February 29, 2008

Budget 2008: 5-yr tax holiday for all hospitals

Budget 2008: The Finance Minister on Friday extended a five-year tax holiday, currently given only to hospitals in the rural areas, to those across the country, sending the shares of healthcare providers higher.

The Finance Minister P.Chidambaram, in his budget for 2008/09, also proposed an excise duty of 8 percent for all goods produced in the pharmaceutical sector, down from 16 percent.

He also proposed to reduce by half the customs duty on certain specified life saving drugs, and its bulk drug ingredients, to 5 percent. These drugs would also be exempted from excise or countervailing duties.

Hospital stocks such as Apollo Hospitals Fortis Healthcare and Malar Hospitals were up between 2-6 percent after the finance minister proposed the tax holiday.

The other drug stocks, which rose immediately after the excise and customs duty cuts, have since fallen or are trading flat.

Aurobindo Pharma was up 1.3 percent, Cadila rose 2.7 percent, Dishman was 3.6 percent higher while Wockhardt was up 1.1 percent.

Budget 2008: India's position on health parameters unsatisfactory: Survey

India's position on health parameters compared to even to some of its neighbouring countries, including China and Sri Lanka, continues to be unsatisfactory, the Economic Survey said on Thursday.

"While India has improved with respect to some important health indicators over the years, it compares poorly with countries like China and Sri Lanka," the survey for 2007-08, which was tabled in the Parliament said.

India's position on health parameters compared even to some of its neighbours continues to be unsatisfactory, it said adding the health sector in the country compares poorly with neighbours like China and Sri Lanka.

There have been some improvement in the quality of health over the years but wide inter-state, male-female and rural-urban disparities in outcomes and impacts continue to persist, it said.

While population stabilisation is in the concurrent list, health is a state subject. The reproductive and child health services reach community and household levels through the primary health care infrastructure.

"Inadequacies in the existing health infrastructure have led to gaps in coverage and outreach services in rural areas," the survey said.

Citing the National Rural Health Mission (NRHM) as a success story, it said the programme's aim was to provide accessible, affordable and accountable quality health care services to the poorest households in the remotest rural households.

February 28, 2008

Doctors, hospitals can no longer advertise

Doctors and hospitals in the State of Karnataka can no longer advertise their professional services, whether boasting of “world-class services” or promising “freedom” from some debilitating disease.

The Karnataka Medical Council, in an order issued on February 11, has said that “every registered medical practitioner registered with the Karnataka Medical Council or elsewhere and practising in Karnataka, shall abide by the Code of Medical Ethics vide 6.1.1. and 6.1.2. including the institutions. Any violation by an individual/institution will be treated as ‘professional misconduct’ and action will be initiated under Section 15 of the Karnataka Medical Council Act”.

The penalty could range from a warning to de-recognition for a year. Persistent violation could attract permanent de-recognition, which means the medical professional cannot practise anywhere in the world.

Speaking to The Hindu, Chikkananjappa, president of the Karnataka Medical Council, said: “Many hospitals such as Manipal, Sagar Apollo, Wockhardt, Trinity and Ramakrishna Hospital are advertising themselves on a mass scale in newspapers, billboards and road medians.” This was against Sections 6.1.1. and 6.1.2. of the Code of Medical Ethics, according to which doctors cannot publish their photographs, write articles with the intention of luring patients, advertise the hospitals they work in or claim false expertise in areas that they knew nothing about, Dr. Chikkananjappa said.

“Some advertisements even go to the extent of saying that every person above 45 should undergo an angiogram.

It is not necessary as it is merely a test and not a cure for any heart disease. Some others go to the extent of saying “buy one consultation and get another free. Medical profession cannot be marketed,” he said. Nearly 70 notices were sent to doctors, hospitals, nursing homes, clinics and diagnostic centres for advertising themselves. “Sixty-five consultants turned up and we explained to them the provisions of the law that self-aggrandisement with the ulterior motive of attracting patients was against ethics. They all agreed to not advertise themselves,” he said.

Vishal Bali, CEO of Wockhardt Hospital, told The Hindu, “Extending the order to institutions is not correct. Hospitals worldwide advertise their services, but doctors do not. Not to allow hospitals to advertise is taking it a little too far. As there is so much competition in this sector, how else can we advertise our services?"

February 27, 2008

Pak Taliban tells male doctors not to enter women's wards

Pakistan Taliban militants have asked male doctors in the Bajaur Agency not to enter female wards in hospitals.

Addressing a meeting of doctors from all hospitals, Tekrik-e-Taliban Pakistan Vice-Chief Maulana Faqir Mohammed asked doctors not to enter wards which are meant for women, the Daily Times reported on Wednesday.

He told the doctors to provide free medicines to poor patients and avoid prescribing costly drugs.

Mohammed also asked the doctors not to recommend unnecessary laboratory tests to patients and keep the charges minimal.

He told the doctors that no one will be allowed to interfere with their profession, adding that their life and property would be protected.

February 26, 2008

Websites for aspiring PG doctors

A senior surgeon working in a Kerala Government hospital has designed two websites for doctors preparing for MD and MS entrance exam and PG students writing MS, DNB and MRCS examinations in general surgery.

Www.Pgmedicalentrance.Org has been specially designed for enriching knowledge of medical graduates preparing for MD and MS entrance exam, Dr R C Thampan, Head of Department of Surgery, Government General Hospital (beach), Kozhikode said.

The online training module has updated details of relevant subjects and answers to more than 25,000 multiple-choice questions, he told PTI.

Anyone having minimum computer knowledge could access the user friendly site, which carries the entrance exam question papers along with answers of the past seven years, to update one's knowledge and gain valuable tips on preparing for the exam, the 54-year-old surgeon, hailing from Kannur, said.

The other site, Www.Msdnbsurgreview.Org, has been designed to benefit the postgraduate students preparing for MS and DNB examinations in general surgery, he said.

The site has study materials in 20 subjects needed to pass theory and clinical examinations and contains detailed and updated information on long and short cases, specimen, x-rays, barium pictures, CT scan, MRI and surgery intruments, he said.

The site that went online in 2006 had been designed after compiling valuable inputs from a panel of eminent doctors from Kerala, Doctor Thampan said.

It has registered several hits with professionals including those from Sri Lanka and the Middle East accessing the site over the last two years, he said.

"As medical students in the late '70's we did not have a clear cut idea as how to go about with the module for the post graduate degree exams.As a medical practioner I realised that many aspiring students were groping in the dark to face the all important exam and in matters of presenting their case study materials," he said.

This motivated him to develop a website for the aspiring medical professionals.

The Doctor said he found time to update latest developents in the medicial field on his sites,at least once a week.

"The two sites have been developed after painstakingly gathering and synthesising knowledge and experience acquired during my over 25-year long service as medical practitioner to provide valuble tips and guidance to aspiring doctors ahead of their examinations," he said.

February 22, 2008

Cow's urine as medicine

Recently the BJP ruled Uttarakhand Government (Feb 2008) has announced that it will procure cow’s urine, on the pattern similar to the procurement of milk by dairies, refine it and sell it to Ayurvedic pharmacies. Other BJP ruled Governments are also working on similar lines.

Cow has been having a central place in the political symbolism of RSS combine. The place of this symbolism may be only next to Lord Ram. On these premises, so far cow has been projected as mother. In its major campaign against minorities’ right since 1950s, BJP predecessor Bharatiya Jansangh, had undertaken a nationwide, Desh Dharm ka nata Hai Gau Hamari mata hai (Cow is related to us through our religion and nation as mother) and also Janm Janm Ka Nata hai Gau hamari Mata hai (Cow is our mother in our every birth). Since Muslims, one does not know why Christians were not targeted for it, are not prohibited from eating beef and since many a butcher belong to Kasai (butchers) occupation, this fact has been used to demonize the Muslim community. We worship cows, they eat, they butcher cows! This has been used to rouse the sentiments of majority community time and over again.

With Uma Bharati becoming the chief minister of Madhya Pradesh (2005) for a brief while, she introduced cow based economy, funds for Goshalas (cow sheds) were given from Government treasury, and her official residence became the first such Goshala. Cow based economy aimed at promoting cow products as the core of economy. The present effort now transcends the earlier efforts as faith is being transformed into blind faith. The Government’s move to collect urine, to procure it, refine it and sell it as a medicine defies all the logic of science and medicine. It is converting the political symbolism into health related prescription which is fraught with dangers.



As such urine is a product excreted through kidneys and contains the waste metabolites. It can also contain the bacteria, bovine tuberculosis for example, and other harmful germs and metabolic products. The biochemical studies of urine have clearly shown its composition. There are some who claim magic healing powers of drinking one’s own urine, called Shivambhu, the most famous consumer of the same was Morarji Desai. Some claim that it contains antibodies which act against the harmful diseases affecting our body, but analytically and biochemical it has not been proven so far. Physiologically kidneys do not let the antibodies pass out of the body as the molecular weight of antibodies is much more than the pore of the kidney membrane. Of course when kidney is damaged, these antibodies can pass out, not when the cow is healthy.



Murali Manohar Joshi, who as MHRD minister initiated the introduction of faith based disciplines like Astrology, Paurohuitya (Ritualism) also diverted some of the funds for doing cow research. One CSIR lab went to the extent of obtaining a patent on a pharmaceutical composition contating cow urine distillate and an antibiotic. Another CSIR lab, in collaboration with a NGO undertook a study to see the effectiveness of cow urine in cancer treatment. Our own ayurveda does not mention any medicinal use of cow urine.



Ayurveda as such has lot of valuable empirical observations which can be deepened by rooting them on firmer rational grounds but that is shrouded in mystery and faith and any questioning of it meets angry protesters, who claim their faith is under threat. Baba Ramdeo does claim that his ‘Ramdeosim’ is scientific but forgets that the basic premise of science is peer review, facing the questions and a constant transcendence of inadequacies in our knowledge system. The faith based enterprise of Ramdeo is too individualistic, too much dipped in faith and has too little to offer on rational grounds.



Same is the method of cow medicine, too much faith, and that too of blind variety, too much assertion and zero scientific research. One will like to explore the veterinary sciences to see if there is something drastically right in cow’s excreta in contrast to the excreta of bullock or buffalo or a dog for that matter. Also one does recall the claims of the section that cow dung has purifying effect. Impurity brought in by the shudras touching of water was undone by mixing cow dung with the water touched by a dalit.



The basic difference between medical sciences, empiricism, and grandma’s medicine needs to be understood before state Government investing and promoting cow excreta, urine, for human consumption and application. Mercifully one has not heard so far of such efforts to promote cow dung. The present effort by the BJP government is an extension of RSS combine’s cow politics. It is totally against the understanding of modern medicinal sciences and also has no mention in the traditional wisdom gained over a period of time.



In a way it is the translation of RSS combine’s political understanding in to the arena of application to human society. In some Islamic countries, on similar lines, state sponsored research to undertake the study on djinns to solve the energy problem. As per mythology djinns are supposed to be infinite source of energy so why bother about oil and electricity when these blessed beings can solve our problems for good. Surely these will also prevent the wars which are taking place in the globe for controlling the energy reserves. And not on a very different track, Christian right is asserting creation science to oppose the theory of evolution.



These efforts have no rational and scientific basis, something which our constitution ordains us to follow in the public domain. Social auditing of efforts, which affect human health are mandatory, control by bodies sanctioning the drugs and other medicinal means are an absolute must for public safety, all the claims of politics notwithstanding.



As such enough of politics has been woven around cow. Just a few years ago, one of the eminent historians of Ancient India, Prof. D.N. Jha, came out with a book on the dietary habits in ancient India, which showed that beef was one of the major items consumed in Ancient India. The move to project Cow as holy animal, mother, was a response to the non violence propounded by Lord Gautam Buddha. With the rise of agricultural society the cattle wealth was to be preserved. As people started embracing Buddhism, the aggressive reaction of Brahmanism came up at theological, social and political level. Cow was projected as the symbol of rising Brahmanism, as a counter to the non-violence of Buddha, and has remained so through centuries. Many a Mughal kings in deference to these sentiments, to respect the feeling of the section of society, advised against cow slaughter. Babar in his will writes to his son Humayun to avoid the slaughter of cows.



In Hindutva politics also there are many streams. While Savarkar called cow as a useful animal, the other sections ignited the emotions against Muslims around cow. Irrespective of that many a poor Hindus and Adivasi did consume beef. Incidentally it is amongst the cheapest source of protein for the poor. Many a surveys showed that a vast number of Indian communities consume beef. RSS combine’s propaganda went on to assert that Muslims are violent and one of the reasons is that they consume beef. This is so much against the pyschosoiological understanding of the human mind and the violence. While one knows that beef is a staple diet in major parts of the World, one also knows and modern psychological theories demonstrate that violence does not emerge from diet but from social and political situations. Beef can surely build muscle power in conjunction with proper exercises, but violence is in the mind.

Undoubtedly one should respect those regarding cow as their mother. RSS combines’ many followers devote their lives organizing fodder and other supports for Guashalas. Some of them, the upholders of Cow as mother, non violence, go to the extent of justifying violence against dalits on the ground that they were skinning a dead cow as happened in the killings of dalits in Gohana. This cow urine in the pharmacy shops defies all the logic and faith and is directly a threat to health of people of the society. Faith can take such dangerous turns is to be seen to be believed.

February 11, 2008

Satyam makes tele-medicine available in remote villages

Satyam Computer Services has launched a project that provides tele-electrocardiogram (ECG) services to patients in remote areas across the country.

The city-based IT major's global health care practice unit has implemented the programme in association with non-profit organisation Byrraju Foundation.

It was launched on a pilot basis last year and it covers 3.5 million people in villages across India. The services are provided through Foundation's Ashwini clinics located in several parts of the country.

In the past patients would have had to travel to a city at great cost to receive an ECG or imperil their health by not having one at all. With this capability, we're able to treat many more patients from a central location, said Arun Kumar, a doctor associated with the health care plan, here today.

As a provider of integrated, end-to-end healthcare solutions, Satyam was able to deliver a system that is effective, affordable and operates in areas with minimal communications and computing infrastructure, providing complete clinical functionality, Kumar said.

"As a non-profit organisation, we are always conscious of creating self sustainable, cost-effective models," said Byrraju Foundation Lead Partner V S N Raju.

The programme enables patients in villages to get an ECG done at a local Aswini clinic while doctors at hospitals such as Narayana Hrudayalaya in Bangalore offer immediate interpretation as well as teleconference consultations.

Electronic journal for medical colleges

The National Medical Library has started an electronic journal consortium, “Electronic Resources in Medicine” (ERMED), for providing full-text electronic journal service to 39 medical colleges and institutions across the country. These include ten Directorate-General of Health Services libraries and 28 Indian Council of Medical Research libraries and the All-India Institute of Medical Sciences library.

Union Health Secretary Naresh Dayal launched the ERMED portal www.nmlermed.in at Nirman Bhavan here earlier this week. According to a release issued by the National Medical Library, the facility offers over a million articles in the open-access mode from over 1,515 medical journals. Articles can be searched by using the choice of journals, publishers, subjects and keywords of database.

“The library has adopted the most cost-effective strategy to put together the project that is aimed at building up a sustainable health information base and is committed to dissemination of a free flow of information,” said an official release.

The Director-General of Health Services is financing the entire project for 39 libraries. “The National Medical Library is the one-stop resource-sharing centre for medical literature across the country,” said National Medical Library director Anjana Chattopadhyay.

February 04, 2008

3,000 Indian doctors left jobless in EU-friendly UK

Indian doctors, who come to Britain in search of cushy jobs and a better life have lately found that life is not that rosy after all. Out of nearly 4,000 Asian doctors who came here recently, 3,000 from India and 800 from Pakistan, a majority is said to be struggling.

Quite a few have run out of money and with no employment prospects in sight, they are considering going back home.

A newspaper had published a photograph of unemployed overseas doctors queuing up outside the Sri Mahalakshmi temple in East London for free meals. Many are working, anonymously, in restaurants while the lucky few are working as assistants in pathology laboratories.

Dr Shiv Pandey, a senior doctor from Liverpool and an executive member of the British Medical Council, had campaigned for these unemployed doctors and even went to India to acquaint New Delhi of their plight. He said there was no hope for the new doctors to get jobs despite the fact that Britain has a shortage of medical practitioners. A few seniors also complain of racism.

At the last count, there were over 6,000 overseas doctors who had come to Britain in the past five years in response to calls by the National Health Service (NHS) for foreign medical staff. They hoped to find jobs after passing the Professional and Linguistic Assessment Board Test (PLAB) - a mandatory requirement for all immigrant doctors. But most of them are still unemployed.

The government earns a lot of money from the PLAB test, also held in India, and so holds them regularly. Most doctors come to Britain hoping for the kind of success their predecessors achieved in the 60s and 70s. Until recently, around 30 per cent of GPs in the NHS were Asian, most of them from India.

But as Dr Sisir Ray, who came here in 1966 and is a consultant at a Harley Street clinic, put it, the situation has changed. Preference is now given to doctors from the European Union and since its enlargement, a large number of them continue to come here. They do not have to appear for PLAB either.

Most senior consultants agreed with Dr Ray that young Indian doctors must be made aware of reality. Not long ago, the Health Secretary had said that those who pass the PLAB were free to come to Britain but there were no job guarantees.

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