Thane Matdata Jagran Abhiyan (TMJA), a body of concerned citizens of Thane, Maharashtra organized a virtual Rugn Hakk Parishad on 31st October. Members of Lok Raj Sangathan (LRS) participated actively in organizing and conducting the meeting. The objective of the Parishad was to learn about the difficulties faced by Covid infected patients and discuss the rights of patients, the present status of public health facilities in Thane and what needs to be done to improve them.
Many relatives of corona patients, doctors, health activists, TMJA and LRS members and other concerned citizens participated in the web meeting. Unmesh Bagwe, the President of TMJA conducted the meeting.
Prathmesh, an executive committee member of the of TMJA and a member of the Thane Committee of LRS, pointed out that Covid has completely exposed the pathetic condition of the public health system in Maharashtra and Thane, in particular.
The per capita expenditure on health by the state government is as low as Rs.776/- per year which is much lower than that of many other states and is less than the national average. The national average itself is extremely low compared to the average of the rest of the world. It is thus clear that the state government over the years, irrespective of the party in power, has continuously ignored public health. It is not surprising that no new hospital has been constructed in Thane over the last many decades while the population has grown manifold. There are hardly any Primary Health Centres (PHCs) in Thane; the shortfall in the number of PHCs is 94%! As a result, people rush to whatever hospitals are available and obviously most are forced to go to private hospitals spending huge amounts of money. Corona affected patients had to bear with a lot of agony since the required beds were not available for weeks! But even for normal patients Thane district government hospitals have only 1343 beds, which amounts to 11 beds per 1 lakh population! The doctors, nurses, ward boys, helpers and other personnel in public hospitals are overworked as there are more than 50% vacancies in most categories.
For weeks together the Corona patients admitted to government health facilities were not getting the required medicines including even something as basic as vitamins and protein supplements. The reason is the very low budget for supply of medicines per patient which has not been revised since 2007! The provision for medicines works out to only Rs.6/- per patient per day for 33 PHCs of Thane district! No wonder that patients have to buy even Crocin themselves.
He emphasized the need to work unitedly and persistently with doctors, nurses, ward boys, safai karmacharis and other health workers and make public health a central issue for the state government, corporations and other local bodies to improve the current pathetic state of affairs.
Dr. Bedekar, a renowned private practitioner of Thane, admitted very frankly that a weak public health system is actually a boon for private medical practitioners since helpless and desperate patients are forced to pay whatever charge is levied by them. He also explained that it is practically impossible for private practitioners to treat patients at cheap rates and that cheap treatment can be provided only by a properly organized public health system.
Many aggrieved relatives of corona patients emotionally shared their bad experience of public and private health providers. They pointed out the following major issues:
- Once corona patients are quarantined or hospitalized for treatment their relatives do not get correct and regular feedback of status of their health. Many times even wrong feedback is given. Most of the times, after admitting, relatives are contacted only for informing that the patient is no more or that the patient is being discharged.
- Though relatives of corona positive patients are supposed to be under self-quarantine they themselves have to organize the supply of medicines; the hospitals don’t.
- Treatment packages as high as Rs.7 lakhs per week per patient were told to many relatives when they were running from pillar to post for getting their patients admitted.
- For the initial 5 to 6 months, there was a huge scarcity of hospital beds with the required facilities.
- Quarantine facilities were very poorly maintained and were without simple oximeters for checking levels of oxygen. This is why many patients who needed oxygen were not treated in time until they started showing serious symptoms.
- A 400 bed Covid facility, put up by the Maharashtra government in Mumbra is being managed by totally incompetent and unqualified persons.
Dr. Abhay Shukla, a doctor trained in AIIMS, and a health activist of the Jan Swasthya Abhiyan as well as a member of the National Human Rights Commission gave very important suggestions to carry forward the work more vigorously. He clarified that an extremely weak public health system and an unregulated private health sector are the root cause of the pathetic condition of public health in our country. He emphasized that the fight for a good public health system is not a fight between doctors and patients, but public health workers and citizens need to unite to get success. He suggested that as many experiences of patients should be documented so that the matter could be raised with authorities. He suggested that actions should be taken up to ensure that (i) each hospital prominently displays the Patient’s Rights Charter (ii) all activists should study the 60 advisories released by the NHRC regarding Covid and (iii) controlled rates for private hospitals published by the Maharashtra government are implemented.
At the end of the meeting, the following resolutions were passed:
(1) The Corona pandemic has created unprecedented problems everywhere. During the pandemic common people are struggling to get beds and injections in hospitals. Similar diseases may also spread in the future. Keeping this in mind the public health system needs to be reorganized. Improving the public health system must be a priority for governments at every level from the Central government to the Panchayat. They must increase their budget for public health so that the government expenditure is at least 6% of the GDP.
(2) Approximately 24 lakh people reside within the boundaries of the Thane Municipal Corporation (TMC). Today people of the district are dependent on the Civil Hospital and the Shivaji Hospital which are extremely inadequate. During Covid time an attempt was made to set up 3 hospitals with 1000 beds. Instead of wasting money on such giant central hospitals, 9 permanent hospitals of 200 beds each in each of the 9 electoral wards of the TMC must be urgently set up.
(3) There is an urgent need to ensure the required number of ambulances, blood banks and a well-equipped Primary Health Centre in each ward of the municipality. An agitation along with other interested people’s organizations must be started to ensure all these actions by the government.
(4) During the Covid times many private hospitals literally looted patients by heavily over-charging. The state government has declared fixed rates and that it will conduct an audit of bills. The government must urgently conduct such an audit and ensure that the extra amount charged is refunded by hospitals. The government should also ensure that all poor patients are refunded complete expenditure under the Mahatma Phule Jan Aarogya Yojana.
(5) All the vacant positions of doctors, nurses, ward boys and helpers in all the Thane public hospitals and safai karmcharis must be filled up by recruiting permanent employees within 6 months.
(6) All patients must be given medicines and the current practice of writing prescriptions and asking patients themselves to buy medicines must be immediately stopped.
(7) The Thane Municipal Corporation must ensure that all the routine tests like urine test, blood test, X-ray, MRI etc. are made available to patients at very reasonable and affordable rates.
In his concluding remarks Unmesh Bagwe pointed out as to how past attempts to convince district and municipal officials to involve volunteers from amongst people have fallen on deaf ears. He thanked all those who participated and also declared the resolve of TMJA to continue to work on the issue of public health with all other interested organizations, including Lok Raj Sangathan and Jan Swasthya Abhiyan.