Is healthcare being compromised due to delay in posting deans to government medical colleges?

Is healthcare being compromised due to delay in posting deans to government medical colleges?

TheDrugs Control Department had pointed out that the medical store in Madurai Government Rajaji Hospital was in a bad shape and had recommended changes to be carried out, but no steps were taken allegedly due to lack of authority of the in-charge dean; In-charge deans cannot match the expertise and experience of deans who are shortlisted for the post, say activists

C. Palanivel Rajan

Madurai  16.09.2024 

Delay in appointment of deans in some of the important government medical colleges in the southern part of the State is hampering not only important administrative processes but also the smooth functioning of the hospitals.

As the post of deans remains vacant in government medical colleges in Madurai, Ramanathapuram, Kanniyakumari, Theni and Virudhunagar, for the time being senior doctors are holding the post with Full Additional Charge (FAC).

Though temporary arrangements have been made for administering the medical colleges and hospitals, the efficiency of a full-time dean cannot be matched by the in-charge deans, say activists and former deans.

For the southern districts, Madurai Government Rajaji Hospital (GRH) remains the key referral point. Though all the districts have their own government hospitals, the GRH, due to its capability of handling large numbers of patients with serious complications, plays a key role in treating numerous patients every single day.

But the irony is that the GRH has been operating with no full-time dean since May 2024. After the retirement of A. Rathinavel, C. Dharmaraj, Professor, General Medicine, Madurai Medical College, assumed office as in -charge dean. Following his retirement, V. Selvarani, Professor, Department of Cardiology, Madurai Medical College, took over as in-charge dean.

The number of dean in-charges in the recent days raises a critical question of how badly this would affect the functioning of the hospital and what is the key role of a dean in a government hospital.

A retired government medical college dean, who does not wish to be named, says that though the powers of a dean have been conferred on an in-charge dean, there would surely be a lag in decision-making. “In-charge deans enjoy both legal and financial powers but their commitment to the post varies. In their short period of stay, they will not wish to bear unnecessary burden,” he points out.

“Though it seems that a dean with full additional charges can operate a hospital like a regular dean, issues like enforcing discipline or getting respect from their subordinates or colleagues may pull down their performance,” the senior doctor adds.

Another dean of a government medical college hospital, listing out the key functions of a dean, said administrating treatment, education and research at their medical colleges and hospitals were the three broad functions.

“The functions are innumerable. But, to point out a few - health delivery system, outpatient department function, inpatient care, central lab services, pharmacy, basic amenities provision, special services, schemes operation, supervision, review and monitoring of services, calamity management, reporting and surveillance of infectious diseases, reporting of births and deaths, budget, finance management, working staff grievances, medicolegal responsibility, fire safety measures, bio-medical and solid waste management - are some of the major responsibilities,” the doctor notes.

Though these might sound like routine functions, each one carries equal importance considering the seriousness of diseases and complexities with which patients were treated at the hospitals.

“In simple things like managing inadequate medical staff at the hospital, a dean can order for using extra staff from a particular department to fill the existing vacancy, but in case of an in-charge dean, though it is performable, due to lack of moral authority, this may not be possible leading to a huge struggle in pursuing the said duty,” the dean says.

In Madurai GRH, the medical store has been identified to be in a bad shape even by theDrugs Control Department, but no steps could be taken to change or modify the infrastructure allegedly due to lack of authority.

A GRH official, requesting anonymity, says, though officials of the Drugs Control Department lack authority to take action against a government hospital for not maintaining the medicinal standards, they can recommend the changes that needs to be carried out.

Based on that, the official says, the Drug Control Department found irregularities in maintenance of drugs at the hospital during a recent inspection and had also reported to the in-charge dean. “As the in-charge dean was not in a position to immediately allot funds for renovation or procure instruments to maintain standards, he refused to carry forward the recommendations of the Drug Control Department,” the official says.

C. Anand Raj, a health activist based in Madurai, referring to such delays in carrying out necessary works, says: “In-charge deans cannot match the expertise and experience of Deans who have been shortlisted for the post. Though the in-charge’s duty is mostly given to doctors in the rank of head of departments, it cannot be said they would have the necessary power to take actions swiftly and boldly.”

Mr. Anand Raj adds that doctors and the public have never witnessed such indefinite delays in several years. “When the panel list for the dean posting is prepared several days ahead of the retirement of a dean, why cannot the health department act on the list that is already placed for their perusal,” he asks.

“Officials were comparing the efficiency of performance observed in medical college hospitals in districts like Virudhunagar and Theni which were administered by in-charge deans. They say the same efficiency can be expectedin super speciality hospitals run by deans in-charge. But, in reality, the super speciality hospitals are of a completely different league demanding high-level of experience from doctors to be appointed as deans,” he notes.

G. R. Ravindranath, General Secretary, Doctor’s Association for Social Equality, says “the delay in appointment not only slows the functioning of the hospital, but also puts a huge burden on the person in-charge, who may be incapable or inexperienced. This also flouts the National Medical Commission’s norms to appoint full-time dean in every medical college hospital” he adds.

The retired government hospital dean said the delay in posting a full-time dean would also affect the prospect of the eligible doctors who were on the list for the position.

He adds that starting from top positions like Directors and Deans to professors, doctors under the Directorate of Medical Education (DME) and Directorate of Medical and Rural Health Services (DMS) and Directorate of Public Health and Preventive Medicine, preparation of panels for promotion was also being delayed.

Due to this, many senior doctors and professors retire without attaining their promotion, the dean adds.

A senior health official says the panel for appointment of dean is ready and as Chief Minister M. K. Stalin was back in the State, the appointment process would start soon.