Original Article

DRDO to train doctors to handle victims of chemical, nuclear strikes

In the wake of chemical and nuclear threats, the Institute of Nuclear Medicine and Allied Sciences (INMAS) of Defence Research and Development Organisation (DRDO) is strengthening its chemical, biological, radiological and nuclear (CBRN) defence by extending training programmes to private and government institutes, health organisations and paramilitary forces. This would also include health institutes such as PGIMER where doctors and nurses are to be provided similar training in order to prepare them on how to deal with CBRN casualties.

Talking about the gravity of CBRN threats and the ignorance among sections of military and para-military forces as well as the public, Dr Rakesh Sharma, Scientist ‘G’, Additional Director and Head, Division of CBRN Defence, INMAS said, “Today, more than the CBRN threat from other countries, it is the threat of proliferation of such highly devastating agents into the hands of terrorist organisations across the globe. Also, there could be incidents where the disaster is a natural one, as was the recent case of Delhi University Cobalt-60 disaster. In contrast to the high intensity of threats, the awareness is very low among professionals and public. Keeping this in mind, for the first time INMAS would have a CBRN training institute where paramilitary, employees at government orgainsations, health institutes and civilians would be trained to prepare them for any CBRN mass casualty.”

Keeping the importance of hospitals and health research institutes in mind, INMAS had already published a 250-page book on medical management on CBRN casualties and distributed in hospitals including PGIMER. “We have already trained a section of doctors, nurses, and other health professionals on how to treat a patient exposed to radioactive agent prior to the Commonwealth Games at Delhi. Talking about the health institute-PGIMER-which caters to patients from various states including Himachal Pradesh, Haryana, Punjab, Uttar Pradesh, etc, it is pertinent to train doctors and nurses for such casualties. Thus, it would also be roped into these training programmes,” stated Dr Sharma.

The training will be premised on the existing defence technique of NBC currently being used in military. This would be modified as per the requirements of the civil sector. For instance, the technology used in military tanks to counter NBC attacks would be modified and simplified for the use of personal vehicles. At present, 62 NBC defence tools are produced by DRDO and already inducted in defence which would be modified for the civil use and accordingly provided training on how to use them.

Dr Sharma further added, “The training is a four step programme where the most important element is protection-of both individual and collective, second is detection followed by decontamination and medical counter measures.”

Link: Original Article

December 10, 2010

AP rules out national quota in medical seats

The state government will not allocate its medical seats to the central pool of seats which is open for candidates from all states in the country.

In an all-party meeting held by chief minister K Rosaiah, minister for medical education Sudarshan Reddy announced that going against the instructions of the central government, the state would not contribute 15 per cent of its medical seats to the national pool.

This would mean that all the medical seats in the state will be available for students from here. Andhra Pradesh is the only state which will not contribute seats to the national share.

The decision against contributing seats to the central pool was taken in consultation with all parties, who opined that national quota would eat into the seats meant for weaker sections in the state including students from Other Backward Classes (OBC).

Meanwhile, the minister also stated that the Centre has sanctioned a 30 per cent increase in PG medical seats.

Link: Original Article

Doctors group protests Desai's election to Gujarat University senate

A doctors group has written to Gujarat Chief Minister Narendra Modi protesting against tainted former Medical Council of India (MCI) chief Ketan Desai getting elected 'uncontested' to the Gujarat University senate.

The letter by Kunal Saha, president of People for Better Treatment, Saturday called for Modi's attention on the matter.

'It is reported that Dr. Desai was elected 'uncontested' to the seat in the Senate of the Gujarat University. It is shocking that a doctor who was arrested by the CBI for heinous crime including 'bribery' and possession of 'disproportionate assets' and is facing criminal trial may be elected to the Gujarat University Senate,' Saha wrote in his letter.

'More importantly, the MCI cancelled the medical registration of Dr Desai on Oct 9, 2010 for 'professional misconduct'... As of today, Dr. Desai's medical licence remains cancelled and he is not authorized to treat patients or act as a medical doctor. He can have absolutely no legal or moral right to become a member of the University senate filled under the 'medical graduate' seat,' the letter said.

Desai, who was arrested by CBI for taking a bribe of Rs.2 crore for granting recognition to a Punjab-based medical college, remains in the seat of the Gujarat Medical Council chief even though his medical licence has been suspended by the Board of Governors of MCI.

He was Friday elected 'uncontested' to the Gujarat University senate to a seat meant for a medical graduate.

Link: Original Article

December 09, 2010

Apollo Hospitals establishes drug reaction reporting centre

Apollo Hospitals today said it has set up an adverse drug reaction reporting center at its facility in New Delhi under the National Pharmacovigilance programme.

"It (the centre) is the first of the corporate entities to join 12 centres of pharmacovigilance programme," Chairman Task force for Research Apollo Hospitals Educational and Research Foundation Ranjit Roy Chaudhury told PTI on the sidelines of pharmacovigilance-global perspective meet.

Pharmacovigilance program of India was launched in July 2010 for detection, assessment, understanding and prevention of adverse effects, particularly long-term and short-term side effects of medicines, as new drugs find their way to the country.

Under the programme, 40 such centres including other corporate hospitals and medical institutions, are planned to be established by 2011.

The program is meant to monitor medicines as used in everyday practice and to identify previously unrecognised adverse effects or changes in the patterns of their adverse effects.
Further, the program intends to assess the risks and benefits of medicines in order to determine what action, if any, is necessary to improve their safe use.

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Bombay HC upset over state’s failure to recognise courses

The Bombay High Court on Friday expressed displeasure over the state government’s apathy towards getting its post graduate medical courses recognised by the Medical Council of India (MCI). “How could this happen?" said the division bench of Chief Justice Mohit Shah and Justice SJ Kathawala while hearing a petition filed by 48-year-old doctor, who has been asked by the MCI to stop practice as MS (opthalmology) - about 21 years after she obtained the post graduate degree from Government Medical College, Miraj.

The petitioner doctor, Shubhangi Nigvekar has sought compensation of Rs 60 lakh from the state for the failure on its part to get her post graduate medical degree recognised.

Dr Nigvekar, who had been constrained to work on consolidated salary because of non-recognition of her post graduate degree, was conferred MS (opthalmology) degree by Kolhapur University in 1989.

Despite repeated attempts MCI has refused to grant her registration as a post graduate medical profession stating her course has not been recognised for want of proper application from the state government.

Her counsel VM Thorat on Friday said the MCI has issued a notice to the petitioner, who works with Rural Medical College, Loni (Ahmednagar district). The MCI has asked her to stop practice as her degree was not recognised.

The court has directed the government to file its affidavit on Dr Nigvekar's petition within three weeks after which it will come up for further hearing. The petitioner has said she was entitled to a compensation of Rs 60 lakh as the MS (Opthalmology) degree was of no use to her since she cannot practise as a post graduate qualified doctor.

Link: Original Article

December 08, 2010

Medical courses: IIT waits for Parliament nod

It will not be long before doctors walk out with MBBS, MS and MD degrees from the Indian Institute of Technology (IIT). Plans are afoot to table a bill to amend the existing statute of the IITs to allow them to introduce medical studies. "Till now, we had churned out efficient engineers. Now, we will also be committed to producing world-class doctors," said IIT Kharagpur's deputy director, A N Mazumdar.

If the Parliament passes the proposed legislation changing IITs' statutes, then IIT-Kgp will be the first among the six IITs to set up a medical school. In its draft proposal submitted to the ministry of human resources development, IIT speaks about introducing postgraduate courses in technology oriented medical education.

"Our strength is technology-driven research. We have thus laid emphasis on introducing technology oriented medical education. We had initially planned to start postgraduate courses like MS and MD. However, due to guidelines and restrictions of the Medical Council of India ( MCI), we will also introduce MBBS courses. Under the guidelines, we can only start a postgraduate programme in medicine if we have an undergraduate programme as well," added another senior professor of the institute.

Students will be admitted to the MBBS course in three phases over the next five years. "In each phase, we will take 50 students for the undergraduate medical course. There are a few options for admitting students. One is to introduce a biology paper in the existing IIT-JEE exam. Another is to admit students through the All India Pre Medical Test. It has not yet been decided and a final call will be taken soon. Once the approval is given, other modalities will be chalked out," said Mazumdar.

Some unique medical technology which will be top priorities for the medical school at IIT-Kgp will be medical teleconsultation, developing sophisticated technology for distant surgeries, usage of hepatic devices, introduction of genetics and genomics in medicine and drug designs. "There is a unique genetic sequence in every individual. Through drug designing, each person with an ailment will be given a particular class of medicines that best suit him or her. This will not be like prescribing general antibiotics. Each drug will be designed for each one," explained Mazumdar.

Another important aspect of the proposed medical school is research on bio-prosthetics and development of alternate material to polymers which are currently used as well as haemodinamic simulations.

IIT-Kgp in the midst of consultation with several renowned medical colleges and hospitals in the country and the US to seek help for faculty as and when the proposal to set up the medical college is sanctioned. "A state of art medical education programme where technology will play the lead role is our aim. We will recruit the best medical teachers in the country in order to impart lessons," concluded Mazumdar.

Link: Original Article

Cheaper medicines through people's drug stores on cards

Quality generic drugs will soon be made available to the public at affordable prices with the Union government's move to open Jan Aushadhi Outlets (peoples' drug store) in every district hospital of the country. This will check soaring prices of branded drugs and bring generic medicines within the reach of the common people, said experts.

"This is an important step as medicines account for 70 per cent of the out-of-pocket expenditure. Even if patients are able to receive a free check-up at a government clinic, they are often forced to pay out-of-pocket for the medicines, said Anant Phadke, co-convenor, state chapter of Jan Swasthya Abhiyaan, a coalition of NGOs working in the field health and right to healthcare.

"But it all depends on how the scheme is implemented. The scheme has been properly implemented in Rajasthan. The Maharashtra government needs to take proactive steps to implement the scheme effectively," Phadke said. Jan Aushadhi Outlets will provide generic drugs to poor patients at around half the price of branded drugs. But opening of the outlets depends on state governments' co-operation in allotting space in government hospitals, Phadke added.

Healthcare expenditure is the second-largest cause of rural indebtedness in India. As of 2008, 72 per cent of total healthcare expenditure was privately funded, 89.5 per cent of which was paid out of pocket by patients. During 1999-2000, 32.5 million patients fell below the poverty line after just a single hospitalisation. As much as 40 per cent of those hospitalised were forced to borrow money or sell assets to meet cost, and 23 per cent of ill patients never sought treatment because of their inability to pay. The WHO estimates that 65 per cent of India's population lacks regular access to essential medicines, states the fact sheet paper of the Jan Swasthya Abhiyaan, Medicine Pricing and Universal Access to Treatment.'

"There is no scientific reason that doctors should prefer an expensive brandname medicine to cheaper versions, as both act exactly in the same way in the human body. However, because the factors behind pricing are complex and poorly understood, doctors tend to equate high price with higher quality, and prescribe the costlier versions. Doctors are also subject to advertising pressure from companies that produce the expensive versions, which influences their prescriptions. If a patient wants to save money, they should ask their doctor to prescribe the least expensive version of the needed medicine," said Abhay Shukla, national joint convenor of Jan Swasthya Abhiyaan.

Except individuals and commercial organisations, NGOs/hospitals/charitable/co-operative/government bodies, which have minimum three years experience with good track record are eligible for running the Jan Aushadhi outlets. Recommendation in favour of the applicant organisations from the respective health department of the state governments is required. Besides this, the state and central governments are also eligible to identify agencies to manage the stores.

Link: Original Article

December 07, 2010

30 per cent increase in AP medical seats - MBBS & PG likely

Medical aspirants will have a better chance of securing a seat in state colleges next academic year as the number of medical seats in the state might increase by an average of 30 per cent, thanks to the new Medical Council of India rules. According to the recent MCI guidelines for admissions, medical colleges which have 1,100 beds can admit up to 250 students. This would mean that several top medical colleges in the state can increase their seats by 20 to even 50 per cent.

According to officials of the medical education department, colleges like Osmania Medical College (bed strength 6,000) which currently has 200 seats, would be able to add 50 more seats. Similarly, Gandhi Medical College (1,100 beds) would be able to add 100 more seats to its existing 150 in the wake of MCI's new guidelines and Warangal Medical College (1,200 beds), again with a seat strength of 150, would be able to add 50 to 100 seats depending upon the number of faculty members.

Officials of NTR University of Health Sciences said that since an average of 60,000 students qualify in the Eamcet every year an increase in the number of seats would be a welcome move. "Every year around 13 students compete for one seat. The competition will come down from the coming year," said T Venugopal Rao, registrar, NTR Health University.

Meanwhile, private medical colleges are unlikely to gain from the new guidelines as their bed strength doesn't match those of government institutions. "Once seats are increased, students having ranks up to 5,500 would stand a fair chance of getting medical admissions in the next year," said a private college management representative.

Meanwhile, senior doctors are still skeptical about number of medical seats going up. "The faculty ratio in a college will also determine the admission policy. Without enough faculty members no college can cope with increased student strength. Hence, the colleges which are eligible for seat increase have to have a bigger faculty," said Pradeep Despande, professor of nephrology and former principal, Gandhi Medical College. According to the current norms, the teacher-student ratio in undergraduate level is supposed to be 1:9.

Prof Siddappa Gourav, principal, Osmania Medical College, is optimistic of getting MCI approval for increasing the number of medical seats in his college as it has a healthy bed strength of 6,000 spread across 10 hospitals and one rural health centre.

MCI has also sanctioned a 30 per cent increase in PG medical seats for the coming academic year.

In the previous year, MCI had increased the seat share in colleges including Gandhi and Osmania by 10 per cent.

Link: Original Article

Himachal to provide free medicines to poor

The Himachal Pradesh government Wednesday announced it would provide medicines free of cost to people living below poverty line (BPL) in the state.

Chief Minister Prem Kumar Dhumal, at a function in Sirmaur district, announced that under the Pandit Deen Dayal Upadhaya BPL Security Yojna, each below-poverty-line family would get 38 medicines free of cost in the government hospitals of the state. Around three lakh BPL families would be benefited.

The government has already launched the Rashtriya Swasthya Bima Yojna or national health insurance scheme, under which it has tied up with the New India Insurance Company Limited to provide an insurance cover of Rs.30,000 to each family.

Link: Original Article

December 06, 2010

'Misleading' ads by doctors upset apex consumer forum

The country's apex consumers' grievance redressal forum has expressed grave concern over cases of doctors luring patients with ''misleading'' claims to treat incurable diseases and has held that such assurances amount to rendering deficient service.

The apex consumer body expressed its worries while dismissing a plea by two medical practitioners, challenging a Kerala consumer forum order asking them to pay a compensation of Rs one lakh to a person for misguiding him on his son's cancer treatment, eventually leading to the youngster's death.

"The case presents a disturbing situation in as much as an ayurvedic practitioner and an MBBS doctor had held out to the public at large through print media that they have the skill to treat the cancerous tumour of children," the National Consumer Dispute Redressal Grievance Commission observed in its order, dismissing the two doctors' plea.

"The compensation of Rs 1,00,000 only, in the opinion of this Commission is quite just and reasonable and is neither excessive nor harsh," Commission member R C Jain said.

The Commission passed the order on a joint plea by Kerala-based ayurvedic practitioner, Dr Kunhalan Gurukkal and medical practitioner Dr Firdous Iqbal, challenging the state forum's order directing them to pay the compensation to A M Muhammed, the complainant.

The Kerala consumer commission had ordered the two doctors to pay the compensation for misguiding Muhammed, whose 21-year-old son had been suffering from osteosacoma (a cancer of the bone) and was undergoing treatment at the Regional Cancer Centre, Thiruvananthapuram.

The cancer centre has advised the patient to undergo amputation of leg in order to save his life. It was at this juncture that Muhammed noticed the advertisement by the two doctors, claiming that they can treat cancer and took his son to them.

But the doctors were able to do precious little beyond administering the patient with some ineffective drugs, letting his plight to worsen further and leading to his eventual death.

Aggrieved, Muhammad approached the state forum seeking compensation of Rs 6 lakh from the two doctors for unfair trade practices and deficiency in service.

Link: Original Article

November 28, 2010

New antibiotic policy may be introduced in 3 Delhi hospitals

To start with, the new national antibiotic policy is likely to be introduced in three central government hospitals in Delhi — Lady Hardinge Medical College, Safdarjung Hospital and Ram Manohar Lohia Hospital.

The policy, drafted by experts from the National Institute of Communicable Diseases, AIIMS, Indraprastha Apollo and others under the chairmanship of Drug Controller General of India (DCGI) Dr RK Srivastava, was on Tuesday sent for approval to Union Health Secretary K Sujatha Rao.

The experts recommended that the guidelines be implemented in the three hospitals as a pilot project and then in other hospitals across the country. Once cleared by the secretary and Union Health Minister Ghulam Nabi Azad, the policy will be sent to Parliament for the creation of a separate Schedule-HX under the Drugs and Cosmetics Act and making it mandatory for antibiotic drugs to be sold against prescriptions.

As per the new rules, doctors will have to write prescriptions for antibiotics in duplicate. The chemist will have to retain one copy for a year from the date of sale in order to facilitate verification and audit.

The decision to formulate a new policy was taken by the DCGI last month to prevent misuse and overuse of antibiotics. The evolution of the ‘superbug’ NDM-1, resistant to even the most powerful group of antibiotics, has been blamed on antibiotic overuse.

About 16 high-end antibiotics, including Meropenem, Cefepime and Moxifloxacin have been put under the new schedule. Also, 58-odd antibiotics such as Penicillin, Ampicillin and 15 drugs containing codeine as well as first-line TB drugs such as Rifampicin, Isomiazid, Pyrazinamid and Ethambutol will require duplicate prescriptions.

Violators will be punished with a fine of at least Rs 20,000 and a year’s imprisonment, which may be extended to two years. The experts have also proposed that hospitals compulsorily set up a “drug control committee” to approve high-end antibiotics and an “infection control committee” to track and analyse infections.

Link: Original Article

November 27, 2010

Firm says top hospitals violate biomedical waste disposal norms

As many as 174 private, civic and government hospitals and nursing homes in the city have been found violating norms regarding handling and disposal of biomedical waste by a BMC-appointed firm for the purpose. These include top BMC hospitals such as BYL Nair, Sion Hospital, Kasturba Hospital, state government hospitals such as JJ Hospital and Cama Hospital and high-end private hospitals such as Lilavati, Kokilaben Ambani, Fortis.

The Maharashtra Pollution Control Board, acting on a complaint sent to it earlier this month by the agency handling biomedical waste in the city, has started physical inspection of these hospitals. Those at fault will be served show cause notices and will be liable to strict penalty under the Bio-medical Waste (Management and Handling) Rules, 1998.

Improper segregation of bio-medical waste (BMW) before disposing it into an incinerator can cause emission of highly toxic byproducts, including dioxins, a carcinogen. The list was sent by Sms Envoclean — the firm appointed by the BMC — to the MPCB.

The firm gathers about 12 tonnes of biomedical waste produced from over 1,200 city hospitals daily and treats them at the biomedical incinerator situated within the premises of the Deonar dumping ground. An official from the firm said many hospitals do not carry out the required segregation which hampers the operations in the incinerator that emit dangerous gases. “Plastic IV fluid bottles, body parts, syringes and soiled bandages are all dumped in the same bag instead of being segregated. Almost 90% of the waste comes unsegregated and it becomes impossible for us to segregate it at the plant,” he said.

MPCB regional officer DB Vadde said that as per the law, biomedical waste has to be segregated in ten categories such as human body parts, expired medicines, medical equipment, plastic IV bottles etc. “If such segregation is not done and for instance if plastic is incinerated along with other bio-medical waste, you are sure to produce dioxins. We have received a written complaint from Sms Envoclean and we will verify their claims by inspecting these hospitals ourselves. Four MPCB teams have been formed for this purpose and those hospitals violating norms can face a fine up to Rs 1 lakh and in extreme cases, cancellation of license,” said Vadde.

MPCB had, in August, sent notices to 47 hospitals in the city for similar violations and given them a period of 15 days to rectify their waste disposal system. Vadde said that most hospitals that were served notices started following norms later.

Residents associations in areas close to the Deonar dumping ground have repeatedly protested against the haphazard treatment of BMW at the incinerator without proper air-quality check systems.

Link: Original Article

November 26, 2010

Mobile health services need a sustainable business model in India

Even as India attempts to scale up access to e-health, the industry is already talking about the next step in health technology—mobile health, or m-health.

M-health will attempt to go one step further and bring health services right to the mobile phone, with junior doctors functioning in a centre much on the lines of a call centre.

At the India Economic Summit of the World Economic Forum, a varied range of panellists brainstormed on the opportunity that lies in m-health at a session on Shaping India’s Mobile Health Ecosystem.

The global m-health technology market is expected to grow 25% annually, from the current $1.5 billion (Rs10,125 crore) to $4.6 billion by 2014.

“The mobile has transformed the way we work, and broadband and connectivity will provide never before (levels of) communication. This is the start to the best possible technology to bring greater access to healthcare,” said Malvinder Mohan Singh, chairman, RHC Holding India Pvt. Ltd.

While m-health creates a whole world of opportunities in healthcare delivery, the key question is whether it can be a sustainable business model.

Sachin Pilot, minister of state for communications and information technology, said that while the idea of m-health is exciting, the biggest challenge would come in the form of language diversity.

“We must not lose time. This is not one ministry’s job… the IT (information technology) ministry and health ministry have to come together to work on this. At the same time, we must keep in mind that India is a very price-sensitive market, so unless the access to m-health is affordable, it won’t work,” said Pilot.

Sangita Reddy, executive director, operations, Apollo Hospitals Enterprise Ltd, said the country cannot afford to create silos of capability.

“How do we find a way to create accessibility? We cannot think of just m-health. Before m-health we have to excel in e-health and before that we have to create basic healthcare for all. It has to work in one continuum,” said Reddy.

She added that projects would need to be started on a pilot basis as part of corporate social responsibility, and then, depending on their success, could be scaled up into sustainable business models.

While all the panellists agreed that m-health could be the future of basic healthcare, it would largely depend on building a sustainable business model for e-health with various service and healthcare providers coming together to work on this.

“This can be a sustainable model, but don’t expect an ebitda (earnings before interest, taxes, depreciation and amortization margin) of 80%,” Pilot said.

Link: Original Article

November 25, 2010

Common exit exam for medical graduates soon

Health Minister Ghulam Nabi Azad Tuesday said the central government is contemplating holding a common exit exam for medical graduates based upon the recommendations of the Medical Council of India.

In a written reply in the Rajya Sabha, Azad said the 'common exit exam' has been suggested by the task force constituted for creation of an overarching body for medical education -- the National Commission for Human Resources for Health.

'The central government had constituted a task force to recommend for creation of an overarching regulatory body in inter-related fields of medicine viz. National Commission for Human Resources for Health (NCHRH),' Azad said in a written reply to the Rajya Sabha.

'The task force, after consultations with the stakeholders, including the Medical Council of India, in its report has suggested an exit test for medical graduates to improve the standards of medical education in the country,' he said.

According to ministry sources, the exam will be similar to the exit exams conducted by the Bar Council of India for law graduates.

Link: Original Article

November 24, 2010

Financial support to medical tourism service providers

Medical tourism is now included under the Marketing Development Assistance (MDA) scheme, under which medical tourism service providers will be given financial assistance, the tourism ministry said Monday.

Medical tourism service providers include representatives of hospitals accredited by the Joint Commission for International Accredited Hospitals (JCI) and National Accreditation Board of Hospitals (NABH), travel agents and tour operators approved by the tourism ministry.

The tourism ministry has sanctioned Rs.12.47 lakh as MDA to 10 medical tourism service providers for the current year, a tourism ministry statement said.

Link: Original Article

November 23, 2010

Malaysia to work with Indian govt to hire medical specialists

Malaysia's Health Ministry has said it will work directly with the Indian government to hire qualified medical specialists to help tackle the shortage of doctors in Malaysia.

Health Minister Liow Tiong Lai said his ministry had advertised in the foreign media for specialists but the applicants were not very good, local media reported.

Apart from India, Malaysia will also work with the governments of Egypt and Pakistan to hire qualified medical specialists, he said.

Malaysia wants to project itself as a medical tourism hub but lack of medical specialists in some areas is coming up as an obstacle in this path.

"The doctors who replied to our advertisements were qualified but many of them were sent back because of attitude problems," the minister said.

"Of course, these doctors also had to go through an interview locally. But, sometimes, they could not perform according to our expectations," he said.

By working directly with the governments, "we would be able to hire better doctors, as they would be vetted by both the foreign and local governments," he said.

Liow said the Egyptian Health Ministry submitted a list of 58 specialists who would be recruited to work in local hospitals or medical facilities.

"The Egyptian government has given these specialists sabbatical leave. So, many of them are more than willing to leave their country and serve here," he said, adding that the agreement was for these doctors to serve only for two years.

Liow said the same system would be applied to recruit specialists from India and Pakistan.

Link: Original Article

November 22, 2010

MCI plans central platform to give boost to research

In a bid to encourage research in medical science in the country, the Medical Council of India (MCI) is considering setting up of a central platform for researchers. The new set up will give awards for superior research work in the area of medical science as well as come up with research facilities at the institute level.

The MCI is also considering to start an MD-Ph D programme under which a student enrolled in MD programme can simultaneously pursue Ph D so as to boost research work in the field of medical science.

Dr SK Sarin, chairperson of the Board of Governors, MCI, announced this during the Research Showcase held at Chhatrapati Shahuji Maharaj Medical University here on Saturday.

“We do not recognise our researchers, the young talent of the country. By 2011, the MCI is trying to have a research platform at the central level for the recognition of good researchers of the country,” said Dr Sarin.

Talking to The Indian Express, Dr Sarin said: “We will very soon initiate a dialogue with the Indian Council of Medical Research for this platform where we can have separate research cell as well as awards for significant medical research. I will be meeting Dr VM Katoch (Director General, ICMR )in this regards very soon as it is in ICMR’s mandate to establish such a platform,” said Dr Sarin.

Link: Original Article

November 21, 2010

Little doctors with big jobs

Geeta Varma has made it a point to boil the drinking water she fetches from a hand pump near her hut in Babrekar Nagar at Malad’s Malvani area. She also covers the food she cooks to protect it from the filth in the narrow lanes of her slum. “My son, Mithilesh is training to become a bal doctor,” said Varma. “He has taught me about good hygiene and the importance of keeping your surroundings clean.”
Fifteen-year-old Mithilesh enrolled for the bal doctor programme six months ago.

An initiative by Youth for Unity and Voluntary Action (Yuva), the programme aims to train children to administer first aid and to handle medical crisis.

They have also been taught how to identify symptoms of different diseases and to encourage people to seek treatment.

Since 2000, the organisation has trained 676 bal doctors from 34 slums across the city.

A fortnight ago, Suraj Kanojia, 15, another bal doctor, realised his mother was suffering from chikungunya and persuaded her to go the hospital.

“She was unwell for a few days, but was unwilling to go to the hospital. From her symptoms I could make out that this was not an ordinary flu,” said Kanojia.

“I have become more aware of my own health and now I also take my parents to the hospital when they are unwell,” said Ravi Gupta, 18, who was part of the first batch of bal doctor trained in the area.

“Many of our young volunteers have understood the importance of hygiene and cleanliness,” said Sumati Belady, a social worker who trains the youngsters.

In order to spread the message, these children are also performing street shows about different diseases in their own locality.

The concept of bal doctors took root when a street boy from Mumbai Central suggested to the NGO workers that they be given a medical kit with basic medicines and first aid so they could treat their friends without delay.

According to programme coordinator Arokia Mary, Yuva had started a health van to give medical services to children in areas where medical facilities were almost non-existent.

“However, due to lack of time and resources, the van could not reach everyone. This is where the bal doctors fill in for us,” said Mary.

“There are so many children in our locality who chew tobacco and smoke cigarettes. Due to this training, my friends and I have never indulged in these things,” said bal doctor Kurban Khan, 18, who now wants to go to college and purse higher education.

“Several of our older children want to pursue higher studies in the medical field. This programme has contributed significantly in boosting their confidence,” said Mary, adding that Yuva now wants to take this concept to schools.

Link: Original Article

BPOs seek doctors, lawyers, CAs, engineers, PhDs, MBAs

For nine years now, Dr Neel Deep Singh Sarvaiya, a family physician in Andheri, has been training young professionals in medical terminology.

However, the people he trains are not medical students, but those looking for careers in business process outsourcing (BPO).

Dr Sarvaiya works with CBay Systems, an Airoli-based BPO engaged in medical transcription, in the mornings and treats patients in the evenings. He says BPOs have opened up a completely different avenue for doctors and other professionals. “So many people with diverse backgrounds want to make careers in a BPO.”

Once associated mainly with college students looking to make a quick buck during vacations, BPOs today employ people with degrees such as MBBS, BSc Nursing, PhD, MBA, CA, BE and BPharm.

“The perception that the BPO sector is not knowledge-driven and is merely a stop-gap career option no longer exists,” says Sanjiv Kapur, senior vice-president and global head, Patni BPO.

According to Manuel D’Souza, chief HR officer, Intelenet Global Services, the need for highly specialised people is because BPO service offerings have widened to include transaction processing, consulting, customer care, technical support, research and analytics, compared with mostly voice related activity earlier.

BPOs service sectors like travel, insurance, banking, financial services, retail, logistics and healthcare, which require highly skilled people, says Keshav R Murugesh, group CEO, WNS Global Services, which has 18,000 people in India, including a large number of doctors, MBAs, CAs and lawyers.

Raghavendra K, vice-president and head, HR, Infosys BPO, which has about 19,300 people, says most entry level profiles are sourced from science, computers, philosophy and theology backgrounds.

“Research, consulting and other such activities now constitute nearly 40-50% of the total BPO sector. So we need CAs for finance, MBAs/engineers for consulting and so on,” says D’Souza.

Kapur says doctors and nurses are needed as BPOs work on behalf of insurance firms to manage medical care of elderly citizens.

“An offshore team of doctors and nurses is involved in reviewing medical records, ensuring if medical check-ups are done in time, timely administration of medicines,” says Kapur, explaining that patients’ medical assessment sheets are sent to the BPO in India, where medical professionals analyse patient details and the information is then sent to the insurance company, and based on this assessment, future diagnosis is done.

Raman Roy, chairman, Quatrro BPO, points out that the sector had even felt the need for PhDs when the human genome project started.

For actuarial work (calculating insurance risks and premiums needed to cover the risks and designing insurance policies) in the area of pensions, property and casualty, etc, science and math graduates as well as actuarial students are needed.

Moreover, BPOs are engaged in activities like medical writing and clinical data management for pharmaceutical companies, which requires doctors and pharmacists, say industry experts.

“All these skilled professionals get international exposure, stable career and good salaries, which is chief attraction,” says Roy.

Also, for doctors who would ideally need a gestation period of 3-4 years to establish practice, BPOs provide them with an opportunity to utilise their knowledge and earn decent money, says Dr Sarvaiya.

In terms of salaries, starting salaries of specialised graduates would be 3-4 times higher than those of plain commerce/arts graduates.

“These factors conjure up to provide professionals with good career growth. We have so many employees who have completed more than 10 years,” says Sanjay Shanmugaum, vice president, HR, CBay Systems.

With demand for specialists growing, the $12.4 billion BPO sector, which currently employs more than 750,000 people, plans to more than double the proportion of such professionals in the next two years.

Roy says the high-end business in BPOs, requiring specialists, is growing at 30% per year. “Currently, we have 600 specialists who make up 20% of our total employee count and that percentage will keep increasing due to the demand.”

D’Souza says from about 10-15% (of total employee base of 33,000) at present, the percentage of specialised professionals will reach 30% in the next 2-3 years.

The staff strength of 6,200 would increase to 10,000 by the end of 2010, Shanmugaum says, adding, “80-90% of our staff have MBA, MBBS and other professional qualifications.”

Link: Original Article

November 20, 2010

86% of all medical trips are made by rural Indians

The story of India's international medical tourism industry is now well known, but the first ever figures on domestic medical tourism are simply staggering. Indians made 126 million domestic trips for medical purposes, spending over Rs 23,000 crore on such trips, over the span of one year (2008-9) alone. That, incidentally, is about 30% more than the Union health budget for the same year.

But just as international migration into India largely reflects a choice of greener pastures while domestic migration is more as a result of the lack of economic opportunity in rural areas, domestic medical tourism too is largely the outcome of poor health infrastructure in rural areas and small towns. 86% of all trips taken for medical purposes are by rural Indians and the poorest spend much more proportionally.

The data is part of the National Sample Survey Organisation's (NSSO) 65th round on tourism which estimates the number and purpose of "trips" taken by persons in its representative sample of seven lakh persons as well as the expenditure on them. The survey defines a "trip" as the movement - for a period of not more than six months - by one or more household members traveling to a place outside their usual environment and return to their usual place of residence for purposes other than migration or employment and which is outside their regular routine of life.

The survey data shows that trips for 'health and medical purposes' form 7% of overnight trips for the rural population and about 3.5% for the urban population. While "social" purposes were the main reason for travel for both rural and urban residents, holidaying and leisure accounted for even less than medical travel - 2% and 5% for rural and urban India respectively. Similarly, 17% of same-day trips for in rural India and 8% in urban India were for health reasons.

While calculating the expenditure on a trip, the NSSO includes all goods and services bought or consumed by the traveler. The high cost of healthcare is borne out by the fact that trips for health and medical purposes were four times as expensive as the average trip for both rural and urban populations. Medical trips were much more expensive for the family than even shopping trips, where the money spent on purchasing goods is included in the total cost of the trip. Trips for health and medical purposes were the most expensive of all types of trips in both urban and rural sectors.

Expenditure on medical trips accounted for 30% of all overnight trip expenditure for rural India and 15% for urban. In addition, a breakdown of expenditure by Monthly Per Capita Expenditure (MPCE) classes shows that in rural India, the poorer the person, the higher the proportion of all travel expenditure that goes to medical trips.

A visit to Delhi's public hospitals only bears out these statistics. On Tuesday and Wednesday mornings, hundreds of people from all over the country thronged the two hospitals' OPDs, with ailments ranging from tuberculosis to cancerous tumours. Subhash Majhi (52) and his wife came here from Orissa's Sambalpur district last week, seeking treatment for a tumour on his back. "I did not get good treatment in Bhubaneshwar and the problem recurred. Our relatives told us that we would have to go to AIIMS," said Majhi, who is living in west Delhi with acquaintances. AIIMS alone receives 10,000 patients every day, the bulk of them from outside Delhi, AIIMS officials said.

Others have come here with no place to stay. Kanti Devi and her husband Gyanchand Kumar, both in their 30s, have left their children in the custody of their relatives in western UP's Muzaffarnagar district. "It is harvest season at home and we are losing work, but I was not getting better, so we had to come to Delhi," says Kumar, an agricultural labourer, who has come here with respiratory problems. The couple, who were in Safdarjung's OPD having just arrived in the city, planned to sleep on the streets.

Unlike in international medical tourism, where transport and accommodation expenditures also form a significant proportion of the trip's cost, three-fourth of the expenditure on a domestic medical trip is on medical expenses alone.

There were roughly 300,000 international visits into India for health treatments in 2009 and the size of the industry is estimated at Rs 8,500 crore, less than a third of domestic 'medical tourism' spending.

Link: Original Article

Keep off Siddha docs practising allopathy , HC tells police

The Madurai bench of the Madras high court has quashed criminal cases filed against seven Siddha doctors for practising allopathy and observed that the police should not interfere in such matters, as it would demoralise the qualified practitioners of the Indian Systems of Medicine.

Allowing petitions filed by S Arockia Varghese, M Ravindran, A Nagarajan, G Suresh Khanna and Porkodi of Tirunelveli district and A Ganeshamoorthy and S Valli of Dindigul district, Justice G Rajasuria said the police cannot interfere in such matters, as it affects the morale of qualified Siddha doctors. If any person was affected by the practice of allopathy by these Siddha doctors, they would have to petition the Tamil Nadu Siddha Medical Council or the Director of Public Health.

He also said the government order of September 8 stated that institutionally qualified practitioners of the Indian Systems of Medicine such as Siddha, Ayurveda, Homoeopathy and Unani were eligible to practise modern scientific medicine based on their training and teaching. Following this, the DGP issued a circular to the police commissioners, inspector-generals of police and superintendents of police directing them not to interfere with the practice of registered doctors of Indian medicine.

The judge said the police should not interfere in such cases, even if complaints in this regard are received from the public against Siddha practitioners with a BSMS degree (Bachelor of Siddha Medicine and Surgery).

The high cout order is in line with the recent trend of protecting qualified practitioners of Indian medicine systems from legal action for prescribing allopathic drugs. In September, the state government issued a notification amending a rule under the Drugs and Cosmetics Act defining a 'registered medical practitioner'. By this, the government will treat practitioners of alternative Indian systems, including siddha, as persons practising the modern scientific system of medicine' for the purposes of enforcing the drugs and cosmetics law. It was aimed at ensuring that siddha, ayurveda and unani practitioners face no proceedings under the Drugs and Cosmetics Act for prescribing or storing allopathic medicines.

The Indian Medical Association's Tamil Nadu chapter has said it will to challenge the new rule.

Last July, the Madras high court ruled that registered practitioners of Indian systems were eligible to practise surgery. "It is imperative that no proceedings can be initiated against any of those registered practitioners in siddha, ayurveda, homoeopathy and unani, who are eligible to practise their respective system, along with modern scientific medicine, including surgery," the court had said.

Link: Original Article

November 19, 2010

Supreme Court frowns at health ministry for opposing combined AIPMT, AIEEE from 2011

The Supreme Court on Friday frowned at the health ministry's opposition to the Central Board of Secondary Education (CBSE) proposal to hold a single examination for class XII passouts for medical and engineering colleges at the all-India level by integrating AIPMT and AIEEE.

When counsel for health ministry Aman Ahluwalia cited logistical problems in conducting a single test and subsequent counselling for students, a Bench comprising Justices R V Raveendran and A K Patnaik wondered as to how it could go back on its word.

CBSE's counsel, senior advocate Altaf Ahmed, drew the Bench's attention to the minutes of a joint meeting of representatives of both health and HRD ministries as well as CBSE, Medical Council of India ( MCI) and Directorate General of Health Services (DGHS) where everyone agreed to the proposal to integrate AIPMT and AIEEE.

The Bench said: "Your objection appears to be technical as you (the health ministry) had clearly mentioned in your affidavit that you shared the concern and commitment of CBSE to ensuring that the examination system is designed in a manner where it maximizes the choices afforded to candidates and minimizes the stress, expenses and inconveniences."

If that was so, then the health ministry must reconsider its objections within two weeks and convey its decision to the court, the Bench said. An affidavit filed by assistant director-general (medical education) Mangla Kohli stated that the difficulties in a combined entrance examination were not insurmountable but required ironing out of lot of creases.

While the All India Pre-Medical/Pre-Dental Entrance Examination (AIPMT) is conducted to fill in 15% seats in MBBS/BDS courses in government medical and dental colleges against the all-India quota, the All India Engineering Entrance Examination (AIEEE) is for drawing up a combined merit list for different categories of engineering colleges. CBSE conducts both AIPMT and AIEEE every year.

Link: Original Article

Private hospitals must treat poor for free, says HC

Big private hospitals who got land at concessional rates in the city can't escape the obligation to provide free treatment to certain percentage of poor patients, the Delhi high court has said.

A division bench comprising Chief Justice Dipak Misra and Justice Manmohan on Thursday came down heavily on private hospitals shirking from extending free treatment to poor patients though it was one of the clause in the lease deed due to which land was given to hospitals at a very cheap price.

HC's comments came on a plea filed by a few prominent city hospitals like Ganga Ram and St Stephen's claiming that the 2007 landmark verdict of HC approving the free bed scheme wasn't applicable on them. The hospitals argued the lease deed with the government never made it compulsory for them to reserve free beds for 10% in the in patient department (IPD) and 25% in out patient department (OPD). They also pointed out how free camps were being held by the hospital administration to provide medical aid to the needy.

But the Land & Development Office of the central government through its counsel, Sanjiv Dube, informed HC that the policy of giving land at huge concessions to private hospitals has remained unchanged since 1949 with the basic premise that as a welfare state the government has a duty to ensure poor get free treatment.

The bench then warned that those found defaulting on 2007 HC ruling might even risk losing their lease deed and emphasized that private hospitals can't pick and choose patients, but its the government who can decide.

In 2007, HC had directed private hospitals, which had been given land at a concession in Delhi to provide free treatment including medicines to patients from families earning less than Rs 2,000 a month. The bench also appointed a special committee to monitor if hospitals adhere to the court order.

When the committee reported back that hospitals were deliberately shying away from honouring the HC verdict, the bench took a strong view and in one case, that of Apollo Hospital, even fined it for not offering free treatment to a poor patient.

Link: Original Article

November 18, 2010

India, Rwanda to cooperate in health care

India and the eastern African nation of Rwanda Friday signed a memorandum of understanding (MoU) on cooperation in the fields of health and medicine.

The MoU, signed by Health and Family Welfare Minister Ghulam Nabi Azad and his Rwandan counterpart Richard Sezibera, covers multiple fields like integrated disease surveillance, medical research, emergency relief, drugs, laboratory and diagnostics, and pharmaceutical products and traditional medicine.

According to an official statement from the health ministry, the cooperation will also extend to fields like hospital management, health tourism, telemedicine and training of human resource.

'The cooperation is likely to take form of collaboration in exchange of information in the field of health and medicine, exchange of experts in the field of health, health manpower development in the field of epidemiology and outbreak, diagnostic laboratory support through testing clinical samples during outbreak situation training in the mutually agreed identified areas, deputation of experts to attend international meetings held in either country, technical support in establishing laboratories/ hospitals and research in mutually identified areas,' a health ministry official said.

The Rwandan minister is on a short visit to India. The MoU comes as part of the growing bilateral ties between the two countries.

Link: Original Article

November 17, 2010

IGNOU launches diabetes training programme

The Indira Gandhi National Open University ( IGNOU) has launched a programme to train medical graduates in treating diabetes, it was announced here Wednesday.

The programme will be open to medical graduates looking to enhance their knowledge and skills in the area of medical diabetology.

IGNOU's School of Health Sciences (SOHS) signed a memorandum of understanding with Hansa Med Cell, a company working in providing medical education, to launch a PG diploma programme for medical graduates in diabetes mellitus.

'Flexibility and outreach are the two important strengths of the university. We hope to use these strengths for improving health care, especially to the poorest sections of society,' said P.R. Ramanujam, pro-vice chancellor of the university.

Srinivasan K. Swamy, group chairman of Hansa Vision, said: 'Diabetes has become pandemic today. The International Diabetes Foundation estimates that the number of diabetes cases in India has doubled from 19 million in 1995 to 40.9 million in 2007. It is estimated that by 2030, every fifth person with diabetes will be an Indian.'

'Hence we have taken up the herculean task of improving healthcare for diabetics in collaboration with IGNOU,' he added.

The course will be launched January 2011 and will be offered through IGNOU study centres as well as the centres of Hansa Vision.

Link: Original Article

Government proposes four-point agenda for population stabilisation

The Centre has proposed a four-point agenda for population stabilisation in the country which includes setting up a separate division in the Health Ministry dedicated to the cause.

These divisions would also be set up at the state, district and block level. This division will focus on providing access to services by co-opting the private sector and also undertaking advocacy efforts at the village level and upwards, the Health Ministry proposed at the latest meeting of the population commission.

Establishment of post-partum centres, which deal with post-delivery services, in all such facilities where institutional deliveries are being conducted, providing contraceptives at doorsteps through village ASHAs (health workers) and enhancing compensation for women undergoing sterilisation are the other steps which are being mulled.

Speaking at the meeting of the population commission recently, Health Minister Ghulam Nabi Azad said at present, the supply of contraceptives is made by the Central Government to the states.

"Most of the time these supplies do not reach below the district level. We, therefore, propose to introduce a new system under which contraceptives will be available at the doorsteps at the village level through the ASHAs (Accredited Social Health Activists) who are our community-based workers.

"This would enable the village community to have direct and easy access to contraceptives. Appropriate incentives for ASHAs to undertake home delivery of contraceptives are being worked out," he said.

Azad said the government was also proposing to substantially enhance compensation for women undergoing sterilisation from the current level of Rs 600.

The meeting of the commission was attended among others by Congress President Sonia Gandhi, Prime Minister Manmohan Singh, Harshvardhan of BJP, Sharad Pawar of NCP, Union Ministers Kapil Sibal, Ambika Soni and chief ministers of some states.

Experts suggested improved health care, availability of family planning services, literacy and empowerment.

To help the cause of population stabilisation, the Health Ministry has also zeroed in on population stabilisation as the theme in the health pavilion at this year's trade fair beginning here from November 14.

Link: Original Article

November 14, 2010

Doctors misleading patients liable to be prosecuted

Doctors misleading patients through false claims about their professional qualifications are liable to be prosecuted for rendering deficient service, the country's apex consumer body has held.

"It also amounts to unfair trade practice by doctors," the National Consumer Disputes Redressal Commission (NCDRC) said.

The NCDRC ruling came on a complaint by Meerut native Surendra Kumar Tyagi against local doctor S K Sharma, who claimed to be a Master in Surgery and operated upon him, allegedly damaging permanently one of his kidneys.

"Though the doctor proclaimed himself to be an MS (Master in Surgery), he was in fact not so qualified (and) that would clearly amount to misrepresentation to the complainant and others about his real qualification and experience," said an NCDRC bench of members R C Jain and S Chandra.

"This is another deficiency in service or what we can term as adoption of unfair trade practice -- unethical practice on the part of a medical professional," it said. Agreeing with Tyagi's contentions and findings of the Uttar Pradesh State Consumer Commission, the NCDRC enhanced the compensation to him to Rs 2.5 lakh from Rs one lakh awarded by the state forum.

Tyagi had approached the apex consumer forum to enhance the compensation awarded to him by the state in the case against Dr Sharma and Meerut-based Jagat Nursing Home and Hospital.

Allowing Tyagi's appeal, the Commission said the compensation in cases of misrepresentation and negligence by doctors should be proportionate to the loss and injury suffered by the patient and cannot be arbitrary.

"For the kind of negligence, deficiency in service and the misrepresentation made by the doctor, award of compensation of Rs 1 lakh only cannot be considered as reasonable or commensurate with the loss, injury and mental and physical pain and agony suffered by the complainant," it said.

Link: Original Article

Rampant sexual harassment of female doctors in Karachi by male staffers

Female doctors in Karachi have revealed that male paramedical staffers at Civil Hospital Karachi are harassing them, and it is causing serious mental stress among them.

The harassment is not limited to only female doctors but also female paramedical staff.

Newly appointed female doctors feel insecure while performing long hours duties in different wards, Outdoor Patient Departments, Intensive Care Unit and the operation theatres of the CHK.

"We are already working under poor and unhealthy living conditions at Civil Hospital," the Nation quoted a new doctor, who is completing her house job training at the General Patient Ward of Civil Hospital, as saying.

"The Staff Rooms available for the junior doctors lack basic facilities of safe drinking water, proper seating arrangement and clean washrooms.

"Nevertheless, the offensive behaviour of the paramedical workers cannot be tolerated by all means.

"We have brought this issue into the notice of hospital administration many times by informing that the male nurses and ward boys do not give proper respect to us.

"They annoy and threaten us verbally, psychologically and sometimes sexually without having any fear and accountability of the hospital management," she added.

Another trainee doctor revealed the junior doctors sometime face sexual harassment by the paramedical staffers.

Dr Samrina Hashmi, a former General Secretary Pakistan Medical Association Karachi Chapter, said there is a high-level of political interference in the public sector hospitals.

"The only way to get rid of this problem is to depoliticise public hospitals," she said.

"In order to improve the performance of the teaching hospitals, the Government should ban political activities in the premises of public hospitals.

"The healthcare institutions should be free from the interference of the political parties," she added.

Link: Original Article

November 13, 2010

Issues over electronic medical records' outsourcing plan

While many of the Indian IT companies have been eying the awaited wave of the US spending to digitize the health care records, but the recent issue where many have shown sensitivity towards this issue over the resistance shown by the American hospitals in sending medical information overseas could thwart efforts to win big contracts have emerged as a big issue in its path.

It is to be mentioned here that the US government is planning to spend billion, of dollars on the health care providers that will be ready with the electronic medical records and doctors operating in the economy will also be facing a federal mandate under which they will have to upgrade software as the U. S. switches to a new system of insurance billing codes.

However, for the Indian companies having a huge experience in the field of software outsourcing, the opportunities are the US healthcare sector is like another leap of growth for the sector. Pradep Nair, head of the health-care practice at New Delhi's HCL Technologies Ltd. Said that this is like another Y2K opportunity.

Link: Original Article

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