The Health Minister’s announcement that 24×7 specialty care services will be introduced in General and district hospitals is all set to stir up a hornets’ nest as the decision has come as a surprise for the stakeholders.

They say they were never consulted at any point and that there are innumerable concerns about inadequate human resources at various levels in Health Services

“We are not questioning the government’s intent behind this decision but are perturbed that this decision has not been thought through. Most hospitals under Health Services do not have more than one or two specialists per specialty per hospital. Redeploying doctors in a district to provide 24-hour service at one hospital is going to play havoc with the existing clinics/surgeries in all hospitals,” a doctor said.

“This is a major policy decision as far as Health Services is concerned. But announcing this with no prior assessment of the human resources situation in the Health Service, gaps in service, patient load in hospitals or district-wise feasibility studies is unheard of,” he added.

The statement issued by the Minister said that in the first phase, specialty services — General Medicine, General Surgery, Orthopaedics, Paediatrics, and Gynaecology — will be assured at one hospital in every district, to be scaled up in phases.

The government has now chosen Punalur Taluk Hospital where this will be implemented first. Accordingly, the District Medical Officer, Kollam, has issued orders reshuffling specialists — Assistant Surgeons who have PG qualifications — from various PHCs/FHCs/CHCs and other taluk hospitals to Punalur Taluk Hospital.

Doctors are being pulled from hospitals in Yeroor, Neendakara, Thevalakkara, Mayyanad, Kundara, Pathanapuram, Nedungolam to be posted at Punalur. These doctors are being replaced by pulling doctors from Chadayamangalam, Mayyanad, Anchal, Sooranad, Oachira and Thrikkadavoor.

The Kerala Government Medical Officers’ Association (KGMOA) has pointed out to the Health Minister that this mindless reshuffle, with no consideration for the patient load or human resources shortage in individual institutions, cannot be sustained.

The KGMOA said 24-hour service cannot be provided on the basis of an on-call system or as work arrangement, without creating more posts of specialists. It pointed out that the way the government had envisaged it now, the very specialist doctors who would be attending emergency calls at night would also be required to handle outpatient/ inpatient care and theatre duties during the day. This would overload doctors, compromising patient safety.

“What is needed is the immediate creation and filling of additional posts of specialist doctors so that proper shift-based duty arrangements can be put in place. Redeploying or moving doctors from peripheral institutions could seriously weaken basic health-care services there,” it said.

“At Kollam Government Medical College, even with 100 house surgeons and over 50 postgraduate medicos, they are unable to run 24-hour service for patients and almost all major cases get shunted to the MCH in Thiruvananthapuram. The Health Service just does not have enough specialist doctors to provide the round-the-clock care that the government is promising. This temporary work arrangement, without new posts is going to be an HR nightmare that will have the entire health system doing a tightrope walk, with disastrous consequences,” a senior doctor said.

He pointed out that the government should be focussing on strengthening Kollam Medical College so that the people in the district can get assured patient care services, instead of travelling to the Thiruvananthapuram MCH.

The KGMOA has written to the Health Minister, urging him to take the organisation into confidence and properly assess the situation and hold discussions before taking a final decision on the provision of round-the-clock care.