‘Government hospitals should promote innovation and research in healthcare’ | Leave a comment

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The All India Institute of Medical Sciences (AIIMS) Nagpur recently revived the transplant programme in Central India’s government healthcare system by making a special arrangement of onboarding private doctors. As no government hospital was running the super specialty service in this region, patients either passed away without a transplant or incurred huge cost in private set ups. AIIMS being a central institute and having world class facilities, a lot of hopes were pinned on it. However, several challenges, including lack of expert urologists, proved a major hurdle. Dr Manish Shrigiriwar, medical superintendent, AIIMS, along with his team under the guidance of their executive director (additional) Dr MH Rao overcame these challenges to make the programme a reality. Dr Shrigiriwar, who is also former dean of Yavatmal GMC and worked at a Super Specialty Hospital in Nagpur, tells TOI how such super specialties can be run in big government hospitals.
Excerpts from an interview…
Q. AIIMS has revived a transplant programme in a government hospital in Central India. How can you ensure it keeps running and doesn’t meet the same fate as other government healthcare facilities?
A. Reviving a transplant programme in a government hospital is a significant step in improving healthcare services, and ensuring its sustainability is critical. A few ways can ensure that the programme keeps running. First is adequate funding: We, AIIMS Nagpur, are doing transplant under the MJPJAY and PMJAY scheme. Various donors and NGOs are helping us to take care of the expenses related to transplant (CSR funds, CM/PM help funds). AIIMS is providing all the essential medicines to below poverty line patients. Next is trained personnel: AIIMS has identified expert personnel for transplant surgeries including experienced urology surgeons. Then you need robust infrastructure: AIIMS has a state-of-the-art operation theatre including high-end investigation laboratories. Regulatory compliance: AIIMS has all the legal regulatory compliance certificates from the competent authority under Transplant of Human Organs and Tissues Act (THOTA). Quality assurance: It’s an integral part of the transplant programme at AIIMS.
Q. How can government hospitals have dedicated transplant centres?
A. Establishing a dedicated transplant centre in a government hospital requires careful planning and execution. Here are some steps that the government can take to establish a dedicated transplant centre in government hospitals: i) Identify and allocate resources: The government needs to identify the resources required for establishing a transplant centre, including personnel, infrastructure, equipment, and funding. ii) Legal approvals: The government hospital needs to ensure that the transplant centre meets all legal and regulatory requirements. iii) Availability of adequately trained staff: A transplant centre requires a skilled workforce, including transplant surgeons, transplant physicians, anesthesiologists, transplant coordinators, and nurses. The government needs to ensure that the staff is well-trained and has the necessary experience to provide high-quality care. iv) Develop collaborations: The government hospital can develop collaborations with other institution’s surgeons, to share knowledge, expertise, and resources. This can help to establish a sustainable and efficient transplant centre. The hospitals can appoint surgeons on a case-to-case basis.
Q. Government hospitals are becoming bigger with world class hospitals. What expectations must the society have from government facilities?
A. As government hospitals continue to expand and improve their services, society can have several expectations from these facilities. High-quality care is one. Society can expect government hospitals to provide high-quality care to patients. This includes access to the latest medical technologies, evidence-based treatment, and skilled medical professionals. Next is affordability. Government hospitals should provide affordable healthcare services to patients. This includes reducing the cost of treatment, medication, and procedures, and providing financial assistance to those who need it through various government schemes. Government hospitals should promote innovation and research in healthcare. Then comes community engagement. Government hospitals should engage with the local community to promote health and wellbeing. This includes providing education and awareness programmes, conducting health screenings, and collaborating with community organizations.
Q. Does this mean that the public will have to opt for step down facilities for routine or minor ailments?
A. The expansion and improvement of government hospitals do not necessarily mean that the public will have to opt for step down facilities for routine or minor ailments. Primary care facilities continue to play a vital role in providing routine and minor healthcare services. They are well equipped to cater to routine and minor ailments. We should have a proper and strong primary, secondary and tertiary referral services for proper management of patients. The tertiary care centres will be able to concentrate on specialized and apex health care services for complex diseases.
Q. Should well-equipped big govt hospitals focus only on super specialties like transplant, heart operations, cancer, etc?
A. Big, well-equipped government hospitals can indeed focus on super specialties like transplants, heart operations, cancer treatment, and other complex medical procedures. By concentrating their resources and expertise in these areas, government hospitals can develop specialized centres of excellence, attract skilled medical professionals, and provide high-quality care for patients requiring advanced treatments. Specializing in super specialties allows government hospitals to offer specialized expertise, advanced technology, and comprehensive facilities for complex medical conditions. This concentration of resources ensures that patients with critical or specialized needs can receive specialized care within the public healthcare system, reducing their reliance on expensive private healthcare options. However, it’s important for government hospitals to also maintain a well-rounded approach by providing basic healthcare services and addressing the healthcare needs of the general population. A balanced approach that encompasses both primary and specialized healthcare services is crucial to meet the diverse healthcare requirements of the community.