Gearing up for ‘Healthy & Clean’ Gujarat

Since the hullabaloo of general election began, ‘Gujarat model’ has been getting ample space in the media and general discussions. But… far beyond the discussions, much before the other States could plan, the Government of Gujarat declared – ‘Clean Gujarat/Nirmal Gujarat’ as the theme year of the state. Quoting Padma Bhushan, Dr BM Hegde, “Healthcare is totally different and divorced from Medical care. Healthcare deals with five things: clean environment, clean air, clean water, clean food, sunlight and earth. These five things come under the job of PWD, civil engineers and sanitation people and no one else.” Gujarat government took this statement literally, adopting separate policies for healthcare and medicare and remarkably succeeded in improving the health index of the state. Cleanliness remains more important in hospitals than other facilities. With adequate awareness and policies, Gujarat is ready to adopt the latest of hygiene-care and facility services.

With ‘Healthy Gujarat, Clean Gujarat’ and Mahatma Gandhi Swachhta Mission’ as the objectives of the State, Gujarat has made its vision 2022 very clear: Accessibility, affordability and availability of Public Healthcare Centres for all; sanitation facilities in line with global standards and awareness about health issues to prevent diseases.

The State has improved the healthcare landscape in record short time. Fast transformed into a healthcare hub with the focused Government-led healthcare initiatives with leading corporate healthcare groups entering this market, it has currently 13 medical colleges, 1,072 PHCs, 7,274 sub centres, 273 Community Health Centres (CHC) and 85 mobile healthcare units. Under the budget 2014-15, the state government has made a provision of र7230 crore for healthcare and medical services, a welcome news for cleaning and facility services industry. Clean India Show to be held in Gujarat this year will be showcasing sophisticated and latest cleaning products many of which are applicable in healthcare facilities.

ID Gujarat

For the past 15 years, the state has become a major Investment-Destination (ID) for all the corporate hospital groups. Sterling, Apollo, Wockhardt, Shalby Hospitals, SAL Hospital, Medisurge hospital and Krishna have made significant investments in the State. While Artemis Health Science is planning to set up a र500 crore medical education hub on the Baroda-Ahmedabad highway, Sterling Hospitals Group, that owns the largest hospital chain in Gujarat is to invest about र200 crore in the state. It, so far has a capacity close to 1000 beds in Rajkot, Baroda, Ahmedabad and Mundra SEZ. Shalby hospitals is also coming up with three multi-speciality hospitals – two in and around Ahmedabad and one in Surat, adding 600-700 beds to its present 240 operational beds in Ahmedabad. Bombay Hospitals under an MoU with MS Hospital would establish an Under Graduate and Post Graduate Medical institute.

Government Initiatives

Based on the success of the Chiranjeevi Scheme, which has significantly reduced the rate of maternal and infant mortality, Gujarat government too has backed the PPP projects under Pradhanmantri Swasthya Sudhar Yojana’. The state government has received a र20 crore aid from the central government to set up a new AIIMS like institution. Under the theme ‘Nirmal Gujarat’, strategic planning, defining the roles of 25 different departments including healthcare, setting a three year normative goals, implementing, systematizing, monitoring, and reporting to the highest levels, tremendous details on every aspect of the execution have been put into place.

A unique and holistic, approach has been designed converging inter-sector activities of cleanliness, environmental and public health issues and covering its activities in the urban, rural, and tribal areas under one umbrella. It envisages capacity building in the management of waste generated in airports and railway stations, hospitals, fairs and temples, office building, roadside eateries, public toilets, streets, community halls, schools, land fill sites, vegetable markets and parking spaces. A whopping र7230 crore (2014-15) has been allocated for healthcare and medical services, part of which is to be invested in the following:

Mukhya Mantri Amrutam (MA) Yojana

Under Mukhya Mantri Amrutam (MA) Yojana, which has proved very useful for the healthcare of the BPL families, treatment is provided for very serious and fatal ailments like cancer, heart diseases, brain diseases, renal diseases, burns etc. absolutely free of cost within the limit of र2 lakh per family. In view of the huge success the scheme has received, it has been decided to extend the scheme to the middle class family of the State.

Public Health

• A provision of र17 crore to start 70 new Primary Health Centres and 16 new Community Health Centres.

• र4.79 crore to start 377 sub centres in tribal area and 70 sub centres in salt-pan area.

• र15.00 crore to provide 100 new ambulances for very popular 108 emergency ambulance service.

• Total provision of र13 crore for increasing the reach of haemodialysis facility presently available in 13 district hospitals, to cover all district hospitals and sub-district hospitals.

• र1022 crore to help medical colleges at Sola, Gotri, Patan, Valsad and Gandhinagar as well as medical colleges under construction at Himatnagar, Vadnagar and Junagadh under Gujarat Medical Education Research Society.

• र20 crore to provide advance facilities to increase the seats from 150 to 250 and provide necessary infrastructure in Government College, Surat.

• Planning to increase present capacity of 450 beds to 650 beds in U.N. Mehta Institute of Cardiology, Ahmedabad.

• र21 crore to upgrade Gujarat Cancer Research Institute and start turshery Cancer Car
e Centre, Rajkot.

• It is proposed to open a new dispensary under the Employee State Insurance Scheme at Ranoli, (District Vadodara) and Alang, (District Bhavnagar) to cover about the 30 thousand worke`

• An amount of र30 crore for starting new hospital attached to Government Ayurved/ Homeopathy colleges at Dahod, Vansda and Rajpipla.

• A provision of र419 crore for renovation and construction of existing PHCs CHCs and SCs. Which includes Hospital Construction, Increase in bed capacity and for necessary staff in Community Health Centres at Dwarka, Botad and Lunawada.

• Extension to Hospital Building for CHC at Dediapada

• Upgradation of CHC at Chhotaudaipur, Bhiloda, Dediapada and Ambaji Hospital.

• To commence nursing school at Darampur, Mandvi(Surat) and Santrampur.

• Staff Quarters at Jamkhambhalia Hospital

• Construction of new building for General Hospital at Dahod and Vansda

• Construction of new OPD Building at Visnagar and Extension of Unjha Hospital Building

• Burns Ward in Cottage Hospital at Upleta

• Construction of Operation Theatre for Eyes and new ward at Surat

• Construction of Eye Hospital Building at Morbi and increase bed capacity with 25 beds

• Strengthening the services for Centre for Excellence for Mental Health at Ahmedabad

• Construction of separate ward for male patients in Mental Health Hospital at Bhuj

“Nirmal Gujarat is also about implementing strategies, innovations, recycling and cleaner-greener technologies, rules and regulations, incentives, administrative charges, and special campaigns. It is an eco-friendly way of living and a completed behavioural change to a green way.”

– Dayanand Nene

Challenges

While the healthcare sector is slowly progressing with the support of above initiatives, there are a number of challenges faced by the sector in the state:

• Improper hygiene standard and uncleansed high traffic areas at civic and many private hospitals

• Burden of infectious and chronic diseases

• Reproductive and child health and nutrition: Life expectancy in India at birth is 66 against the world average of 72. Mortality rate stands at under five per 1000 children, 56 against world average of 48.

• Lack of equal access to healthcare facilities: Due to lack of quality infrastructure and specialized doctors, rural population depends on urban hospitals and spends most of their income. Though healthcare facilities in urban India have developed in the past few years, the supply and demand gap has widened, despite increase in the spending capacity.

• High healthcare costs: Healthcare expenditures exacerbate poverty, with about 39 million people falling into poverty every year as a result of such expenditures.

• Insufficient healthcare workforce and infrastructure

First time being held in Gujarat, Clean India Show will address the above issues and will help meet the solutions under one roof.

Outsourcing FM

There is always a disagreement between cost and quality standards. While in other sectors, it is a bit easy to manage by outsourcing FS at large, in case of hospitals, it is not as simple as that as at the end of day, it is hospital which would be held accountable first for any mishaps. Better late than never, under the improvised SLA where providers too will have to take the responsibility from their side, many of the hospitals groups have started outsourcing their facility services. To keep up to the expectations and get the expertise, some service providers have collaborated with the leading research institutes to keep themselves ready in the field.

While Wockhardt, Mumbai recently decided to outsource its payroll activity to Mafoi Care Hospital, Hyderabad has also outsourced its payroll activity as a pilot initiative to examine its permanent viability. Hiranandani Hospital, Mumbai has made a tie up with the University of Sydney in Australia to train its nursing staff. Among the other areas being considered are billing, revenue cycle management (RCM) for credit billing, back-office work, medical records storage (electronic and hard copy), patient records transcription or medical transcription and diagnostic facilities.

There is a great potential for service providers in healthcare sector in Gujarat. The state has got good infrastructure, single window clearance policy and easy manpower availability in place, which one needs to harness and rise up to the healthcare expectations.

Pilot projects are being run to check the permanent visibility.

Apollo Hospitals, Ahmedabad adopted the Bhat Village with a population of approximately 10,000, in Gujarat, and organized Cleanliness Programs and Health Awareness drive, all of which were extremely well received.

Compiled by Suprita Anupam

With inputs from Express Healthcare