Why OPD At SMHS Hospital Functions Like A Pharmacy? 

Srinagar — Insufficient health infrastructure and human resource in district and sub-district hospitals of the Valley is putting Srinagar’s understaffed SHMS hospital under “tremendous” pressure.

Doctors who treat and operate upon patients in out-patients and in-patient departments of SMHS hospital said that they are merely “meeting the patients” rather than offering medical consultation to them.

“Considering the huge number of patients which we receive at this hospital, we mostly prescribe medicines without properly examining the patients. It is not recommended to prescribe medicines without examining the patients properly and getting their medical examinations done in laboratories,” said a senior doctor who treats the patients in one of the out-patient departments.

He agreed to share his views anonymously as no one in the hospital, including the medical superintendent, is allowed to speak to media without the approval of the Principal of Government Medical Srinagar (GMC).

Several hospitals in Srinagar such as SMHS, G B Pant, Lal Ded Hospital, Psychiatric Diseases Hospital, Bone and Joints Hospital and Chest Diseases Hospital are associated with GMC and are headed by the Principal of the college.  

 “But, we feel compelled to treat the patients this way given that we have to see each and every patient who turns up for medical consultation at the hospital. Resultantly, we see hundreds of patients every day whereas a doctor can’t examine more than 15 patients in a day as is the norm in Arab world and the west,” the doctor said.

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A doctor from another department described this way of treating the patients in the hospital as “like running a pharmacy.” He said that the doctors end up prescribing medicines only as they have to make sure that no patient returns home disappointed without “meeting” the doctor. 

 “There is a shortage of over 40 percent doctors and other staff against the sanctioned posts. Naturally, it puts much stress on those who are working in the hospital and also compromises the quality of treatment,” a senior official in the hospital administration told Kashmir Observer.

He said that if a doctor is supposed to examine a patient for at least 15 minutes and he gets only one or two minutes because of the workload, “where is the quality?”

Every day, he said, “we get complaints” from patients that they are not satisfied. “But, it is all because of the workload that our doctors and para-medical staff have to bear. For example, in the past few weeks, we received well over 5000 patients on many days,” the official said.

But, the Principal of GMC, Dr. Saima Rashid, refused to accept that the hospital is facing challenges such as lack of human resource. “We have some minor challenges which we can’t discuss with you. But there is no shortage of staff,” she said. She asked her IT staff to pull down a report from the SMHS website (linked to GMC website) which had details about shortage of para medical staff arguing it was a “four-year-old” report though the date mentioned in the report was “March 31, 2018.” Kashmir Observer has copy of the report.    

Doctors in the hospital said that patients in the in-patients departments suffer the same way because of insufficient human resource. “Sometimes, a patient has to wait for over a month for undergoing surgery because of the patient load in the hospital,” doctors said and added that the hospital is overburdened mainly because most of the patients from rural districts are referred to SMHS even as they are supposed to treat them in district or sub-district hospitals. Another doctor said that sometimes doctors in rural districts refer patients to Srinagar because of lack of facilities at their hospitals.     

In March 2018, the state health department came up with a report on manpower audit, which paints a gloomy picture of health-care facilities across the state.

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“Though funds for raising/upgrading civil infrastructure for both the Health Services & Medical Education sector have been coming under various Centrally Sponsored Schemes and now also under Prime Minister’s Development Plan (PMDP) for J&K, want of commensurate creation of posts of manpower to man these new Institutions has bred a culture of running the new Institutions whether these are New District Hospitals, SDHs/CHCs or PHCs or the Medical Institutions like new Medical Education Institutes like Ayurveda College or GNM/ANM Colleges etc. ‘on internal adjustment basis’ which has led to cannibalization/depletion of the Staff of the existing Public Health Institutions and has harmed both the Old as well as the New Institutions leading to public dissatisfaction and the weakening of the basic Health Care Delivery System,” the report says.

According to the report, which quotes the National Sample Survey 2014 conducted by the union ministry of statistics and program implementation, private health sector provides 72% of the healthcare services in rural areas and about 79% in urban areas in the country. “However, In Jammu and Kashmir, nearly 97% of the healthcare needs of the 14.3 million population of the state are met by public health institutions as the private sector has not developed in the state due to its geographical remoteness, disturbed security scenario and restrictive land laws.”

The doctor to patient ratio in Jammu and Kashmir, the report says, is amongst the lowest in India. “Compared to the doctor-patient ration of 1:2000 in India, J&K has one allopathic doctor for 3,866 people against WHO (world Health Organization) norm of 01 doctor for 1,000 population,” it says.

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The Comptroller and Auditor General (CAG) in it 2017 report had also raised an alarm about the pathetic lack of health infrastructure and human resource in the state’s hospitals. According to the performance audit conducted by the CAG in 84 community health centers (CHCs) and sub-district hospitals (SDHs) of the state, there were only 270 specialist medical officers available in these health facilities against the sanctioned strength of 504 specialists. There was 46% deficiency of specialists in these health centers.

According to the CAG report, the position of staff in blood banks in district hospitals “was worse” as there were only 10 staffers available in these blood banks against the sanctioned strength of 132 posts.

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