October 31, 2010

More medical seats in offing in Jharkand

Following chief minister Arjun Munda’s nod, the state government has begun working towards increasing MBBS seats in the three medical colleges of the state.

At present, Jharkhand produces only 190 MBBS graduates every year from the three medical college-cum-hospitals. While Ranchi-based Rajendra Institute of Medical Sciences (RIMS) offers 90 seats, Jamshedpur-based Mahatma Gandhi Medical College and Hospital (MGMCH) and Dhanbad-based Patliputra Medical College and Hospital (PMCH) offer only 50 seats each.

“A preliminary decision to increase MBBS seats in the three medical colleges was taken today. RIMS will offer 250 seats, followed by MGMCH and PMCH, which will offer 100 seats each. We will now start working towards setting up infrastructure and recruiting teachers, nurses and other staff. After fulfilling the minimum criteria for increasing the number of seats, the state will approach Medical Council of India (MCI) which is the final authority on the matter,” additional secretary in the state heath department Arun Kumar Sinha told.

Today, chief secretary A K Singh held a crucial meeting to decide the nitty-gritty of executing the plans with principal secretary of health department A.K. Sarkar. Sinha and senior representatives of the three medical colleges were also present during the meeting.

The need to increase the number of MBBS seats in the three medical colleges has been felt since long in the wake of acute scarcity of doctors to man government health establishments at every level — from district headquarters to blocks.

A few decades ago, RIMS used to offer as many as 150 seats, while MGMCH and PMCH, 100 seats each. But over the years, the number of MBBS seats shrunk, thanks to the stringent MCI norms the colleges failed to adhere to.

Former vice president of Indian Medical Association (IMA) Dr Ajay Kumar Singh welcomed the state government’s noble initiative, but exercised caution at the same time. “It should not remain a hypothetical situation. I see good co-ordination between chief minister Arjun Munda and chief secretary A.K. Singh. They can work hard to ensure increase in the number of seats which will benefit people,” he said.

According to rough estimates, the state faces a shortage of 5,000 doctors. Of the over 10,000 doctors needed to serve a population of over three crore, the government health establishments have only 2,000 doctors at their disposal with many in administrative capacity as civil surgeons, directors, superintendents and others.

About 3,000 doctors work in the private sector due to several reasons, including less pay offered by the government and lack of infrastructure in community health centres.

Link: Original Article

Cabinet clears health insurance for street vendors

In a major push towards aam aadmi reforms, the Union Cabinet on Wednesday cleared two big ticket schemes -- conditional cash transfer for pregnant women and health insurance for street vendors -- likely to benefit 18.3 lakh women and 42.19 lakh street vendors respectively.

The Indira Gandhi Matritva Sahyog Yojana will be launched in 52 districts as a pilot project where a sum of Rs 4,000 will be paid to pregnant and lactating women over a period of six months on fulfilling certain conditions. The government will pump in Rs 390 crore for 2010-2011 to ensure that pregnancies are registered, women attend an ante-natal check-up and counselling session besides adhering to health norms like immunisation and exclusive breastfeeding.

The cash transfer scheme mooted by the ministry of women and child development (WCD) will be monitored by a committee that will include elected representatives, members of the gram panchayat besides external audits. "The scheme will cover 492 projects in about 87,000 anganwadis and will address issues of low birth weight, high infant mortality, anaemia and maternal mortality," WCD minister Krishna Tirath said.

The Cabinet also approved the labour ministry's proposal for extension of Rashtriya Swasthya Bima Yojana (RSBY) to street vendors. The RSBY scheme, which presently extends to Below Poverty Line (BPL) families (a unit of five) is a smart card-based cashless health insurance scheme.

The government said in a statement that street vendors, who form an important segment of unorganised workers in urban areas, will now be covered under RSBY. "The government proposes to cover all registered street vendors under RSBY by the year 2013-14, out of which 4.21 lakh are proposed to be covered in the current financial year. The premium for the insurance scheme will be paid by the central and state governments in the ratio of 75:25 and for the northeastern states and Jammu and Kashmir, the expenditure is shared in the ratio of 90:10," said the statement.

The total expenditure on the part of the central government during the current year will be around Rs 20 crore. The recurring expenditure after 2013-14 will be around Rs 200 crore annually.

Beneficiaries under RSBY are entitled to coverage up to Rs 30,000 for most diseases that require hospitalisation. Coverage extends to five members of the family, which includes the head of the household, spouse and up to three dependents. "Till October 15, 2010, 27 states are in the process of implementation of the scheme. The scheme has been operationaized in 24 states and more than 1.95 crore smart cards have been issued covering more than 7 crore persons," added the statement.

Link: Original Article

October 30, 2010

Maharashtra to get 6 new medical colleges

Maharashtra is all set to get six new medical colleges, with two of them being planned for Mumbai city. Significantly, officials insist that more than 1,000 seats will be up for grabs from the next academic session.

According to the ambitious project drafted by the state government, the plans are in the final stages of implementation and will ensure that the colleges are operational at Nandurbar, Alibaug, Gondia, Chandrapur, near CST (G T Hospital) and a yet-to-be decided location in the city from 2011-12.

"Proposals for Nandurbar, Alibaug and GT hospital have already been submitted to the Medical Council of India, while the ones for Gondia, Chandrapur and another in Mumbai suburbs, either Andheri or Dharavi, will be submitted soon,'' a senior medical education department official told ToI on Wednesday. "With the setting up of the new colleges, students intake capacity for the undergraduate course will shoot up by 500. In addition, we have submitted a fresh proposal for enhancing the intake capacity of the 14 government-run medical colleges from 2,061 to 2,661. "If our proposals are accepted, then our intake capacity will increase from 2,061 to 3,161 from the next session,'' he said.

An official said the initial plan was to set up a medical college at Gondia, home town of civil aviation minister Praful Patel. Later, there was a debate over the proposal following opposition from minister of state for irrigation Vijay Wadettiwar, who demanded a medical college at his home town, Chandrapur.

"Medical education minister Vijaykumar Gavit then decided that colleges could be set up at both Gondia and Chandrapur. Similarly, there is a dispute over the suburban college. Public health minister Suresh Shetty is insisting on a college in Andheri, his assembly constituency, while minister of state for medical education Varsha Gaikwad is keen on setting it up at Dharavi. The CM will take a final decision," the official said, adding that they are expecting Rs 650 crore fom the Centre for the project.

On enhancing the intake capacity, the official said, according to the guidelines prescribed by the MCI, it was now possible to increase the intake capacity of 200-seat medical colleges to 250, 150 to 200 and 100 to 150 and 50 to 100-seat medical colleges. "Accordingly, intake capacity of Grant Medical College, Pune and Nagpur colleges will be enhanced from 200 to 250. In all the existing 14 government medical colleges, we have adequate infrastructure for the purpose,'' he said.

On the requirement of staff, the official said ever since the implementation of the Sixth Pay Commission, several teachers, who had taken up private jobs were now returning back to government-run, medical colleges. "We are expectinga special grant of Rs 650 crore from the Centre for upgradation and modernisation of the colleges, " the official added.

My information is that in last one year, 10 professors have returned to the state services. In the days to come, we are sure, most of the teachers will return to the state fold,'' he said.

Secondly, the official said for a 100-seats medical college, it requires 18 professors, 47 associate professors and 81 lecturers. "We have changed our recruitment and promotion policy, as a result, we expect to recruit the entire staff required for a new medical college,'' he said.

On the financial assistance from the Centre, the official expected a special grant of Rs 650 crore - nearly Rs 40 crore per college for upgradation and modernisation of the medical colleges. "In fact, we were pressing the centre for financial assistance of R 150 crore for seven to eight colleges to bring them on par with AIIMS, but it did not materialise,'' he said.

New medical colleges proposed : G T Hospital, Andheri or Dharavi or Bandra, Gondia, Chandrapur, Alibagh and Nandurbar

Intake capacity of each college : 100

Existing intake capacity of 14 medical colleges : 2061

Intake capacity after new medical colleges : 3161

Link: Original Article

Expert group on universal health coverage set up

It will develop blueprint to achieve ‘health for all' by 2020

Recognising the importance of defining a comprehensive strategy for universal health coverage, the Planning Commission has set up a high level expert group to develop a blueprint and investment plan for meeting the human resource requirements to achieve ‘health for all' by 2020.

The 15-member high level group on universal health coverage, chaired by K. Srinath Reddy, president of the Public Health Foundation of India, is mandated to rework the physical and financial norms needed to ensure quality, universal reach and access to healthcare services, particularly in underserved areas and to indicate the role of private and public service providers.

“The expert group, constituted with the approval of Prime Minister Manmohan Singh, will also explore the role of a health insurance system that offers universal access to health services with high subsidy for the poor and a scope for building up additional levels of protection on a payment basis,” Syeda Hamid, a member of the Planning Commission, told The Hindu.

The expert group will suggest critical management reforms in order to improve efficiency, effectiveness and accountability of the health delivery system, among other things.

The other members of the expert group are: Abhay Bhang (Society for Education, Action and Research in Community Health), A.K. Shiva Kumar (member, National Advisory Council), Amarjeet Sinha (senior IAS officer), Anu Garg (Principal Secretary-cum-Commissioner (Health and Family Welfare department, Orissa), Gita Sen (Centre for Public Policy, IIM Bangalore), G.N. Rao (Chair of Eye Health, L.V. Prasad Eye Institute, Hyderabad), Jashodhara Dasgupta (SAHYOG, Lucknow), Leila Caleb Varkey (Public Health researcher), Govinda Rao (Director, National Institute of Public Finance and Policy), Mirai Chatterjee (Director, Social Security, SEWA), Nachiket Mor (Sughavazhu Healthcare), Vinod Paul (AIIMS), Yogesh Jain (Jan Swasthya Sahyog, Bilaspur), a representative of the Ministry of Health and Family Welfare, and N.K. Sethi (Advisor (Health), Planning Commission).

Link: Original Article

October 29, 2010

IIT-Kharagpur medical college in two years

The Indian Institute of Technology, Kharagpur, is upbeat about the medical school they believe will come up in the next two years. According to senior officials of IIT-Kgp, the Centre is likely to introduce a bill in the Parliament in the next session to change IIT Act so that the institute can run a medical college.

“We have decided to name the medical college Bidhan Chandra Institute of Medical Sciences in the honour of the first chief minister of the state,” Damodar Acharya, the director of IIT-Kgp said.

Acharya said the institute which will come up in 2012 will have an investment of Rs 500 crore. Recently the institute, with support from the Indian Railways, tied up with the 250-bed Railway hospital at Kharagpur. “We plan to use the Railway hospital as a teaching hospital. For medical research, we need to connect with a hospital that has a steady number of patients. This hospital gets about 1 lakh patients every year and will help us in research,” he said.

Link: Original Article

Bangalore doctors perturbed over rising online consultation

The recent trend in online medical consultation is sending alarm bells ringing with medical professionals saying that it could be more harmful than cure.

With websites such as Dr Google and others replacing doctors, the GenX, who no longer want to consult a doctor for a mild cold, fever or even other illnesses are opting to type in the symptoms on the website and take a printout of the prescription. The convenience of the process is attracting many youth to this concept and is spreading among the urban crowd.

“When are you late to work and down with cold, you really don’t have the time to wait at the doctor’s clinic. Also, blindly buying some medicine given by a medical store keeperis not a good option. By just keying in the symptoms on the Internet, you get the name of the medicines to be taken. So, why wouldn’t someone go for this?” asks Radhika Menon, a HR professional.

The concept started initially with patients double-checking the medicines online, prescribed to them by their doctors. It soon became a source for prescription, boosting the numbers over counter medicine.

The trend, which is widespread in Western countries, is catching up in the sub-continent as well. But medical professionals are worried about the increased numbers of self-diagnosis using Internet.

Dr Sudarshan Balal, chief of medicine, Manipal Hospital says that computer-based treatment could be dangerous for the person’s health. “A computer cannot replace a doctor. For instance, if a patient comes to the doctor with fever, it could be a symptom of a bigger problem. Unless a proper diagnosis is conducted, this cannot be found out if there is a serious problem,” said Dr Balal.

Although the doctors’ community is against this concept, there are many, who are part of the Internet consultation. Search words like online medical consultation or online prescription would guide one to many websites. Not just that, even hiring of doctors for the post of online consultants are taking place on Internet job portals.

However, officials at the Indian Medical Association (IMA) say that they do not subscribe to this concept. But, there are no rules which prohibit the member doctors from online consultation, they add. “The symptoms, diagnosis and treatment vary for different persons,” said Dr Vishi Shanmuganathan, president, IMA, Bangalore chapter.

According to him, online communication between two professionals is something which would be allowed, as the professional will be able to communicate properly unlike patients.

Link: Original Article

500 first yr medicos flunk in exam in TN

In an unprecedented trend, more than 500 medicos have failed in the three subjects of the first-year MBBS exam, results for which were published just a couple of days ago.
Of 1,762 students from 15 government-run medical colleges in the state, who attempted the anatomy paper, 1,561 have passed. In physiology, 1,622 out of 1,788 have cleared the paper, while 1,605 out of 1,791 students have passed.

“There is definitely a spike in number of failures. Usually, not more than 50 students fail to clear the paper in each subject,” says a senior academician and public health official. “If the students do not pass their first-year subjects, they will have to repeat the year as carry over is permitted only from the third year,” he says.
The seven private colleges have also recorded a similar increase in failure rate. In anatomy, 163 out of 620 students failed, 153 out of 639 in biochemistry and in physiology, 134 out of 636 have failed.

Health secretary V.K. Subburaj attributes the shocking trend to stringent rules of Dr MGR Medical University, and students not preparing well. “The present rules do not allow granting of grace marks, which can be one of the reasons for the increase in failure rate. Also students tend to relax after admissions, and do not study seriously until their second year,” he said.
While senior professors agree about students not preparing well, they also admit that the quality of teaching at medical colleges has deteriorated.

Link: Original Article

October 28, 2010

Lancet - praise for India's rural doctors scheme

The Union Health and Family Welfare Ministry might still be awaiting “formal” clearance for its much debated Bachelor of Rural Health Care course that aims to create a cadre of healthcare workers for the rural areas, but the Centre has received global appreciation for “trying to find an innovative solution to a deeply entrenched problem which is not unique to India.”

The latest edition of The Lancet Infectious Diseases journal carries an article on the proposed initiative which says that whether or not the government succeeds, it should be praised for the innovative solution. “In the end, the quality of care will depend not only on the duration of medical training, but also on its quality and, perhaps even more importantly, the ‘after-sales' service.”

This praise from Lancet comes weeks after the same journal published an article on the discovery of the antibiotic-resistant ‘superbug' in India and Pakistan. That article created a huge controversy, with India having to deny that foreigners treated here had developed immunity to antibiotics due to the indiscriminate use of drugs.

Titled “Rural MBBS Degree in India,” the latest article is written by Sanjay Kinra and Yoav Ben-Shlomo. It dismisses criticisms levelled at the “rural MBBS,” such as increased likelihood of mistakes or infringement of human rights due to treatment by inadequately trained doctors, saying these bear little credibility.

Currently, the shortage of doctors in rural India stems from the unwillingness of most doctors, who were born and trained in urban areas, to move to rural areas. The rural MBBS scheme aims to train people from rural areas in those rural areas, in the belief that they will stay, which offers some hope of providing medical care to large parts of rural India that currently lack it.

It seems plausible to deliver the required education and training in this time, especially because rural doctors will be expected to focus on a particular setting. The course will be delivered entirely in rural health centres and hospitals, which ironically might result in the rural doctors having a higher level of competency in clinical skills, which are generally agreed to be important for doctors, compared with their urban counterparts. What remains to be seen, however, is whether it will be possible to consistently and reliably deliver high-quality education in mall rural centres, the article says.

Drawing attention towards a sharp debate that has ensued in the Indian media, with the vocal medical fraternity generally opposed to the new degree on the grounds that the shorter duration will result in inadequately trained professionals, the writers say inherent to this debate is the assumption that the current duration of the MBBS in India is right, and more generally, that we know how long it takes to produce a competent medical doctor.

After reviewing medical curricula for 55 countries, the writers arrived at the conclusion that the duration of medical education is relatively consistent across the world with medical training taking about 6 years before a licence to practise is obtained. Medical training is typically split into 5 years of schooling, of which the first 3 years are preclinical and the fourth and fifth are clinical, followed by a 1-year apprenticeship on the job. However, there is considerable variation in the intensity of teaching, with shorter courses either being more intense, or requiring the students to be graduates. Course content and delivery will affect the course's duration, the article suggests.

Link: Original Article

Star-rating service for hospitals on cards

A group of Indian expat doctors from the UK and the US is planning to launch an affordable star-rating based certification service for hospitals around early next year. The group would mainly target small and mid-sized hospitals in the Indian market. These stars would be awarded by the London-headquartered Kemp Healthcare based on parameters of safety, quality, timeliness, effectiveness and patient satisfaction.

As health insurance expands in India, Kemp promoters feel there is a growing but unmet need among the hospitals, especially the medium-sized ones, to comply with quality and safety norms. “A large section of mid-sized hospitals in the country want to spruce up safety and quality of service but they cannot afford global accreditation services to authenticate their services. That is the gap we intend to fill,” Pallav Bhatnagar, co- founder and managing director, Kemp told FE. Kemp 5-Star hospital certification would give hospitals additional credibility and confidence in a competitive market and will make them more attractive to health insurance providers, panel companies and medical tourists, he added.

Bhatnagar, however, refused to share the range of cost that hospitals would have to shell out to improve on these parameters, which would vary with the current performance of the hospital.

The service would be launched in the National Capital Region in the first quarter of the next financial year and expand to other parts of the country later.

How will Kemp award the ratings? Explains Bhatnagar: “To attain a star for timeliness, a hospital must provide primary angioplasty to a patient with heart attack within 90 minutes or treatment of thrombolysis for stroke due to a blood clot within 3 hours of onset of symptom. We would quantify the time taken by hospital in these cases and install processes which would help hospitals reduce the time loss on part of the hospital so that these events do not turn fatal for the patients.”

It is estimated that 93% of hospitals, 64% of beds, 80% of doctors, 80% of outpatients and 57% of in-patients in India are accounted for in the private sector. The private health care sector provides 79% of outpatient care for those below poverty line, for which payment is primarily out of pocket.

Link: Original Article

October 14, 2010

Allopathy: Ayurveda docs take on MCI

The Pune chapter of BAMS Graduates Association of India has condemned a recent release by Medical Council of India that said “candidates registered in Ayurveda have no right to practice in allopathy.” BGA president Suhas Joshi said, “BAMS graduates are legally allowed to practice in Mahasashtra. In the 1999 amendment in Food and Drug Act of 1945, individual states were asked to frame their own laws to decide upon whether BAMS graduates can practice in alloapthy or not. Maharashtra government passed an order regarding the same. Other states should also follow the same.”

Joshi added, “Whenever there is reference to bogus doctors or quacks, Ayurvedic doctors are cited as examples. Organisations like MCI are responsible for this. BAMS graduates get training in allopathy medical sciences also including pharmacology. This fact is always ignored.” The members pointed out that they may initiate legal action if the MCI does not respond. Subhash Ranade, president of International Ayurveda Academy, said, “The ancient science Ayurveda is being given step-motherly treatment by the government. The recently-formulated National Council for Human Resources in Health does not have any representative of AYUSH (Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy ). This is really unjust.”

Link: Original Article

October 13, 2010

MCI suspends licence of its former chief Ketan Desai

The Medical Council of India (MCI) has suspended the licence of its tainted former chief, Dr Ketan Desai, said a council official. The council announced the suspension in a letter to Desai on Saturday, saying his licence to practice medicine has been suspended "during the pendency of appeal before Ethics Committee of Board of Governors in Super-session of Medical Council of India".

"A final decision on the issue will be taken only after providing adequate opportunity to Dr Ketan Desai to represent his stand before the committee," read the MCI Ethics Committee proceedings.

The Central Bureau of Investigation (CBI) had arrested Desai and two others in April on charges of accepting Rs2 crore as bribe to grant recognition to a medical college in Punjab.

Confirming the news, Dr SK Sarin, chairman, Board of Governors, MCI, said: "His licence has been suspended and he also has been served a showcause notice by the committee. He is a qualified doctor, but he cannot practice in the interim period when the case is with the committee," said Sarin.

According to MCI's Code of Ethics and Regulation, "a doctor indicted for moral trepidation or criminal offence" must lose his licence to practice medicine.

Besides temporarily debarring Desai from practicing medicine, the order also banned him from participating in any medical conference and association.

Desai was granted bail last week to take part in the World Medical Association (WMA) conference to be held in Canada this week.

He was scheduled to attend the conference to be held between October 13 and 16. Desai is the president-elect of the WMA.

"Ideally, he should follow the decision of the council and the Ethics Committee, but ultimately the choice is his. He is a very senior doctor, and it is for him to decide whether he should go or not," said Sarin.

Desai was issued the suspension order following a complaint by Dr Kunal Saha, founder of People for Better Treatment (PBT), to MCI on October 8.

"Soon after his arrest, I had filed a complaint with the Gujarat Medical Council (GMC), demanding immediate cancellation of his licence. I waited for almost six months. However, when the GMC didn't act, I filed a complaint with the MCI two days ago," Saha Said.

Link: Original Article

October 12, 2010

TN to encourage private sector in medical education

Tamil Nadu Government would encourage the private sector to set up medical colleges in the state as there was a huge shortage of doctors, a top Medical Education official said today. At present only 35,000 medical graduates passed out of the over 300 medical colleges in the country every year against the requirement of one lakh doctors per annum, state Medical Education Director Dr V Kanagasabai said. Inaugurating a private medical college at the suburban Tiruvallur, he said the resource crunch faced by governments made it impossible to invest a huge amount for setting up government medical colleges and hence the private sector had a role to play in this. With a huge population in the country, medical care was yet to reach rural masses and shortage of doctors was the main reason, he said. He said the state was in favour of opening more medical colleges both in public and private sectors to overcome the shortage. College Chairman T Deendayal Naidu said the college hospital, which had 300 beds now as per the norms of the Medical Council of India, would be developed into a 3,000 bed hospital at a cost of Rs.6,000 crore in the next five years with 141 departments, making it one of the biggest in Asia. The college administration also proposed to set up a health city in the coming years, besides planning to open another medical college in the city.

Link: Original Article

Pune doctors go online to reach out to patients

Be it sending alerts to patients for a scheduled vaccine, texting a reminder for a quarterly visit or a periodic investigation, more and more city doctors have started to utilise information technology (IT) to enhance patient care, thanks to a new website.

"We all know that our patients forget to take vaccines on scheduled dates and miss scheduled visits for antenatal care. Some also tend to forget follow-up visits, which leads to reduction in the quality of care a doctor provides. In this context, services developed by IT professionals in the city, are helping healthcare providers enhance patient care in a big way," said paediatrician Rajeev Joshi, member, National Executive Committee of the Indian Association for Medical Informatics (IAMI).

As many as 100 doctors, including members of the Indian Medical Association and IAMI have registered themselves with the website, www.arogyamitra.com, to render effective services to patients. There are more doctors who are also making inquiries and showing interest, he added.

"The service is absolutely free for doctors as well as patients. Even patients can register themselves for availing this service. However, they have to put in correct date of birth or in a case of pregnant women, they have to mention date of last menstrual period. The schedule will be calculated and reminder messages will be sent accordingly," said Joshi.

One can set schedule vaccination reminders, antenatal visits, quarterly visits, periodic investigations for chronic diseases, etc. Patients get SMS and email on scheduled dates with a pre-defined message, which is extremely easy to set and be customised by the doctor or hospital management, said diabetologist Rakesh Biswas from Bhopal.

"I started using this service a few weeks ago. Initially, I registered patients who have been visiting me for the last few years or so and sent them SMS reminders through Arogyamitra to take swine flu vaccine. Several patients responded positively to the message. Several families called for appointment and came to take the vaccine," said gynaecologist Dipti Panchnadikar.

Elaborating on patients feedback about the service, Joshi said, "I asked a few patients about their reactions. The response has been very positive. All of them were happy to receive such suggestions, as most were confused regarding swine flu vaccination and not sure whether they should take it or not. I asked them whether they felt that it was marketing initiative. Most of them said that since it was from the doctor they knew, they did not think it that way. Others said it does not matter even if it's a marketing initiative; we get hundreds of senseless messages every week, anyway. This one is truly in our own interest."

"This and similar services are being offered free of cost to all doctors. We have also plans to develop a partnership with doctors who want to support enhanced doctor-patient communication. I am sure this will substantially increase the hospital revenue from forgotten visits and also improve patient relationship considerably. It will also help completion of vaccination and reduction of disease-load substantially," said Uday Thatte, director, Hitech Medical Information, and the man behind the website.

"This is an excellent initiative. SMS reminders for clinic appointments and vaccination reminders especially for paediatrics is a great application of this simple technology," Thanga Prabhu, secretary, Indian Association for Medical Informatics, said.

Link: Original Article

October 11, 2010

Council for human resource in health soon, says PM Manmohan Singh

Stressing on the need to revamp the health education system in the country, Prime Minister Manmohan Singh on Friday said that a bill for the formation of a council for human resource in health will be introduced in parliament soon.

"The government of India is reviewing the existing regulatory system for medical education. Ministry of Health has prepared a draft bill for setting up a National Council for Human Resources in Health that will be introduced soon in parliament," the prime minister said, addressing the 38th Convocation of All India Institute of Medical Sciences (AIIMS), the country's premier research and referral hospital.

"The bill will seek to create an enabling environment that will address issues of quality, quantity and equitable distribution of medical education resources. National Council for Human Resource in Health will be formed soon," he added.

The prime minister's announcement brings to end the turf war between the human resource development and health ministries, which started when the HRD ministry proposed taking medical education under the ambit of its proposed National Commission for Higher Education and Research (NCHER), while the health ministry proposed a separate National Council for Human Resource in Health (NCHRH).

Highlighting the need to revamp the education system in health, the prime minister said that an inter-disciplinary approach is needed.

"The need of the hour is to produce professionals who address health not only from the perspective of the individual patient but as part of a team integrated into the larger health system. Inter-disciplinary and health system connectivity have to be the key coordinates on which medical education has to advance," he said.

"In the future, it is not biology alone that will drive medical care. Disciplines such as epidemiology, economics, social and behavioural sciences, ethics and human rights will all influence the manner in which health will be promoted and healthcare provided to our nation."

While the health ministry looked enthused over the backing, a deadline for bringing the bill was not given.

"Health education will remain with health ministry, the consultations for the bill is on," Health Secretary Sujatha Rao told IANS.

Highlighting the shortage of trained medical professionals as one of the biggest problems, the prime minister said that several schemes are being launched to address the issue.

"India needs many more health professionals, of different categories, to fill the huge shortfall in the health workforce," he said, adding that work for starting six new AIIMS-like institutions is in progress.

Manmohan Singh also highlighted several other schemes to increase the numbers of doctors, and other medical staff.

"A new scheme, with the potential of adding about 5,000 postgraduate seats, starting with the 2012 academic session, has been approved for strengthening and upgrading state government medical colleges," he said.

He added that efforts are afoot to increase the allocation to health care and the Eleventh Five Year Plan (2007-12) envisaged an increase in public expenditure on health to at least 2 percent of GDP while the Twelfth Plan period aims to achieve the goal of taking the total allocation for the health sector to 2-3 percent of our GDP.

Manmohan Singh also stressed on creating a vision for the growth of AIIMS to make it one of the top ten medical institutes in the world. Backing the recent Veliathan Committee report which among other things suggests autonomy for AIIMS, the prime minister said changes were needed to meet the aim of growth of AIIMS.

Read more: Council for human resource in health soon, says PM Manmohan Singh - The Times of India

Link: Original Article

I-T survey on 6 more private hospitals in Mumbai

The irregularity involving wrong declaration of doctors as professionals rather than employees, by hospitals to evade tax is turning out to be bigger than expected. The tax deducted at source (TDS) wing of the income tax (I-T) department continued its survey on Monday and covered six prominent private hospitals to study the payment details of around 600 doctors.
The tax evasion suspected by the department has gone up to more than Rs 45 crore.

"It could be more as we are still in the process of going through documents," a senior I-T official said.

The authorities had found that many city hospitals were declaring doctors employed by them as professionals to evade TDS payment.

According to I-T officials, if a doctor is shown as an employee, then TDS at the rate of 33 per cent is required to be deducted and paid to the I-T department. However, if the hospitals show that they have engaged doctors as professionals, then TDS is deducted at the rate of only 10 per cent.

On Thursday, the authorities had conducted survey on six hospitals and studied payment details of around 1,000 doctors. From that survey, the officials suspect that the evasion could be around Rs 25 crore. From Monday's survey, the officials suspect that evasion by another set of six hospitals could be over Rs 20 crore.

The team, comprising 70 officials and staff of the department, took copies of computer records and account details which had information on payments made to the doctors.

Once established that the hospitals evaded TDS payment, the I-T department can levy a penal interest of 15 per cent per annum on the amount. Also, a penalty of 50 per cent can be levied.

Link: Original Article

October 10, 2010

Aircel & Apollo launch mobile healthcare services

In association with Apollo Hospitals Group, Aircel has announced the launch of its mobile healhcare initiative, the ''Aircel Apollo Mobile Healthcare'' on Wednesday.

The mobile initiative will allow patients to consult a physician or specialist over video in real time.

One of the services, Tele Triage will allow people to address their health concerns via a telephonic interaction with Apollo doctors round the clock at a cost of Rs45 per consultation.

The telecom operator will also set up centers in select Aircel outlets and third part franchisee models across the country in partnership with Apollo Hospitals.

''The services will be rolled out in Chennai and gradually go pan India,'' Gurdeep Singh, chief operating officer, Aircel said.

Aircel will be launching the services in both rural and urban areas.

Link: Original Article

TN MGR Medical Univ's largesse to medical students: 10 to 45 grace marks each

In what could leave a serious dent on the quality of medical education and prove a gross violation of the Medical Council of India (MCI) Act, the Tamil Nadu Dr MGR Medical University has admitted that it granted as much as 45 marks as grace for students who appeared for a supplementary examination in February 2009. A university committee granted all students, who failed the first year exam, 35 grace marks for anatomy and biochemistry and 10 for physiology. The number of students who passed the exams after this shower of largesse rose from 81 to 161.

The MCI rules state that grace marks up to a maximum of five may be awarded at the discretion of the university to a student who has failed only in one subject (Percentage required for passing is 50). The rule is intended to make education rigorous and uphold quality in medical training, say senior doctors. But the university, in a reply to questions under the Right to Information Act, has admitted that in each of the exams it conducted for different batches of MBBS students between February 2007 and August 2009, it granted between 10 and 45 marks. As a result, the number of MBBS students who passed the exam per batch was between 20 and 540. In the same period, the university also granted between 8 and 25 marks to students who appeared for the BDS exams (Dental Council of India also does not permit universities to grant more than five grace marks), which helped up to 458 students per batch to pass.

For instance, in August 2009, first year MBBS students appearing for the first or second time got 20 grace marks. For those appearing for the third time, grace was increased to 30 marks in anatomy, 10 in physiology and 20 in bio-chemistry. Thus, the number of students who passed the test after revision rose from 1,386 to 1,926.

A senior university official sought to defend the concessions granted by saying, "There are no rules for awarding grace marks. It is decided year on year. For instance, if we find a greater number of students appearing for the examination for the second or third time, we may decide to award grace marks to ensure such students are cleared fast. A passing board committee decides on the grace marks."

Dr Meer Mustafa Hussain, who was the vice chancellor between 2007 and 2009 when such high grace marks were awarded, could not be contacted. But his successor, Dr Mayil Vahanan Natarajan, criticised the flaws in the system and said the varsity has now tightened its rules. "There was no transparency in the past. In fact, students could not even obtain photocopies of their own marksheets. This will not happen from this academic year. We have decided not to award grace marks henceforth. We are ready to give photocopies of answer sheets and allow re-evaluation instead of moderation," he said.

All 17 government medical colleges and eight private medical colleges are presently affiliated to the university. The state also has one government dental college in Chennai and 16 private colleges affiliated to it.

Senior professors, doctors' associations and former academicians have demanded an inquiry into the issue. "Besides discouraging meritorious students, such acts would degrade the quality of medical education. We normally get the cream of students for MBBS. There is no need to award them huge grace marks to help them pass. What we need to do is offer intensive and quality training," said Dr George Thomas, editor, Indian Journal of Medical Ethics.

Members of the Indian Medical Association said such acts would degrade the profession. "Anyone who doesn't have adequate training is a quack with or without the degree. If the university has been helping students pass, it has been producing quacks," said Dr TN Ravishankar, honorary secretary, IMA (TN).

Health department officials claimed they were not aware of the university's decisions to award high grace marks. "I am not aware that such things happen in the state's premier medical varsity. I don't know if they have the power to award such high grace marks using just an internal committee. We will initiate an enquiry. Action will be taken against anyone who dared to degrade medical education in the state," said health secretary VK Subburaj.

However, several colleges, including the government colleges, say part of the problem is the fact that currently many institutions do not have enough professors for courses like forensic medicine, pharmacology and anatomy. "If there are no teachers, how will the students pass?" asked a senior doctor.

Senior professor in surgical gasteroentrology at the Stanley Medical College Dr R Surendran agreed. "It is time we had quality training in medical education to ensure we have qualified doctors. Else it is a compromise on human lives," he said.

Link: Original Article

October 09, 2010

Apollo bets big on Africa, health tourism

Apollo Hospitals , Asia's largest healthcare chain , is betting big on Africa, not just to expand operations there but to also attract what is called health tourism from the vast continent.

Apollo Group chairman Prathap C. Reddy, who pioneered corporate healthcare in India, is particularly upbeat on Mauritius, where the hospital chain already has a presence for the past four years, as well as Nigeria and Uganda.

" Africa is going to be the next big thing in everything that's going to happen. China is smart and is present in a majority of African countries trying to build its wealth and influence. Fortunately China is not in a position to compete with us," he said.
"So, I think, if we won't miss the boat, we will keep ahead of China," Reddy, a trained physician himself, told IANS in an interview, speaking about his plans for the group, which has 8,500 beds in more than 50 hospitals in India and overseas.

Reddy said five African countries had already expressed interest in collaborating with his group and an in-house team was studying the feasibility of the projects to finalise on at least two in the near term. He, however, did not name the countries.

"In Africa, Apollo Bramwell hospital in Mauritius is our show piece. We had the first anniversary three years ago. Prime Minister Navin Ramgoolam himself thanked me. He said it was a 'Kohinoor' (an invaluable gem) in their healthcare system."

The Apollo founder, who had been conferred India's second highest civilian award by President Pratibha Patil earlier this year, the Padma Vibhushan, said the group was also partnering with the Indian government on a Pan-Africa tele-medicine programme.

"It is a great opportunity and a wonderful project. They don't have to pay for anything. It is free. The government of India is funding it. Nigeria and Nigerian doctors are so happy with this project," Reddy said.

At the same time, he was also keen to promote health toursim in India, especially out of Africa, and feels there is a potential for at least five million health tourists a year. "But we need to work on set guidelines. We need to publicise it through the government."

He said the reason why he was keen to draw health tourists from Africa was that during his own university days in Britain, he saw a large number of overseas health tourists flying in for treatment.

"I conducted a study and found that among the large number of patients who came to England for treatment, Africans were the second largest. So there is a tremendous potential for this in India. We are also much more cost-effective."

He did not think health tourism will come down in India following some adverse reports on its hospitals after a recent Lancet study noted that a multi-drug resistant super-bug had its origins in a patient admitted to a hospital in India.

"This study is a little premature. We all know infection and resistant bugs are present in all healthcare systems in the world. But I can't undermine the study and say we don't have it," Reddy said.

"At the same time, I'm also able to control infections and maintain the discipline in infection control. That's why we have a Department of Microbiology. We strictly go by the guidelines given for infection control," he added.

According to Reddy, the group's target now was to add 3,000 beds to its network by 2013 at an estimated cost of around Rs.2,000 crore ($440 million) and was confident that the deadline will be met.

Link: Original Article

Health insurance portability coming soon, vows IRDA chief

In a further announcement of the government's presumably good intentions, the head of India's Insurance Regulatory and Development Authority today said that mediclaim policy holders as well as motor insurance policy holders dissatisfied with the services of the respective companies will be able to switch service providers at the same premium.

"It's high time that the insurance industry also moves to offer portability so that the mediclaim and motor insurance policy holders can switch their service provider. We have initiated a debate on the idea of portability and we would be arriving at a conclusion very soon," IRDA chairman J Hari Narayan said at a CII insurance summit in Mumbai.

To a question on whether this portability concept would apply to ULIPs (the troubled unit-linked insurance schemes) also, he said, "Yes and no. Yes in the sense that there has to be a balance in the churn of ULIP's policy and their portfolio has to be evenly managed."

Hari Narayan also said IRDA would soon come out with merger and acquisition norms and is in discussion with Reliance General for the proposed acquisition of a south India based insurance company. "M&A norms would be announced soon. A committee is studying the issue," he said.

Earlier, there were reports that the Anil Dhirubhai Ambani Group-promoted Reliance General Insurance is looking at buying 74 per cent stake in its rival Royal Sundaram. If successful, it would be the first time that a general insurance firm acquires a rival and therefore the relevant guidelines need to be sought from IRDA.

Hari Narayan further said that IPO norms for life insurance companies are expected very shortly from capital market regulator Securities and Exchange Board of India (SEBI).

His pronouncements may mean little on the ground, however. Mobile number portability, promised almost two years back, is still to be implemented, with new deadlines being dished out every month to a credulous media. And with the turf battle between regulatory authorities far from resolved, 'health portability' seems a far-fetched dream indeed.

Link: Original Article

October 08, 2010

Medical council relaxes norms to set up colleges

The Medical Council of India (MCI) governing body has recommended relaxation of norms to set up medical colleges.

This includes changing the student to bed ratio in collegiate hospitals to 1:5 from 1:8 and increasing the retirement age of its teachers to 70 years from the existing 65 years.

"The retirement age has been increased to retain experienced and talented teachers and to overcome the faculty shortage that medical colleges across the country are facing," said MCI member Devi Shetty, chairman of Narayana Hrudayalaya.

The decision came at a meeting of the MCI held in Delhi on Saturday.
Also, the MCI has reduced the land requirement to set up a medical college and hospital to 10 acres from the existing 25 acres.

It has been decided that the established medical colleges can now take up to 250 students as against 150 earlier.

According to the MCI, India faces a shortage of 7.5 lakh doctors and expects about 100 new medical colleges to come up every year across the country.

Shetty said if the government cleared these norms, then the country could produce 8,000 to 10,000 more doctors each year and have 50,000 more doctors by 2012.

Link: Original Article

CBI arrests two Chandigarh doctors for PGI admissions racket

The Central Bureau of Investigation (CBI) Tuesday arrested two doctors of the prestigious Post-Graduate Institute of Medical Education and Research (PGIMER) here after the lid was blown off an organised admissions racket at the premier health institute.

CBI officials here said that the doctors, Amit Musale and Sujay Sonawane, were pursuing a post-graduation course at the PGIMER. The doctors had obtained admission to the course, one of the most sought after in the country, on the basis of impersonation and manipulation during the admission process.

CBI sources said that another person, who was running the admissions racket, was arrested by their counterparts in Mumbai.

'Anti-Corruption Branch of CBI, Chandigarh, has registered a case against two doctors pursuing their post-graduation at PGIMER and few other people on the allegation that these two doctors have procured admission in the post-graduation course on the basis of impersonation and manipulation,' CBI Deputy Inspector General Mahesh Aggarwal said.

The sources said that seats in the prestigious course were going for as high as Rs.80 lakh per student.

PGIMER authorities here, embarrassed by the startling disclosures, have offered to help the CBI investigations.

CBI sources said that several past admissions to the PGIMER could be investigated.

'These doctors obtained admission through organised racket assuring admissions in various private and government medical colleges by charging hefty amounts running into lakhs of rupees. The admissions to government colleges are procured by impersonation,' the CBI official said in a statement here.

'In such cases some brilliant student, part of the organized racket, appears in the entrance exam by impersonating the aspiring candidate. The two doctors pursuing post-graduation at PGIMER, Chandigarh were questioned by the CBI team. After questioning, these two doctors have been placed under arrest,' he added.

The CBI conducted raids Tuesday at several places, including Chandigarh and Mumbai, to find the roots and beneficiaries of the admission racket.

'A number of incriminating documents and other material have been seized pointing to the wide reach of this network. The aspiring candidates took admission on the basis of result of their impersonators,' the CBI official said.

Earlier September, the CBI had unearthed a racket of admissions in Punjab Engineering College here. These admissions were procured on the basis of fake and forged documents.

Link: Original Article

October 07, 2010

300 more medical seats to be available in TamilNadu from next year

Students in the state aspiring to be doctors will have nearly 300 odd seats at their disposal from the next academic year with new government medical colleges coming up in the districts of Perambalur and Sivagangai. "The number of government medical colleges in the state are very few and the medical profession needs more and more people every year. In order to meet the demand we plan to open more colleges in the state," said Dr Mayilvahanan Natarajan, vice-chancellor of Tamil Nadu Dr MGR Medical University.

Dr Mayilvahanan was inaugurating a one-year fellowship in oncoradiology and allied Bsc degree courses in imaging technology and laboratory technology launched by Dr Kamakshi Memorial Hospital. The courses will be affiliated to Dr MGR Medical University. "We have only 10 diplomas and 25 BSc courses in the state. There is a need for more such courses recognised by the appropriate authority," said Dr Mayilvahanan. Speaking about the degree courses in imaging technology and laboratory technology, he said that these were essential courses with good job opportunities and a lot of demand. "MGR Medical university will recognise these courses and students will get a university-approved degree," he said.

"This is the first time in India that a fellowship in oncoradiology in being introduced and it is a highly specialised field and doctors who have completed their post graduation in radio diagnosis can join this course," said Dr T S Swaminathan, head of department of radiology. He said since the number of cases related to oncology in the hospital were multivaried, the courses would be a great learning experience for the students.

Link: Original Article

FDA concerned over tall claims in medicine advertisements

The directorate of food and drugs administration (FDA) has warned citizens against self-medication goaded by medicine advertisements that not only make false claims but are also illegal.

To counter such advertisements, the FDA placed an advertisement recently, which read. "A number of advertisements are appearing in the print and electronic media regarding Ayurveda, Siddha, Unani ( ASU) medicines and herbal products making exaggerated claims on curing certain disease conditions; such misleading advertisement cheat the public leading to their exploitation by unscrupulous manufacturers/agencies."

FDA director Salim Veljee told TOI, "According to the schedule of Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954, advertisements for conditions like obesity, sexual impotence, cancer, diabetes, etc. are prohibited. The Act says nobody can make such claims of curing the diseases in the schedule. Such advertisements are being placed in the local media."

Veljee shows a recent advertisement in the print media for an Ayurvedic oil, which promises cures for quick discharge, nightfall, impotancy (sic!), gonorrhoea, syphilis, infertility, etc. "100 per cent successful treatment for these problems," the advertisement claims. The schedule of the Act mentions a list of 54 diseases including AIDS, cancer, heart diseases, brain disorders, rheumatism, stature of person, sterility of women.

Veljee says, "The main objective of the Drugs and Magic Remedies Act is to ensure that people do not resort to self-medication. If somebody goes to a doctor, who examines him and then prescribes medication, we have no issue. But people taking drugs solely on the basis of advertisements can be dangerous."

The Act itself explain its objective thus, "The main object and purpose of this Act is to prevent people from self-medicating with regard to various diseases. Self-medication in respect of diseases of serious nature mentioned in the Act and the Rules has a deleterious effect on the health of the community and is likely to affect the well-being of the people."

The Act continues to explain that some advertisements tend to encourage the reader to resort to self-medication due to its exaggerated nature and therefore it was thought necessary, in the interest of the public, "that the puffing of advertisements is put to a complete check and that the manufacturers are compelled to route their products through recognized sources so that the products of these manufacturers could be put to valid and proper test and consideration by expert agencies."

Veljee says that for the FDA to act, the advertisement must name both the drug and the diseases. The FDA has filed about 4-5 cases under the Act in the last 10 years. Two cases were convicted with fines of 1,000 each and 3 cases are under trial. While one advertisement was of a fish for the cure of ashtma at least two promised cures for sexual impotence. Sadly, the Act being old, the punishment is imprisonment of 6 months or fine, which is not specified. Mostly courts award a fine of 1,000.

The FDA tests these advertised medicines for the active ingredients as mentioned on their labels. It has no yardstick to check their effectiveness. Recent tests by the FDA on so-called Ayurvedic medicines did not show the presence of allopathic ingredients. So the FDA is sensitizing the media and urging them not to accept such advertisements because according to the Act, the media is also responsible for the advertisements, Veljee said.

Link: Original Article

October 06, 2010

Interview with Prathap Reddy, Apollo Hospitals

Often referred to as the father of modern healthcare in India - after all, he revolutionised healthcare in India at a time when the country was mired in babudom - doctor-entrepreneur Prathap C. Reddy remains unfazed by such adulation. When he set up Apollo Hospitals in Chennai in 1983, private healthcare institutions were virtually unknown to the country.

Today , with a network of over 8,000 beds across 52 hospitals in India and abroad, Reddy has laid the foundation for one of the largest hospital groups in the world. As his voice crackled over the phone from Apollo's Chennai headquarters, it told anecdotes of his interactions with top politicians and a wide array of other experiences. Excerpts:

A doctor in business or a businessman who happens to be a doctor?

It's very interesting because my father wanted me to be a businessman and I wanted to be a doctor. I went to NASA when the Apollo landed and saw 70% of NASA had Indians. Some were top doctors too. Why couldn't we provide the best healthcare in the world back home? That set me thinking. But I didn't do the business. I just picked up the right people as the concept took root in the early Eighties.

I told Mrs (Indira) Gandhi only the rich and powerful get access to healthcare and she really gave the first impetus by telling everybody that here's a man who wants to reverse the brain drain. But the man who changed the face of healthcare in the country with his vision and clarity was none other than Rajiv Gandhi — by opening up hospitals to funding and other opportunities . I am a doctor in the business of health because I use professionals. So I'm doctoring the business.

The Eureka moment when you decided to be an entrepreneur?

What drove me was an incident that occurred once I came back from the US. In the Seventies, there was no acceptable surgery in India. On November 19, 1971, I lost a young man since he couldn't afford $50,000 to go the US for his operation.

What was the most difficult part of being a businessman and a doctor?

Creating trust between the patient and the doctor by weaving in the element of care.

The one lesson your daughters have taught you?

Compassion. There are no limits to what people can deliver . With compassion comes passion. That's why the 70,000-plus members of Apollo are a family.

You like being a contrarian...

We challenged everything. If there are a million bricks in Apollo, I had a million problems. Obtaining import license was a problem, for instance. We imported 375 items when we started. Every week, I used to go to Delhi to get the import license cleared. Having said that, many people have also helped me in enabling better health in India.

Is world-class service at low prices a pipe dream?

We charge $5,000 for a bypass surgery here, whereas elsewhere it costs $50,000 and above. From Day 1, I created a three-tier system in my hospital-a general ward, a middleincome ward and a very small high-income group area. All my wards are air-conditioned to keep the infection out. Naturally , the cost of air-conditioning is woven in to the overall cost.

But we maintain the same operation theatre, the same post-operative rooms and the same surgeons for the patients . Even the nurse doesn't know if the patient comes from a super deluxe ward or a general ward. The ultimate outcome is care.

A mistake you regret?

My biggest mistake was when I was not in medicine. In entrepreneurship, I was interested in IT and was perhaps the first Indian to have invested $1 million along with my brother-in-law in an IT company in Chennai that did work for Intel. But when I started out, I paid high customs duties and that was unsustainable at that time.

A survival strategy that every youngster should know...

Every one of us have tremendous amount of potential. If we are not able to deliver our best, it is because of a screen that pulls us back. So we must stay positive.

Best business book?

Bhagwad Gita because it tells you your karma. You learn all principles of success because all inhibitions will go.

What kind of mails do you hate seeing in your mailbox ?

When somebody says, I'm God. Of course, my secretary screens them for me.

Your biggest management dilemma?

Getting greater access to all people.

Any Reddyisms?

Be positive. In Telugu, there's a saying: Reddywa Rajwa (Are you a Reddy or a king?) . Perhaps, it's in my DNA now (chuckles).

Decision-making : Theory or gut?

Whatever we call dreaming, is not a dream. Apollo has now done 300,000 check-ups in the world, making it the world's largest health check-up hospital. But I tell my people how can we achieve 5x or 10x of that number. Ultimately , it's all about teamwork. Take away the 'I' and replace it with 'We' . Gut feel comes from the way you've positioned yourself and theory comes later.

Best life lesson?

I say, 'Good Morning, Apollo' , when I walk in to my office each day. And when I leave, I wrap up the day with a simple prayer saying that we've done our part but hope for the very best from God.

Link: Original Article

Sam Pitroda suggests innovative plans to health ministry

Prime minister’s adviser on innovation Sam Pitroda has come up with some innovative plans for the health ministry. The government will now work towards innovating standards in health sector, sterilisation procedures, low-cost diagnostic facilities and mobile hospital units.

During a meeting, the National Innovation Council headed by Pitroda and the health ministry discussed a detailed action plan on the various areas the government needs to focus on.
Working groups have been formed for areas including health awareness and education, capacity building, food and nutrition, drinking water, continuing education, insurance, innovative and PPP models, creation of standards, diagnostic centres/ low-cost devices, mobile hospital units, facility upgradation, telemedicine, health portal in multiple languages, sterilisation procedures, science in health, adopting a district and performance indicators.

The need for traditional or local systems of medicine to lay down systematic protocols for treatment and at the same time, use this knowledge to help the population access reliable health care systems, was also discussed at the meeting. It is believed that 72% of the Indian population still depends on traditional/local systems of medicine for treatment.

Prof Ranjit Roy Chaudhary, Member Board of Governance, Medical Council of India had suggested measures to overcome the problem of posting doctors in rural primary health centres and re-orientation of traditional medicine practitioners.

Bhargav Dasgupta of ICICI-Lombard suggested that a private entity should adopt one district and ensure that the district gets appropriate health care services. He said the district’s performance outcomes should be monitored every 4 to 6 months.

The best practices should be elaborated on and models should be replicated all over, he said.

Besides, focus on sex education for adolescents, thrust on safe deliveries and not on institutional deliveries to reduce maternal mortality rate and standardisation of the cost of healthcare were also discussed at the meeting.

Link: Original Article

October 05, 2010

Pilot project for traditional health practitioners

In an initiative to bring traditional health practitioners under the fold of the formal public health system, a national pilot is all set to be launched in Arunachal Pradesh.

With the East Siang having been identified for the start, the project aims to integrate the traditional health practitioners, also known as folk healers or Grama Vaidya, with the public health system, official sources said on Saturday.

The project to be implemented by IGNOU Institute of Vocational Education and Training (IVET), Shillong and supported by the department of Ayush, the Union Government will help the traditional health practitioners get their knowledge assessment for certif ication with certain standard benchmarks.

“The Quality Council of India and Institute of Ayurveda and Integrative Medicine will provide domain knowledge and standardisation support,” the sources added.

Link: Original Article

Medical, paramedical seats lying vacant

Admission for medical and paramedical courses in Gujarat was held in four phases and yet, seats in many colleges are still empty.

This trend has left many college administrations and the state education department worried. The Joint Admission Committee for Professional Courses (JACPC) of state education department, which conducts the admission process, held three rounds of re-shuffling between October 22 and 24 after the admission formalities were completed.

"The extra rounds of reshuffling were meant to give more deserving students a chance to follow their choice of careers and to fill up the vacant seats in all colleges. The last round of reshuffling was held for 75 empty seats of Akhandanand Ayurvedic college in Ahmedabad," said an official from JACPC.

However, the empty-seat syndrome refused to abate as 47 seats were found to have been left vacant in physiotherapy colleges and six in homeopathy colleges.The total number of seats available in various medical and paramedical colleges in the state was 6,130. Of these, 786 are still lying empty, after three rounds of reshuffling. "The largest number of empty seats is in dental colleges which are missing 172 students. All these seats will now be handed over to the respective college administrations for admissions," the official added.

Link: Original Article

India's health system has failed miserably: Survey

In the recent past, India has been resting on its medical laurels, but an international survey has revealed that the reality is an altogether different story. The country's healthcare system fails miserably in almost all parameters when compared to six developed and developing nations such as the US and UK, China, Brazil, and Singapore, reveals a newly released study. The most telling finding was that despite having 10.8 lakh beds—the second highest among all the countries surveyed—there is less than one bed for every 1,000 people.

The joint study was conducted by the Federation of Indian Chambers of Commerce and Industry (FICCI) and HOSMAC, a hospital planning and management consultancy firm. The UK tops the bed-patient ratio parameter with 3.9 beds higher than WHO's norm of three beds per 1,000 people. India's burgeoning population, say industry experts, cannot be used as an excuse given that China has 40.63 lakh beds, and meets WHO's norms (see box).

The report stated that to achieve the desirable norm a minimum of one-lakh beds have to be added to the country's existing kitty over the next 30 years. "About two-third of these beds have to come up in rural areas to ensure an even development of health infrastructure," said director of FICCI Shobha Mishra Ghosh, adding that in some areas even the UAE and Brazil surpass India in providing medical care.

China has successfully managed to create an efficient healthcare system with an army of medical personnel.
In terms of manpower, our neighbour has three times the number of doctors working in India, and 1.22 crore nurses. India has only 13.72 lakh nurses.

According to industry watchers, policy-makers must acknowledge that in the healthcare expenditure pie, the government's share is only around 26%. "One suggestion is that the government should emphasize on primary and secondary healthcare facilities, while leaving tertiary centres to the private sector," she added.

It goes unsaid that the urban-rural divide has to be addressed. "The government has to provide lucrative incentives for private players to move to rural and semi-urban areas," said managing director of HOSMAC, Dr Vivek Desai.

The only silver lining in the study is that India holds the top position in the number of medical and nursing colleges—-303 and 3,904 respectively. But then, despite having less than half the number of medical colleges as compared to India, the United States has more doctors on its rolls. "There could be many possibilities, but brain drain could be one of the main reasons," said Desai. Statistics suggest that in 2008 nearly one-tenth of doctors in the UK were not British citizens, while the percentage stood at 26% in the US.

Read more: India's health system has failed miserably: Survey - The Times of India http://timesofindia.indiatimes.com/city/mumbai/Indias-health-system-in-sick-bay/articleshow/6623424.cms#ixzz11Rlnozu8

Link: Original Article

October 03, 2010

Panel push on medical education - NCHER, NCHRH

A task force set up by the human resource development ministry has suggested bringing medical education within the ambit of an overarching higher education commission.

Disregarding opposition from the health ministry, the task force has drawn up a draft bill for creation of a National Commission for Higher Education and Research (NCHER) that would “holistically” look after higher education. It has also suggested that legal education be brought under the commission’s ambit but the Bar Council of India (BCI) has opposed it.

The task force has, however, said that agriculture education should remain outside the NCHER purview as agriculture is a state subject and bringing it under the commission would require a constitutional amendment.

“We have finalised the draft NCHER bill. We have stuck to our stand that legal education and all branches of medical education should be brought within the NCHER ambit. Agriculture education should be kept out of NCHER as it is a state subject,” a member of the task force said.

The task force members included professors Mrinal Miri, M. Anandakrishnan, Goverdhan Mehta and N.R. Madhava Menon.

Health minister Ghulam Nabi Azad and secretary Sujatha Rao have opposed the HRD ministry’s proposal. They have decided to set up a National Council for Human Resource in Health (NCHRH), which would regulate all branches of medical education, including medicine, dentistry, pharmacy, nursing and physiotherapy.

The health ministry has already prepared a draft NCHRH bill, which has been sent to different ministries for consultation.

HRD minister Kapil Sibal has said the draft NCHER bill will be discussed with all “stake holders” before it is finalised. The draft bill will be sent for inter-ministerial consultation before it is taken to the cabinet. If the cabinet clears it, the bill will be introduced in Parliament.

The BCI, which regulates legal education, has opposed the task force’s suggestion and boycotted one of its consultation sessions.

“We have prepared the bill as per the recommendations of a committee on higher education under professor Yashpal. The committee had said that all branches of higher education should be brought under one overarching body,” the task force member said.

The basic objective of the NCHER is to give autonomy to universities to innovate and experiment. Bringing all types of education under one body will break barriers between different branches of education and promote excellence, the member said.

Link: Original Article



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