NEW DELHI: 35-year-old Savita wanted to see a gynaecologist for a month. But it was proving to be difficult. She could neither afford a private doctor nor skip a day at work to queue up at the government hospital. Then she learnt of the Kalyanvas polyclinic, which was opened by the Delhi Government a few months ago.
“A neighbour told me about it. She said it is open in the afternoon, which is very convenient for us,” she said.
The polyclinic has a gynaecologist and ENT, orthopedic, pediatric and medicine specialists posted on rotation from the nearby Lal Bahadur Shastri Hospital. While the polyclinics are open till 4 pm, registration at the hospital is over by noon.
However, the crowd at the polyclinic is sparse. Its location, in a gated government colony, is an inhibiting factor.
The Kanti Nagar polyclinic in East Delhi, the first to open in Delhi, caters to nearly 1200 patients a day and has doctors posted from the Dr Hedgewar Arogya Sansthan Hospital. It was started in November last year in what used to be an unsuccessful maternity hospital.
Anil Kumar Bajpai, MLA, Aam Aadmi Party and Parliamentary Secretary, Health, reels off a list of facilities available there, “22 types of blood tests can be done in the laboratory here. Soon ultrasound and X ray machines will be installed here. Maulana Azad Medical College will be starting a dental unit here. An eye centre, a physiotherapy centre, and an ayurveda centre will be started here.”
“Private doctors tell us they are losing customers because of this polyclinic. A patient would have spent nearly Rs 500 for his consultation. Here it is all free,” claimed Mr Bajpai.
Polyclinics are a key element of the healthcare plan drawn up by the Delhi government to decongest government hospitals and make healthcare accessible to all. 22 of the 150 planned polyclinics are now operational and there is patient satisfaction. Says Preeti,” We come and get everything done so quickly. It’s very comfortable for us.”
The Delhi government is also planning to set up 1,000 mohalla clinics by year end. The mohalla clinics, which will be the people’s first contact point with the healthcare system, will refer patients needing a specialist to the next level: The polyclinic. The polyclinics will refer only patients who require surgery or hospitalisation to a multi-speciality hospital. A referral will be essential for a patient to go to a hospital.
The Delhi government is also improving the efficiency of the third and fourth level of the healthcare system, the multi-speciality and super-speciality hospitals. The number of beds will be increased and reforms introduced in hospitals. There are plans to remodel hospitals. The idea is to have optimum deployment of resources.
Experts say kickbacks and bribes have become a part of the healthcare delivery system. There is corruption involved in the construction of hospitals, purchase of equipment and medicines. To address this, the government is looking for ways to increase transparency and rationalise delivery of services.
Satyendar Jain, Minister of Health and Family Welfare in the Delhi Government, said, “We want to computerize the entire healthcare system in Delhi. Paperwork consumes a lot of time. We have nurses who are highly qualified and highly paid, but we use them only to make entries in registers. Patients will no longer have to carry their medical records. We will make a health card for each person and the data will be saved virtually. You can even show this to a private doctor. And in case you are not carrying your card, you can use your thumbprint to access the data.”
The new processes will reduce the burden on the system, the government hopes. “Sometimes the same tests are repeated, the papers are lost or they just do not know where they have gone, there’s no record,” he said. Several studies indicate that nearly 30 per cent of the doctors’ time is spent on administrative work .
“Our doctors are taking care of the management work in a hospital. For instance, what would be the security arrangement? What vegetables should be cooked by the kitchen? They even supervise the cleaning of toilets. This is not doctors’ work. We want to separate doctors, nurses, paramedics from non-clinical work. We will hire expert managers who are both qualified and interested in the work. Today we tell a doctor to supervise a PWD building, he won’t be interested. He is interested in his patients, in performing surgeries. Only people with the right expertise will be given the work,” Mr Jain added.
To make the community comfortable with the health system, the government is setting up soft skills training protocols for doctors. The health minister said the biggest challenge is the attitude of those working in the healthcare system. There is a feeling that they are givers and patients are the takers of a free service. Compare that to private hospitals where the patient is the king, the purchaser of services.
The government has also made available medicines, diagnostics and small procedures free of cost. It claims a zero tolerance policy towards stock outs. The crowds at pharmacy counters have in fact become longer as people realise that medicines are not just free, they are available. The government has instructed that doctors prescribe only drugs that are available.
Dr Amita Saxena, Medical Superintendent at Lal Bahadur Shastri Hospital, said, “The instructions are strict to all the stakeholders, right from the time the doctors are writing their prescriptions: Stick to generic drugs, put your stamp on the prescription and write the essential drugs, which are always available in our pharmacy. The pharmacists also ensure that before dispensing (medicines), the stamp is there. In case you have deviant people writing prescriptions without following the instructions, then we can trace them and take necessary action.”