Tertiary hospitals to have referral system in Kerala

THIRUVANANTHAPURAM: With all existing services - inpatient, outpatient and super speciality - being stretched to limits in medical colleges and district hospitals, the LDF government has decided to enforce referral system strictly in tertiary hospitals across the state. The state health department runs 1,250 odd institutions including district, general and taluk hospitals and community health centres and primary health centres having more than 35,000 beds.

But despite having such an extensive medical infrastructure, the existing facilities are not being used effectively to ease the pressure on tertiary hospitals. Health minister K. K. Shailaja Teacher is keen on making a difference. She says the facilities at the PHCs and CHCs will be evaluated and if need be upgraded to ensure that those requiring minor medical help are treated at the local level. At the moment, even for minor ailments like fever and cough, people rush to the medical colleges and district hospitals.

The government hopes to revamp the entire system with information communication technology-enabled networking. It wants to implement the e-health programme to ensure effective referral linkages between secondary and tertiary care hospitals.

Though last year the government decided to implement the referral system in Thiruvananthapuram Medical College on a pilot basis, the attempt could not succeed because of the indiscreet referrals from secondary and primary health care institution.

Experts say each health sub-centre should cater effectively to a population of  5,000, primary care centres 30,000 and community health centres one lakh and above to ease the pressure on the tertiary and super speciality hospitals.

The strength of doctors and nursing staff needs to be enhanced at many places besides arranging suitable laboratory facilities to create a sense of confidence among people about seeking treatment in primary and secondary institutions.

Another big challenge before the health minister will be to implement the national pattern of one post each of gynaecologist, paediatrician, physician,  surgeon and anesthesiologist in all community health centres.