Having a hands on experience for the last 6 months in one of the busiest hospitals in the country, and one where the cost to benefit ratio for a patient would be undoubtedly be pegged the most favourable, the experience of working under the Haryana Government Post Graduate Institute of Medical Sciences has been both rewarding and frustrating. And the virtues do outshine the vices.
Foremost is the facilities that Rohtak has included to be given free or at negligible costs. So we have Lab tests like ANA, CRP, D Dimer, FDP, HBA1C, RA Factor, HbF, Osmotic fragility, Coomb's, Trop I, CPK-MB and so on... and to include CDs to be incorporated soon. None of these are done in any state medical college...And are charged every cent even in a college like PGI Chandigarh...To get these tests done here, in the batting of an eye lid, for every single patient, regardless of his/her income, is awesome...The sheer number of patients getting treated and followed up in this manner has been pegged to be the highest in the country, in AIIMS treatment is restricted to a limited number of people, in other state colleges, people are lost to follow up.
In terms of therapeutics, the scene is better. Government servants, be it a Primary school teacher, or a university Professor are given 100% insurance coverage...So we have Multiple Myeloma patients receiving bortezomib every 4th day and a patient of panhypopituitarism receiving somatotropin, not to talk about IFN-gamma, and CSFs and what not occuring on a daily basis. The work that the government is doing in this regard is undoubtedly, commendable and aweinspiring. The amount of traffic in terms of medications procured and dispensed, the system of follow up is easier than a central institute chiefly because the beneficiaries are a state popuation and in terms of a state, Haryana is cosy, small and neatly packaged between Punjab and Delhi...So transport is easier, people are more aware of their rights and status than perhaps any other state. Hence its heartwarming to see patients actually coming with a BPL card and asking the investigations and medications to be made poor free....And, even when these people do come from a BPL background, their affordability VIS A VIS the rest of the country, is quite favourable.
In conclusion, I feel every state machinery, if it functions as efficiently as this one state, could bring about a paradigm shift in the way health care is disbursed in India. I shall deal with it in subsequent articles. To be honest, as of now I am beginning to get my language correct and frame of reference more analytical than emotional....The rest, learning from this set-up where I work presently, upto the point where I shall make the best use of all resources, will be a journey I shall grow wiser with.
Trouble with other state systems is manifold and unique. I am not aware of the functioning of states like Maharastra yet, and what I have heard upto now about the way healthcare functions in Maharastra scores pretty high, though the private system like Seven Seas, Breach Candy and others there yields more power. But when I compare PGIMS, Rohtak with SCBMCP, Cuttack, the diferences loom large and outline for each individual institutes' advantages and disadvantages.
( to be continued....)
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