South Goa District Hospital:Pvt interests intersecting Public interests

By Cleofato A Coutinho
10 July 2020 22:24 IST

Covid-19 pandemic has exposed our public health-care system. It is shameful that healthcare remains the most neglected sector with investment as low as over one percent of GDP. The availability of beds and medical professionals in the public hospitals is appallingly low. Government offered subsidies and even provided land, other facilities and concessions to private hospitals to augment the health care system .The Health insurance by the state, it was thought would even provide better care for those who cannot afford. According to FICCI, the private nursing homes and private hospitals account for 60% of the total hospital beds and employ 80% health professionals. The healthcare in our country is dominated by private sector.

Goa boasted of robust health infrastructure and even thought of starting health tourism with some hospitals claiming state of the art facilities rivalling five star hotels.

The corona pandemic has highlighted the total apathy of the private health care system.  What happened from in Bangalore city is an illustrative and eye-opener. A trader died this week, after he was admitted in a Government run Bowring and Lady Curzon Hospital.   18 hospitals allegedly refused to admit him due to him showing symptoms of Covid-19. Four private hospitals refused to admit a sick doctor suffering from high fever, fearing that he was covid positive. The collector of Jalgaon district was moved by certain social activists as his health deteriorated and required ventilator.  A 32-year-old covid positive cardiologist from Sri Jayadeva Institute of Cardiovascular Sciences was turned away by four private hospitals before he got admitted in the cardiac rehabilitation unit of Jaydeva institute. 

Number of patients have died in Telangana on way to public hospitals as private ones turned them away. Most private hospitals turned away the covid infected and covid suspected. A patient with cough, fever or respiratory issues were routinely rejected and referred to government hospitals and if non covid patients are admitted, they had to undergo covid -19 test and pay for PPE which inflated the bills.

The private players had to be mandated by states to do their bit by the force of law      and the it appears they are now falling in line .Karnataka state has invoked the Disaster management Act and Karnataka Medical Educational Establishments Act. On 26th March Union health Ministry issued directions to all private hospitals to create separate wards for isolation and treating covid infected. Few private hospitals responded to the call of the country’ health ministry in most difficult times.

The greatest lesson of this pandemic is that the government must strengthen the public health system and the private sector must be mandated to step in for handling of the health emergencies with monitoring and regulation so as to avoid people being fleeced. No one expects same pricing standards for medical services in both public and private hospitals. Neighbouring Maharashtra pioneered the requisition of rooms and hospital beds from the private hospitals. It has decided to take over 80% of private hospital beds at capped charges and permit the hospitals to charge the normal rate for remaining 20%.  That what is requisitioned/taken over is not sufficient is a different matter altogether. Other states have followed and designated hospitals for covid treatment at capped the prices after public uproar over the costs.

The Goa Governments preparedness to deal with the pandemic has been lacklustre. An existing ESI Hospital at Margao was designated as Covid-19 hospital. Why the Goa government has not roped in private players in the fight against corona virus is anybody’s guess! It is strange that when all states are flexing their muscles in getting the Covid infected treated at private hospitals at  capped prices,  our  state which thought  of health tourism, the people have  no choice in getting Covid -19  treatment at hospitals  they choose.  Even state like Tamil Nadu has provided options to the people to get treatment  free in hospitals taken over by government  for covid  treatment under the arogyasri scheme or not  and  those who can afford can choose private government approved hospitals.

As numbers soar, the current Covid-19 hospital at Margao could get overwhelmed. It is now clear that  the government failed to anticipate a spike in cases and made no further arrangements except for care centres for asymptomatic cases. The facilities and services at covid care centres are a shame to this state and it’s people. The lockdown period was frittered away in self-adulation as the cases slipped to zero. What is disturbing is that despite a continuing surge in cases in June, the government has failed to involve the private players. Why should the Goan private health players not be incorporated in the pandemic fightback?

 A five-floored superstructure for 800 hundred bedded South Goa District hospital is almost ready. Present Government downsized it 500 bedded hospital. It is mystery as to why the Out Patients departments (OPDs) were shifted in the midst of the pandemic and the medicine department shifted by end of June- a time when the state looks unprepared to deal with the emerging situation. When such a fine infrastructure was available for covid treatment at one place, the indecent hurry of shifting a part of Hospicio Hospital to the new District Hospital has raised eye brows. Shifting of the OPDs scuttled the district hospital becoming a covid hospital and care centre. The Hospicio hospital is currently functioning as operation theatres could not be shifted and it is expected that shifting of the entire hospital would take some time. Corona virus phase would pass with time and the Hospicio hospital could be shifted thereafter. After all the new hospital is delayed by 8 years.  Two floors still remain unused mysteriously. When other states are setting up new hospitals and care centres, our state is criminally wasting a resource that could be used to deal with emergent situation.

A newspaper reported that a private medical  college is being planned at the South Goa District Hospital. Is that the reason for shifting the OPDs in difficult times? Only time can answer that. Let it not be forgotten that the pandemic has taught us a great lesson. Minimize private interest in health sector. Let our jewels not slip into private hands!

Disclaimer: Views expressed above are the author's own.

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Cleofato A Coutinho

Cleofato Almeida Coutinho is a senior lawyer and one of the constitutional expert in Goa. A member of Law Commission of Goa, he also teaches at Kare College of Law in Madgao.

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