City hospitals on sick bed

Efforts by the govt to erase the ignominy associated with its hospitals are too little, too late as problems there only seem to be compounding  

Caught in a twister of spiralling private healthcare costs, a large number of Bangaloreans are looking for options in the government sector. But what they find in hospitals galore isn’t a picture rosy enough to take that first step.

Despite a much-delayed facelift for the City’s century-old government hospital buildings, the doctor-patient ratio and patient-bed ratio remain grossly skewed. Yet, if you can live with that, you may not escape bribery, so rampant that it makes a mockery of the so-called “affordable” healthcare.

Hospitals such as Victoria, Vani Vilas, Minto, Government Dental College and Bowring and Lady Curzon, which fall under the purview of Bangalore Medical College and Research Institute (BMCRI), had gained autonomous status some time ago, receiving the impetus to improve their infrastructure.

Even K C General Hospital and the Jayanagar General Hospital that are under the Health and Family Welfare Department are slowly improving their infrastructure. The number of patients has increased two-fold in the last few years, making it tough for the existing doctors to cater to everyone’s needs.

Patients often complain that ward boys and ayahs in many of these hospitals are notorious for demanding bribes even for the simplest of tasks.

Recently, a woman who delivered her baby at Vani Vilas Hospital was asked to pay a fee even to see her child for the first time. Although the woman’s family members protested, the issue was buried after negotiations. Lack of strict administration has apparently ensured that this trend continues unabated.

Poor doctor-patient ratio

The country faces a huge crunch of medical professionals, and this finds a big echo in Karnataka - particularly, Bangalore - too. Here the urban poor and lower middle class face the maximum trouble. Experts attribute the shortage to the continuing demand for engineering course at the cost of medical courses. Here are some statistics: Karnataka has only one medical college for every 16-lakh population and one doctor for every 30,000 population. The World Health Organisation recommends one doctor for every 1,000 population. But India is expected to achieve this target only in 2028. 

However, Dr O S Siddappa, Director-cum-dean of BMCRI, feels there are enough doctors to cater to the needs of patients in government hospitals, but the problem lies in the acute shortage of staff nurses and paramedics.

“We do have enough doctors, at least in the urban scenario. But what we need is health workers, especially trained paramedic staff. We have approached the Health Ministry and are expecting to recruit additional staff for a period of time shortly,” he said.

Patient-bed ratio

Building additional blocks in government hospitals, though welcome, does not seem to be enough to cater to the growing population. The demand for more beds continues without respite. Ramesh Kumar, attending his daughter at Victoria Hospital, says he had to wait for more than two days to get her admitted there.

“It is not just waiting for bed allocation, but we also need to bribe the ward boys. In case the attendants need any services from the health workers, they have to pay a price for everything,” laments Thyagaraj, attending another patient.

Dr Siddappa agrees that patients have to wait for allocation of bed due to the rush. However, he adds, emergency patients are admitted on priority. Lack of beds with ventilator facility is another issue. Currently, there are 25 beds with ventilators in Bowring and Lady Curzon Hospital, while there are only 12 such beds in Victoria Hospital.

“Sometimes, ICU patients shifted to government hospital may have to wait, since allotting beds with ventilators becomes a problem,” he says.

Infrastructure projects

Medical Education Minister S A Ramdas had announced recently that five hospitals — Victoria, Vani Vilas, Minto, Nephro-Urology and Dental College, including BMCRI, will be brought under one campus on the lines of the All India Institute of Medical Science.

The department has prepared a blueprint for Rs 200 crore and the State government has already sanctioned Rs 121 crore for various development works. Space measuring 11,000 square metres, a children’s hospital, an extension of the existing Vani Vilas hospital, will be constructed in the next two years. BMRCL has agreed to construct a compound with a single entrance-and-exit point, to create landscape and a modern parking zone for the children’s hospital.  

Generic Drug Houses

The Bangalore Development Authority (BDA) has agreed to establish ‘Generic Drug Houses’ where medicines will be sold at 50 per cent of the market retail price. BDA will also construct a food court and a 200-metre-long skywalk for easy accessibility to the campus.

The minister had also announced supply of latest medical equipment to Vani Vilas Hospital, which conducts over 1,500 deliveries a month, where most of the deliveries are referral cases from BBMP hospitals.

The Karnataka State Pollution Control Board had issued notices to all government hospitals to install effluent treatment plants (ETPs). To reuse water from the ETPs at Victoria and Bowring hospitals, pipelines were laid for 3.2 km at a cost of Rs 2.4 crore.

The Public Works Department will asphalt 800 metres of roads of these hospitals at a cost of Rs 1.5 crore and box drains will be constructed at a cost of Rs two crore.

The government has allotted Rs 48 crore to Victoria Hospital which will be spent for the construction of a KPTCL block, an OPD block, Minto super-speciality block, anatomy dissection hall, twin tower on MS building, OPD at Vani Vilas, road restoration and ETP work. An additional Rs 19.19 crore has been sought. Bowring Hospital wants another Rs 12 crore.

BMCRI will also introduce 100 postgraduate courses and hike the number of medical seats by 250 for 2012-13.

The institute has sought Central government grants of Rs 276.13 crore for the purpose. A central research laboratory is also proposed to be set up at Victoria Hospital at a cost of Rs 35 crore. Ramdas had also announced a separate administration wing, examination hall, modern classrooms and auditoriums, for which the government will give special attention in future.

Nimhans overstretched

The National Institute of Mental Health and Neuro Sciences (Nimhans), a Central government hospital, caters to head injury, psychiatry and neurological problems not only to local people, but also people from Tamil Nadu, Andhra Pradesh and Kerala. No wonder, the institute is stretched beyond its capacity.

The hospital treats more than 1,500 OPD patients in a day and 850 in-patients. There are 114 exclusive beds, meant for emergency and casualty patients. Nimhans director Dr P Satish Chandra informs that the bed occupancy is more than 100 per cent at any point of time. 

“We have augmented our services at the emergency ward, having a team of doctors only to attend trauma cases. Sometimes, the patients are shifted to the nearby Sanjay Gandhi Institute of Trauma and Orthopaedic Hospital. Despite this, the load of patients is too high, making it extremely difficult for the hospital. Increasing the bed capacity will not completely solve the issue as there is a need for equal participation from private hospitals as well as patients in finding a solution,” he said. Satish Chandra said many times, the patient’s attendants get very annoyed if there is a delay in allotting beds.

There have been instances of doctors being attacked, but the hospital is doing its best to accommodate every patient, he added.

As an Institute official informs, more than 30 per cent of the patients in the outpatient department are from West Bengal. Although Nimhans has over 400-odd nurses, there is a need for at least a 50 per cent increase in the number of doctors, especially neuroanaesthetists. Instead of increasing the bed capacity, more centres like Nimhans need to come up in different parts of the City. The neurosurgery department at BMCRI also needs to be strengthened.