Beginning September 1, 2014 the doors of 20 Central Government Health Scheme (CGHS) wellness centres in Delhi will be thrown open to senior citizens from among the public for free consultation. Dr Harsh Vardhan, Union Health Minister, unveiled today a pilot project with wide ramifications for the future of public health care. There was wide criticism of the CGHS’ closed door policy towards people in need of medical help who were not family members of central government employees. “This is a pilot project for now. We will see how much demand accrues for the CGHS clinics and the ability of the clinics to handle demand from the general public before extending the service to more people in more cities,” Dr Harsh Vardhan said. The service for senior citizens will be available on all working days between 1.30 pm and 3 pm. They will however not be given free medicines which is only for central employees. On his first day in office, Dr Harsh Vardhan had announced that governance in all the outreach departments of the Ministry of Health would be made transparent. Within the first three months, the CGHS has completed a thorough review of its operations with the intention of identifying vulnerable spots which often offer scope for corruption. The Minister has ordered that all information regarding medical claims that are pending for more than 30 days be put on the website, http://msotransparent.nic.in/cghsnew/index.asp. Over the years complaints had been piling up over the opaqueness of the process of reimbursing claims. There were also complaints of CGHS doctors prescribing branded drugs beyond the approved list. Taking all factors into consideration, it has been decided that all beneficiaries and the public at large ought to know which the drugs are on the list and so they will be on view on the above-mentioned website, the Health Minister stated. Dr Harsh Vardhan reiterated that henceforth only 1,447 generic and 622 branded medicines will be prescribed. Exceptions will be made only for patients suffering from cancer and similar diseases. Additionally, it has been decided that CGHS beneficiaries will be provided with medicines for a maximum of one month. In case they are going abroad for extended periods, the medicines will be given for three months, he informed. The CGHS doctors will be forbidden to prescribe investigations or implants that are not listed. A technical committee has been constituted to update the list of medicines, investigations, procedures, implants and other procedures of treatment. Dr Harsh Vardhan said he is considering broad reforms in all wings of the ministry. “I encourage people, especially the media, to probe our affairs so that over time the employees realize the futility of trying to be corrupt. In addition, I will use information technology to prevent corruption at source.”
“Trauma is the most common cause of death for those under 45 years, with traumatic brain injury accounting for about half the mortalities. It is time we developed an integrated trauma support system in our pubic health care architecture”, Union Health Minister, Dr Harsh Vardhan, said at a function at Mussourie today.
Addressing the 23rd annual conference of the Neuro Trauma Society of India (NTSI), the Minister noted that World Health Organisation (WHO) has predicted that road traffic accidents would become the fifth most common cause of death and disability by 2030.
Dr Harsh Vardhan said, “Over the years I have observed that our hospitals lack spontaneity and specialised staff to deal with trauma cases. We need an inter-disciplinary and horizontally integrated approach. I will ensure that the new National Health Policy focuses on this need.”
At the same time, it is important to have a culture of observing road safety discipline, he stated. The vast majority of Indians are unaware of the need to wear seat belts in cars. And even here, most think that wearing back-seat seat belts is unnecessary. As for helmets on two-wheelers, most women who ride pillion disregard the most basic precaution of strapping on a helmet, he said.
In this connection Dr Harsh Vardhan mentioned that he had written to Mr Nitin Gadkari, Minister for Road Transport and Highways, with the suggestion to make the wearing of back-seat seat belts mandatory by amending the Motor Vehicles Rules.
The Health Ministry is also drawing up an extensive list of suggestions for the Roads Ministry on safety. These include punitive rules for talking on mobile phones or texting while driving and removing unnecessary speed breakers because these cause spinal injuries. The Health Ministry is also receiving suggestions from public-spirited individuals and organisations which it is forwarding to the Ministry of Roads. One of them says that two-wheeler riders who don’t wear helmets should be denied petrol sales.
“India has 1 per cent of the total vehicles in the world, yet accounts for 6 percent of total road accidents globally. About 4 lakh road accidents are reported each year of which 1lakh result in deaths. With the vehicle population growing on our roads and highways, I realize the need to roll out a comprehensive and all-inclusive trauma support service,” Dr Harsh Vardhan said.
WHO’s Essential Trauma Care (EsTC) project advocates a wide range of activities to decrease trauma morbidity. This comprises surveillance and basic research to preventive programmes and effective trauma management strategies.
The Minister said he was concerned over the state of trauma reception in even the best hospitals of the country. “The victims are rushed to the nearest hospital by friends and relations with great hopes, but find to their dismay that the personnel and facilities are quite ill-suited for the task. About 55-91 percent of the reported errors that contribute to preventable death occur during trauma reception and resuscitation.”
The conference was hosted by the Doon Neuro Club and was attended by some of the leading professionals of the country drawn from Neurosurgery, Neuro-Critical Care, Neurology, Neuro-Anesthesia and Neuro-Radiology. There were also Neuro-Rehab experts and Neuro-Nurses.
The organising chairperson, Dr A.K. Singh, former Head of Neurosurgery of G.B. Pant Hospital, Delhi, Dr B.S. Sharma, Head of Neurosurgery, All India Institute of Medical Sciences, New Delhi, the president of NTSI, Dr (Brig) P.K. Sahoo, Head of Neurosurgery, Apollo Hospital, Bhubaneswar, Prof. V.D. Sinha, Professor of Neurosurgery of SMS Medical College, Jaipur, Dr Sanjay Kumar of Apollo Hospital, Ranchi and Dr U. Dewan of Max Hospital, Dehradun, were present.
Dr Harsh Vardhan said that since most of the victims of neuro trauma are young, the country loses much promising human talent because of the lacuna in spontaneous reception. “Through a mix of awareness building and protocol building in the supply side we could end up saving valuable human resources. That is why I am so committed to this cause,” he added.
