At PHCs, patients present but docs absent
Corporation Underutilised Central Funds; Nearly One-Third Posts For Doctors Vacant; Nurses Treat The Ill
Komal.Gautham@timesgroup.com
For two days, R Lakshmi, a 55-year-old street vendor, has been walking into the urban primary health centre (UPHC) with breathing difficulties only to be turned away because the doctor on duty was not available.
“I came yesterday but the doctor wasn’t here. I have to travel 5km from Lloyds Road to reach this centre,” she said.
But Lakshmi is not the only patient neglected by the UPHCs. Hundreds are sent back every day from various centres run by Greater Chennai Corporation. Many centres are run by nurses as doctors either do not turn up or their posts are vacant. A rough estimate shows that nearly one-third of the posts are empty.
Four of the five UPHCs TOI visited did not have doctors on two consecutive days. The National Urban Health Mission, which funds UPHCs across the country, recommends that doctors should be on duty from noon to 8pm. But the corporation has put up boards stating doctors will be available from Monday to Saturday between 8am and 3pm. Even then, they either shorten the working hours, or abstain from duty altogether.
NUHM has been providing the corporation ₹35cr to ₹40cr each year to run and maintain the centres. But for two years now —2016-17 and 2017-18 — the national body did not send funds citing underutilisation. On an average, the civic body has used ₹11cr per year.
“Audits have shown that funds were diverted to other works following which funding was stopped,” said Venkatesan Jayaram, convener of Arappor Iyakkam. “We did an audit of primary health centres in 2015-16 and found that in 94% of the cases the doctors did not complete the seven-hour duty. Of the 15 UPHCs we visited, doctors hardly stayed for two or three hours. In 23% of the cases, doctors were not available at all. Facilities at these centres are outdated, scan machines are often in repair and the patients are asked to get scans done at private centres. This leads to over-crowding at government hospitals,” said Jayaram.
Each day, on an average, 150 patients visit these centres with complaints of fever, common cold, hypertension, diabetes. Pregnant women are regulars too. Most patients said they were often treated by nurses. “Most of them are regular patients. Based on their previous case history, we advise them. But we cannot prescribe medicines,” said a nurse.
Director of public health Dr K Kulandaisamy admitted that most of the UPHCs had part-time doctors as medical officers. “We are willing to recruit doctors and depute them to bring down the vacancy. Since promotion and assured career progression are not there, doctors and nurses are not willing to be posted in such health centres. We are slowly recruiting and deputing doctors. Last week, we deputed five doctors,” he said.
A senior corporation official said apart from doctors, there was a shortage of auxiliary nurses and midwives.
A former city health official blamed the corporation for the shortage of doctors. “We have asked the civic body to recruit permanent doctors and nurses but it says that due to fund shortage, recruitment has been stalled. It has no choice but to depend on the state health department,” said an official.
Corporation Underutilised Central Funds; Nearly One-Third Posts For Doctors Vacant; Nurses Treat The Ill
Komal.Gautham@timesgroup.com
For two days, R Lakshmi, a 55-year-old street vendor, has been walking into the urban primary health centre (UPHC) with breathing difficulties only to be turned away because the doctor on duty was not available.
“I came yesterday but the doctor wasn’t here. I have to travel 5km from Lloyds Road to reach this centre,” she said.
But Lakshmi is not the only patient neglected by the UPHCs. Hundreds are sent back every day from various centres run by Greater Chennai Corporation. Many centres are run by nurses as doctors either do not turn up or their posts are vacant. A rough estimate shows that nearly one-third of the posts are empty.
Four of the five UPHCs TOI visited did not have doctors on two consecutive days. The National Urban Health Mission, which funds UPHCs across the country, recommends that doctors should be on duty from noon to 8pm. But the corporation has put up boards stating doctors will be available from Monday to Saturday between 8am and 3pm. Even then, they either shorten the working hours, or abstain from duty altogether.
NUHM has been providing the corporation ₹35cr to ₹40cr each year to run and maintain the centres. But for two years now —2016-17 and 2017-18 — the national body did not send funds citing underutilisation. On an average, the civic body has used ₹11cr per year.
“Audits have shown that funds were diverted to other works following which funding was stopped,” said Venkatesan Jayaram, convener of Arappor Iyakkam. “We did an audit of primary health centres in 2015-16 and found that in 94% of the cases the doctors did not complete the seven-hour duty. Of the 15 UPHCs we visited, doctors hardly stayed for two or three hours. In 23% of the cases, doctors were not available at all. Facilities at these centres are outdated, scan machines are often in repair and the patients are asked to get scans done at private centres. This leads to over-crowding at government hospitals,” said Jayaram.
Each day, on an average, 150 patients visit these centres with complaints of fever, common cold, hypertension, diabetes. Pregnant women are regulars too. Most patients said they were often treated by nurses. “Most of them are regular patients. Based on their previous case history, we advise them. But we cannot prescribe medicines,” said a nurse.
Director of public health Dr K Kulandaisamy admitted that most of the UPHCs had part-time doctors as medical officers. “We are willing to recruit doctors and depute them to bring down the vacancy. Since promotion and assured career progression are not there, doctors and nurses are not willing to be posted in such health centres. We are slowly recruiting and deputing doctors. Last week, we deputed five doctors,” he said.
A senior corporation official said apart from doctors, there was a shortage of auxiliary nurses and midwives.
A former city health official blamed the corporation for the shortage of doctors. “We have asked the civic body to recruit permanent doctors and nurses but it says that due to fund shortage, recruitment has been stalled. It has no choice but to depend on the state health department,” said an official.
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