Kerala’s 24X7 specialist care plan faces manpower test

Thiruvananthapuram, Aug 27 (IANS) The Chief Minister V.D. Satheesan-led Kerala government’s ambitious plan to take specialist healthcare beyond medical colleges and make it available round-the-clock at district and general hospitals, has run into its first major reality check, with government doctors warning that the reform could strain the public health system unless the state creates fresh posts and fills existing vacancies.

The Kerala Government Medical Officers’ Association (KGMOA) on Thursday while welcoming the initiative as a long-standing demand, has cautioned against implementing it merely by redeploying existing doctors.

Such a move, it says, could weaken the three-tier public healthcare system rather than strengthen it.

Health Minister K. Muraleedharan has positioned the initiative as a major shift towards bringing specialist treatment closer to people’s homes.

The first phase is expected to cover at least one district or general hospital in every district within six months, with medicine, surgery, orthopaedics, paediatrics and gynaecology among the specialities.

The plan also envisages emergency procedures and surgeries during night hours.

The government hopes the strengthened district-level network will reduce the growing dependence on medical colleges and ease their patient burden.

However, Dr P.K. Sunil, President, and Dr Jobin G. Joseph, General Secretary, K.G.M.O.A. in their statement said the manpower available at district and general hospitals is nowhere near what is required for a genuine 24X7 system.

“A medical college department providing round-the-clock care may have nearly 100 doctors, including faculty, senior residents and junior residents.

“Several district and general hospitals, in contrast, have only three or four specialists in some departments,” the medical officials said.

Doctors warn that simply placing these specialists on call would be unsafe.

Specialists attending emergencies through the night would still be expected to handle OP, IP and theatre duties during the day, raising concerns over both doctor fatigue and patient safety.

The association says the Health Department already has around 800 vacancies for doctors, including nearly 300 in the specialist cadre, besides 476 vacancies in the general cadre.

Kasaragod, Kannur and Palakkad alone have more than 100 doctor vacancies.

There is also concern that redeployment could deprive primary and community health centres of much-needed doctors.

These institutions provide immunisation, maternal and child care, control of communicable and lifestyle diseases, and are crucial to preventing unnecessary referrals to higher-level hospitals.

K.G.M.O.A. has urged the government to create new specialist posts, recruit doctors to fill existing vacancies and strengthen emergency departments with more casualty medical officers and effective triage systems.

The message from the medical fraternity is not a rejection of Muraleedharan’s reforms.

Doctors support the idea of bringing specialist care closer to patients, but warn that a 24X7 system cannot be built by stretching an already depleted workforce.

–IANS

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