- Only Govt. Hospitals will have to take 98 pc COVID-19 W-3 critical load-so strengthen local authority ‘therein’ 7
2nd Corona wave is showing some decline. But at the same time it has also been suggested by the experts/ analysts / world organisations that like US/UK India may have to also pass through a 3rd Corona wave ( with new variants), with the onset of autumn season.
So without wasting any time wisdom lies in looking at the deficiencies / the gaps/ short falls that have been so far there. First need is to see where we have fallen back in terms of management at social / community level, making optimum/ timely use of available resources/ authority in terms of health infrastructure & manpower/, utilities/finances/ administrative procedures; which sector will have to take bulk of the Covid-19 load, government sector or private sector !.
No society / country like India within means can create infrastructure worth handling extreme infinite demands but still with better management lot more can be drawn from the available infrastructure and finances.
Government / planners will have to keep their focus on the facts like (i) in a country like India under the storm of pandemic like Corona -19 may be 95 of the citizens would be able to afford only services from the government hospitals ( it will not the wrong to say that common man emergencies will be received by only the government hospitals) (ii) the critical cases will not be that sportingly carried by the ‘private sector’ and hence government infrastructure would be still more loaded (iii) since so far no any specific medicines / treatment has been prescribed for Covid-19 and experience so far has been that there has been fast deterioration in some (though very less percentage) cases the doctors on spot have been prescribing support equipment and medicines to their ‘wisdom’ as is often done in critical cases with the sole objectives of saving one’s life even in the initial stages which may have resulted in extra medications and also loaded the family of the patient with huge out of pocket expenses which might have put many families under debts/shattered economy (iv)in the so pressing and discouraging Covid-19 environment when all have been advised social distancing and even the near friends/relatives of the Corona infected patients preferred to enquire whereabouts only on phone or through contacts but most of the health workers/doctors have to be with the patients (willingly or unwillingly) and in most of the cases only 1-2 very near in house relations were available to run around during hospitalisation (v) government managements were found short of ‘immediate authority’ and finances due to which most of the patients ( even Ayushman Bharat) had to buy the prescriptions from market (vi) like. Often patients/ attendants are complaining that Government Hospitals ( even Medical College Jammu) are not entertaining Ayushman Bharat beneficiaries for cashless services, it has been alleged that even such patients where costly tests are involved/surgeries the patients are not admitted and are denied free tests where as the private hospitals entertain such patients and perform the tests etc after admitting them and the treatments needed 9 including surgeries on cashless basis.
One reason that could be assessed for not admitting patients for cashless treatments by government hospitals could of no absolute sanctions and lack of finances available with hospital authorities like Superintendents worth making purchases for medicines / utilities not available with them from local market even on credit basis since local traders do not come forward for making supplies on deferred payment basis looking at the system/ procedures that prevail on date. So UT administration will have pointedly attend to this aspect.
So, while planning for the 3rd Wave Government among other jobs that have already been set on priorities must also include ( if not included) in the priority class to (i) Ensure that immediate prescription audit of the prescriptions written in the COVID care centres / COVID Hospitals is conducted to find out which not needed medicines / tests/support equipments have been prescribed so that the future patients are saved from financial burdens(ii) how far the doctors have been prescribing by chemical name and to what extent Jan Aushadhi Stores have been made use of since it could have lowered load on families / state exchequer (iii) since it has been reported that most of the critical cases had deteriorated fast and often need had been felt for life saving actions needing superior decision making so how far the Senior doctors were immediately available to the interns / house surgeons / PG students /Registrars for expert opinion for taking to or not taking to life saving treatment or deciding for life saving treatment (iv) during this period how many Ayushman Bharat Insurance card holders have been treated for COVID and non COVID treatments on cashless basis since it has been reported that Card patients are being made to buy medicines and utilities from the market since either the requirements are not available in stocks or the superintendent concerned / doctor concerned does not have readily available funds at his/ her disposal for making emergency purchases (v) since most of the government doctors who have been allowed to see/ attend patients in private on fee basis in relaxation of the government servant conduct rules had also stopped attending the calls / closed their clinics in view their own self protection there is need to examine how during odd hours those allowed private practice are motivated / made to attend emergency calls even during lock downs.
(vi) And above all a critical review of the administrative and financial authority that so far lacked with the Directors of Health / Principals of Medical Colleges in States / UTs like J&K in view of acute centralisations in the Administrative Departments in the Secretariat is needed by the Chief Secretary/ LGs in UTs like J&K so that the field operations do not suffer since it had been observed that Field Heads had been given only ‘responsibility’ but no delegated Authority worth even managing the officers / staff working under them.
Government should hence on priority have a critical test review of the status and working of the government hospitals/ corona care centres/ corona designated hospitals and the health services available particularly in the sub-urban / rural areas.
(Daya Sagar is a Sr Journalist & a known analyst of J&K affairs dayasagr45@yahoo.com).