A policy for the future

THIRUVANANTHAPRUAM: The LDF government’s health policy has come out with a detailed road map to face the newer challenges in health sector, consolidate on the gains achieved in the past and build a robust health care infrastructure. For decades Kerala has boasted of health indicators comparable to the developed countries and received accolades globally for its health care model. However, at the moment the state seems to be slipping in some areas and continues to be stagnant in many other spheres. There is a drop in vaccination coverage, infant mortality though the lowest in the country needs to be brought still further down, infectious diseases have taken its toll on people’s health with dengue deaths remaining on the higher side in the state and untreated waste posing a big threat. While the health institutions including medical college hospitals are bursting at the seams, research activities have taken a back seat.

It is in this context that the new health policy proposes to bring ground breaking changes right from the primary health sector to the super specialty, making significant changes in the administrative and clinical services. The policy, framed by a 17 member committee headed by noted public health activist B Ekbal,  proposes a PHC in each panchayat with facilities which include OP clinics, minor OT , Labor room , basic pharmacy, laboratory services, health information collection mechanism and health education system. Under E-Health, the medical details of all families residing within the limits of the PHC will be collected. This is to map the health profile of the population and take steps accordingly. In view of the frequent outbreak of communicable diseases in the urban areas, the day to day public health activities will be brought under the District Medical Officer. At the moment the corporations are also handling the work within their jurisdiction. Health sector has been bifurcated into two departments in the new policy; Director General of Ayush and Director General of Modern Medicine. The health department will have two directors; one for clinical services who will be the in charge of all hospitals and director of public health who will take care of the  administration of hospitals and works related to public health.

The government plans to regulate the appointment of nurses, technicians and pharmacists in a transparent manner and by making required qualification mandatory. Private hospitals will be liable to answer any queries raised by the state health authorities. The policy has prepared basic guidelines for human resources required for the next 25 years in health sector. It has proposed strict enforcement of norms for infrastructure facilities and faculty in medical college hospitals. The government will withdraw essentiality certificate and Health University will cancel affiliation of medical college hospitals without the required faculty and minimum patient  strength. In order to make the hospital administration and health institutions more transparent and people friendly, the policy has proposed effective steps to check corruption. Hospital vigilance system will be strengthened further and ban on private practice will be enforced strictly.

The administrative autonomy  proposed for government medical colleges will improve the efficiency and quality of health care in such institutions. Most of the principals and hospital superintendents  have complained of lack of powers – financial and administrative – to run these institutions . The police has emphasized on determining the number of seats for PG courses and Super Speciality Courses strictly on the basis of  human resources requirement . Some of the important courses proposed include emergency medicine, geriatrics, family medicine, critical care, sports medicine, clinical embryology, radiation physics, genetics and hospital administration.

Pharmacy education: Pharmacy colleges will be set up in all medical colleges. PG diploma, Pharm D , M Pharm and PHD courses will be introduced. Registration and grading on the basis of facilities will be made mandatory for all clinical laboratories and Imaging Centres. A Clinical Diagnostic Technology Council will be constituted to monitor the facilities and services of these centres.
A modern medicine research centre will be established. The state government will make efforts to manufacture patented drugs, adhering to Indian Patent Act . This is to ensure making patented drugs available to people at a reasonable price.

Emergency services and Trauma Care: A comprehensive trauma care and emergency medical services will be set up and participation of public in rescue and relief of trauma patients will be ensured. Special ambulances will be deployed with trained staff in potential accident prone zones. Comprehensive trauma care facilities will be provided by pooling resources of government, private and cooperative hospitals in every 10 km area. Compared to other states, the infant mortality rate in the Kerala is low but it needs to be brought further down. A survey will be conducted in areas reporting infant mortality and appropriate remedial measures will be taken. The ongoing Mrithasanjeevni programme will be strengthened. Organ transplant facilities will be extended to other medical college hospitals.