September 27, 2010

Raise retirement age of government doctors

To overcome the shortage of medical practitioners, the Medical Council of India (MCI) has recommended enhancing the retirement age of government medical professionals to 70 years from the existing 65 years. It has also suggested relaxations in the land requirement for setting up new medical colleges.

Announcing this at a press conference here on Saturday, S.K. Sarin, Chairman of the Board of Governors of the MCI, said enhancing the retirement age of government medical professionals would help in producing more MBBS doctors and prevent private medical colleges from poaching on experienced and talented teachers.

In another important recommendation made to the Union Health and Family Ministry, the MCI has said that the land requirement for setting up a new medical college should be reduced to 10 acres instead of the present 20 acres in urban areas, but within a 5-km radius. In difficult areas like hilly areas, tribal areas and the North East region, the land can be taken up at two places within a 10-km radius for setting up a hospital and medical colleges so that students are able to visit the patients in the hospital.

The government had earlier relaxed the land norms from 25 acres to 20 acres with permission to take land in two pieces in difficult areas and densely populated cities about a year ago due to non-availability of large chunks of land. Similarly, the retirement age of Central government doctors was also increased to 65 years from 60 years. The Government medical colleges had also been allowed to increase the number of under-graduate seats but without compromising on the quality of education.

The MCI too, has recommended reducing the student bed ratio from 1:8 to 1:5, meaning that a 1,500-bedded hospital could have 250 undergraduate students.

Link: Original Article

September 26, 2010

Notification on CET for PG medical courses soon

The Centre on Friday informed the Supreme Court that it supported the Medical Council of India's proposal to have a common entrance test (CET) for admission to post graduate medical courses and that it wanted to notify it within a week.

Solicitor-General (SG) Gopal Subramaniam, appearing for the Centre, also told a Bench of Justice R.V. Raveendran and Justice H.L. Gokhale that for the proposed MBBS CET the draft rules and regulations would be submitted to the court and the response of all States would be sought.

When Mr. Subramaniam sought the court's nod for issuing the notification, Justice Raveendran said: “We do not want to be party to the policy decision. How can we approve a proposal which is not before us. We must know what the proposal is. You first place the proposal before us, then we shall see.”

Justice Gokhale cautioned the Centre: “Now Tamil Nadu is opposing the CET for MBBS. A number of other States will also oppose. Students are now volatile, you have to understand this. Go step by step. Do it for PG first. Otherwise there are chances that you [Centre] may land in some other problem.” Referring to the Centre's plea for allowing notification of the PG CET, Justice Gokhale, in a lighter vein, said: “The court has contributed to many problems. We don't want to add one more problem.”

Justice Raveendran told Mr. Subramaniam: “If you notify the CET for MBBS without hearing the States, they will challenge it. We will be glad if some consensus is developed after the State governments respond to the notices. We cannot put a seal of approval without hearing the States, as one State government [Tamil Nadu] ad already opposed the system. Let us not rush it through. The proper way is to seek the response of the States and then notify it.”

To which, the SG said: “We will notify the CET for PG within a week and place on record the draft rules for MBBS CET.”

Counsel Harish Kumar, appearing for Tamil Nadu strongly opposed the CET both for MBBS and PG courses and said the State had enacted law abolishing CET for professional courses. Earlier, Mr. Subramaniam explained the steps being taken for arriving at a consensus and said it had received support from doctors, private and government medical colleges. Justice Raveendran was quick to point out “unfortunately, doctors don't make laws.”

Mr. Subramaniam said the CET was intended to improve the quality of medical education and medical services in the country.

Senior counsel Amrender Saran, appearing for the MCI, said new rules and regulations for the CET had been put in place and they had been approved by the government. There would be centralised counselling after the CET and at the end of the course there would an exit test for doctors. The Bench directed the matter to be listed after a week.

Link: Original Article

MBBS must clear exit test to practise

Those intending to become doctors and treat patients may soon have to clear a common exit test after getting the MBBS degree from medical colleges.

The regulating body, Medical Council of India (MCI), has given a statutory recommendation for a mandatory exit test, which is under active consideration of the health ministry, the Supreme Court was informed on Friday.

Considering the sensitive nature of the profession -- dealing with life and death -- and keeping in mind varying standards of education in medical colleges, MCI has proposed a common exit examination for MBBS pass-outs intending to become doctors and treat patients, Solicitor General Gopal Subramaniam told a Bench of Justices R V Raveendran and H L Gokhale.

This recommendation of the MCI was to standardise the skills of doctors, said the regulatory body's counsel senior advocate Amarendra Saran supplementing the arguments of the health ministry advanced through the SG.

This is in line with the decision of the Bar Council of India (BCI) making it mandatory for law graduates to clear a test to be able to practice in courts.

Importantly, both Subramaniam and MCI counsel, senior advocate Amarendra Saran, informed the Bench that very soon a notification would be issued to put in place a single window admission test for filling post-graduate course seats in all private and government medical colleges from the next academic session (2011-12).

This would ease the tension and trouble of thousands of students competing for few PG seats, for which they have to travel to different places to appear in entrance examinations for PG courses of different colleges. Clashing of the dates of examination used to add to the woes of the students. But, these will be a thing of past from next year, thanks to the common entrance test for PG seats in all private and government medical colleges.

However, the joint attempt of MCI and the government to push through the common admission test for MBBS courses in private and government medical colleges did not get the stamp of approval from the apex court, which said it could not do so without getting the responses from the state governments.

The reluctance of the SC stemmed from the fact that Tamil Nadu, which has a special law for the purpose which has already received President's assent, had strongly objected to the common admission test for MBBS across the country.

The Bench said: "We do not know which all states will object to this and how the students, a volatile community, would react to this proposal. So, let the Centre put before us the proposal and we will seek the response of the state governments."

The SG agreed and said though the health ministry was carrying out the task of achieving a consensus among the states for a single window admission test for MBBS courses in all medical colleges, it would be easier and expeditious if the apex court helped through the judicial process to achieve the goal that would benefit the entire community of students aspiring to be doctors.

Giving the Centre a week to place the proposal before it for issuance of notices to the state governments to elicit their response, the Bench said: "The courts have already contributed to a lot of problems and we do not want to contribute to this by giving a go-bye to the settled procedure."

Link: Original Article

September 25, 2010

PG medical entrance: TN opposes SC for cautious approach

The HRD Ministry's proposal for a single window entrance test for admission to post-graduate courses in medical colleges was today opposed by Tamil Nadu in the Supreme Court which favoured a cautious approach to the issue as students are a "volatile" community. The Centre has supported the new draft regulations of Medical Council of India (MCI) for holding the Combined Entrance Tests (CET) for admission to PG courses in both goverment and private colleges. Solicitor General Gopal Subramanium said there was also a proposal for holding a single window entry test for undergraduate MBBS courses. The Centre and MCI have sought the apex court's approval for the proposal. However, the apex court said it cannot pass any direction in the absence of the notification in this regard or the regulations placed before it. "How can we pass any direction when there is neither notification nor the regulations before us? The state governments are required to be served with notices and they have to be heard," a Bench comprising Justices R V Raveendran and H S Gokhale said. The Bench said a cautious approach has to be taken on the issue as students are a "volatile" community and there are chances that "you (Centre) may land in some other problem". It said there should be a law in this regard and every state should be given opportunity to respond. "Now Tamil Nadu is opposing single window system for admission to PG courses. Several other states may follow them," the Bench said adding "you have to go step by step". "Let us see the reaction in the PG courses, then we will form some opinion," the Bench said adding "we do not want to add any more problem".

Link: Original Article

Medical bodies demand Rajasthan CM's appology

The medical community has strongly objected to the comments made by chief minister Ashok Gehlot on private hospitals during a state level function on Wednesday. Doctors of almost all the medical associations have deplored the chief minister's remarks.

The health organisations plan rallies and burn effigies of the chief minister at all district headquarters on Friday. They also plan to meet Prime Minister Manmohan Singh and Congress president Sonia Gandhi over the issue.

"The chief minister needs to publically apologise for his statements and should ensure security and good working environment for medicos," the organisations said in a joint statement.

The BJP too strongly objected to the CM's comments. "Instead of accusing the entire fraternity, the CM should have taken legal action against cases of unfair practices at medical institutions that might have come to his knowledge," said former health minister Digamber Singh.

According to some doctors, the CM's statement may have a lasting adverse impact on patient-doctor relationship and would hamper treatment.

The Indian Medical Association ridiculed the statements and demanded the chief minister prove the allegations or make a public apology.

"The chief minister accused private hospitals of keeping dead patients on ventilators for days. Hwever, medically it is not possible to keep a dead body on a ventilator for more than four hours," said Dr S S Agarwal, state secretary, IMA.

"However if some doctor has been able to keep a body for longer duration and the issue is in notice of the chief minister he should prove it," Dr Agarwal added.

The doctors are planning to file an application under the Right to Information demanding a list of such instances that might have come in notice of the chief minister. Also the action initiated against such medical institutions.

" Trust has a keen role in treatment of a patient, chief minister's remark will deteriorate confidence of the patients and affect the treatment process" said Dr Vijay Kapoor secretary, Private Hospitals and Nursing Homes Society, Jaipur.

Though the chief minister has specifically mentioned the private hospitals, the doctors in government setup also felt offended with the statement. "There remain few rogue elements in every fraternity however those cannot be sighted at a public platform to accuse the entire community" said a senior faculty member at the SMS medical college.

"Such a statement is expected to further increase in instances of patient doctor dispute, it appeared as if chief minister was provoking public anger against the medial practitioners" he added.

The medical organisations held meeting and officially condemned the chief minister's action. Demanding an apology from the state government, medical associations across the state have decided to hold protests at district level and burn effigies of the chief minister.

"Its only when a patient is critically ill that he is put on ventilator, people now may want to give a second thought before shifting their patients to ventilator" said Dr Surendra Kala, president medical practitioners society.

State government has had bitter relations with the medical community over the past few weeks. The private hospitals had held a demonstration against alleged police atrocity against a senior gynecologist in Jaipur, the issue was subsequently followed by a state wide strike by resident doctors following police assault on the S N Medical college in Jodhpur.

Link: Original Article

September 24, 2010

Siddha doctors in TN can prescribe allopathy drugs

In a move that will enable practitioners of Indian medicine to prescribe allopathic drugs, the Tamil Nadu government has amended a rule under the Drugs and Cosmetics Act defining a 'registered medical practitioner'.

By this, the government will treat practitioners of alternative Indian systems, including siddha, as persons 'practising the modern scientific system of medicine' for the purposes of enforcing the drugs and cosmetics law.

The notification, dated September 8, has been issued as a government order and will be published in the state gazette.

It modifies the definition of 'registered medical practitioner' under the Drugs and Cosmetics Rules to include those with qualifications under the Indian Medicine Central Council Act and the Tamil Nadu Siddha System of Medicine Act and who are registered under these laws as practitioners of modern medicine.

The amendment will ensure that siddha, ayurveda and unani practitioners face no proceedings under the Drugs and Cosmetics Act for prescribing or storing allopathic medicines.

The Indian Medical Association is likely to go to court against the order.

Link: Original Article

Punjab takes steps to encourage doctors to work in rural areas

In a bid to encourage government doctors to work in rural areas, the Punjab government today revised the eligibility guidelines for admission in state-run medical colleges to pursue post graduation. According to the policy, 60 per cent PG seats will be reserved for Punjab Civil Medical Services (PCMS) doctors who have completed three years of rural service. Every year's additional service beyond three years would fetch one extra mark, a spokesman said. The revised guidelines would be implemented with effect from November 1, 2010. Rural service for this purpose means service at health institutions situated beyond 15 km of the notified municipal areas. The 15-km limit has been fixed for all the municipal towns irrespective of their size and the category of municipal committee, the spokesman said.

Link: Original Article

September 23, 2010

Students seek single-window medical entrance, SC finds merit in petition

The Supreme Court has admitted an urgent application jointly signed by medical students from across the country seeking a single-window system for MBBS/BDS or PG courses at the all-India level to prevent “rampant seat blockage/wastage and seats being sold for crores”.
A Bench of Justices R V Raveendran and H L Gokhale took “serious note” of the application seeking intervention in an already pending litigation filed by doctors against the Union of India in which, as per the application, the government on August 13, 2010 recorded its approval for a Medical Council of India proposal to amend regulations relating to courses of graduate and postgraduate students by providing “a single eligibility-cum-entrance examination”.

The court had on August 13, 2010 given the government three weeks to notify the single-window scheme and place it on record, it said.

The contents of the students’ application, the court said in a short hearing on Friday, were reflective of the ground realities.

Advocate Avdesh Chaudhary, lawyer for the students, said his clients were “medical students belonging to the middle-class strata of the society, who have very limited resources for pursuing medical studies in private colleges and have either pursued or are pursuing or will have to pursue in government medical colleges”.

The students’ representative in the application, Dr Prashant Kumar Sharma, told The Indian Express that they “have been or are victims of the present system of admission process for medical education in one way or the other as large number of seats go either vacant and subsequently are manipulated and filled for financial considerations in various government medical colleges.

“In the wake of the directions dated 13/08/2010 given by this Hon’ble court for introduction of ‘Single Window Scheme’ for the undergraduate and postgraduate courses, these medical students wish to demonstrate the urge, necessity and overwhelming facts for strict and urgent implementation of the directions,” the application stated.

The students complained they have been denied of the chance for a second round of counseling to the 15 per cent all-India quota of medical seats because of the lapse shown by states to adhere to the time schedule.

They argued in favour of a uniform admission process, explaining that the “whole ideology of having a single-window system for admission to medical courses has its own rationale as students, after being successful in the entrance examination undergo one counseling and are offered confirmed seats in medical colleges and there is no scope of having students being offered/allotted multiple seats in different medical colleges”.

Right now, all those seats later vacated by these candidates go unreported and vacant and genuine and meritorious students do not get the opportunity to pursue medical courses, which give rise to seats being manipulated for monetary consideration, they said. It was submitted that many seats in PG medical courses go waste every year due to the fact that students resign mid-session when they get better branches in the exam of some other institute.

“Even in the apex institute of the country — AIIMS — 54 seats in January 2010 session and 8 seats in July 2010 session have been simply wasted due to mid-session resignations when the students have got a better branch in other institute. As many as 88 seats in AIPGME have been similarly wasted for the year 2010-2011,” the students said in their petition.

Link: Original Article

IIT-Kharagpur's experiment in medicine course a non-starter

Despite a lot of hype around IIT Council's decision to start courses in medicine, the decade-old performance of School of Medical Science and Technology (SMST) in IIT-Kharagpur shows the programme is yet to catch popular imagination.

SMST was started in 2001 with an inter-disciplinary three-year post-graduate programme in medical science and technology, where MBBS pass outs are eligible for admission through an all-India entrance test.

"It has failed to create a niche," says a professor of IIT-Kharagpur. According to him, students have dropped out in phases despite a monthly assistantship of Rs 15,000.

To make matters worse, SMST, says the professor, has been severely hamstrung by an acute shortage of practicing physicians.

Over the years, IIT-Kharagpur could not hire even a single practicing physician as a SMST faculty. Most of the SMST faculty are from engineering background, while others have medical degrees from abroad and consequently cannot practice in India.

"In the absence of any practicing physician among the SMST faculty, which is the hall-mark for the success of such an inter-disciplinary programme, IIT has outsourced one of its practicing physician from its hospital to SMST," the professor explains.

The entire SMST faculty is at the level of assistant professor save a superannuated professor.

"The faculty profile of SMST is similar to any private engineering college, where the faculty comprises junior people," the professor says.

Absence of senior-level faculty has led to outsourcing of the SMST head from other engineering departments of IIT-Kharagpur. For instance, the present SMST head belongs to the department of electrical engineering.

"The SMST programme is lop-sided. It is more in favour of engineering than medical science," the professor admits, claiming that this is not the first time that talks are on to start courses in medicine in IITs.

For instance, in May 2007, the then President, Dr A P J Abdul Kalam, had laid the plaque for starting a medical school offering MBBS and super-speciality degrees in IIT-Kharagpur without seeking clearance from Medical Council of India that was rejected later.

Subsequently, IIT Council has decided to amend the Institutes of Technology Act.

Link: Original Article

September 22, 2010

Apollo Hospitals in talks with Khazanah for medical education

Healthcare major Apollo Hospitals on Tuesday said it is in talks with Malaysian sovereign fund Khazanah for a possible collaboration in healthcare education in India as well as Asia.

"We are in talks with them but its still on a very preliminary stage," Apollo Hospitals Executive Director Finance Suneeta Reddy said.

Malaysian fund Khazanah was recently entangled with India's Fortis Healthcare, Apollo's rival in India, for the control of Singapore-based hospital chain Parkway Holdings. Khazanah also holds nearly 12 per cent stake in Apollo Hospitals.

As per information available on its website, the healthcare major offers a variety of courses, including nursing education and medical courses.

The company, however, did not disclose the education vertical for which it will collaborate with Khazanah.

Apollo Hospitals operates one of the largest hospital chains in the country and currently has 9,000 beds at its hospitals.

As per its expansion plans, the company will increase its bed-capacity to 12,000 from the current 9,000 beds by 2015. It also plans to have a total workforce of 85,000 employees.

Link: Original Article

Panel to monitor Arogyasri constituted

The State government has constituted an Empanelment and Disciplinary Committee (EDC) for Arogyasri.

The panel under the chairmanship of a Chief Medical Auditor (CMA) appointed by the Arogyasri Health Trust will look into all the complaints against hospitals received from various sources and recommend follow up action against the network hospitals.

The post of CMA was created to continuously monitor the quality of medical care being provided to the beneficiaries.

Chief Minister K. Rosaiah during an interaction with the Arogyasri Minister Pithani Satyanarayana, Chief Secretary S. V. Prasad and Arogyasri Trust CEO A. Babu was informed about the EDC. Officials pointed out that show cause notices, with warning and order to withhold payments, suspension, de-empanelment and de-listing, would be served on erring hospitals.

Further explaining the role of the EDC, officials noted that necessary steps were being initiated by the trust in a transparent manner through the online workflow.

In case of hospitals suspended from the scheme, their explanation will be considered case by case based on merit.

Link: Original Article

September 21, 2010

Hospitals agree to offer discounts to patients with health cover from Big 4 insurance companies

Corporate hospital chains have agreed to offer discounts to patients with health cover from the four state-owned general insurers, who refused to honour bills submitted by these chains from July onwards, alleging they were inflated.

If the proposal is accepted, patients with insurance from these companies will be put under a different billing structure within the same hospital. The discounts on cost of treatment will benefit insurers by reducing their payment to hospitals. As most consumers have a ceiling on their mediclaim, discounts will help stretch the money further.

The Big Four — New India Assurance, Oriental Insurance, United India Insurance and National Insurance Company, control more than half of the country’s health insurance market. Indians spend $35 billion every year on healthcare.

“We are ready to offer between 3-7% discount if they bring us business in bulk,” Prathap Reddy, chairman of the country’s largest hospital chain Apollo Hospitals told ET, on the sidelines of a health conference. The proposal is being discussed between top corporate hospitals, including Apollo Hospitals and Max Healthcare, and state-owned insurance firms, he added.

The chief executive of a general insurance company, on the condition of anonymity, said modalities of implementing the discounts are yet to be finalised.

Pervez Ahmed, CEO of Max Healthcare, said some hospitals, including Max Healthcare, Ganga Ram and Medanta, have separately submitted a revised rate list for 42 procedures to insurance companies.

Along with general and life insurance companies, who provide health insurance, there are three private exclusively health insurance firms — Apollo DKV, Star Allied Health Insurance and Max Bupa. Insurance companies bring bulk business for hospitals through their group insurance schemes.

Link: Original Article

Pak beats India, introduces gory pics on cigarette packs

This is one thing that India can take a leaf out of Pakistan's book.

Pakistan has introduced gory pictorial warnings on all tobacco packs from August 30 in a bid to deter consumers from smoking or chewing tobacco. On the contrary, India, where 2,500 people die daily due to use of tobacco, has put off the introduction of strong and gory pictorial warnings till December 1.

Pakistan has made it mandatory for 40% of all tobacco packs — on both sides — to carry the image of a rotting mouth suffering from cancer along with a health warning. While 30% of the tobacco packs shows a patient stricken with mouth cancer, 10% carries the warning text.

Gradually, the pictoral coverage will be increased to 50% as recommended by the Framework Convention on Tobacco Control ( FCTC), an international treaty that was signed and ratified by Pakistan in 2004. Earlier, the ministry's public notification had announced that it would be mandatory for all such packs to carry the photograph of a cancer-stricken mouth from June 1.

The present warning, which is considered too soft and counter-productive, will continue till the new one comes into vogue. Pictorial warnings were enforced on May 31, 2009, after the SC intervened. As per the rules, pictorial warnings should be rotated every 12 months.

"The health ministry ministry forced by the tobacco lobby has decided to go ahead with the soft warnings till December 1," an official said.

The new warning was finalised after a field test was conducted by the Voluntary Health Association of India and Healis in seven states on request of the ministry. An overwhelming 98% of the respondents chose the picture of the cancer-stricken mouth as a substitute for the present one that depicts a lung and scorpion. Tobacco users felt that the replacement would help them quit smoking and chewing tobacco.

"The warnings cannot be soft. International experience has taught us warnings need to be big, scary and colourful. Only then do they catch the eye and deter people. In India, only 2% smokers quit," a ministry official said.

Presently, nine lakh people die in India annually due to tobacco-related diseases.

At a conservative estimate, about 250 million people across the country usetobacco products like gutkha, cigarettes and bidis. Over 16% are cigarette smokers, while 44% smoke bidis. According to the health ministry, 40% of health problems stems from use of tobacco.

By 2020, tobacco will be responsible for 13% of all deaths in India — and studies suggest that without any intervention — more than 38.4 million bidi and 13.2 million cigarette smokers may die prematurely due to this harmful habit.

Gory pictorial warnings are used in several countries, including Australia, Belgium, Chile and Hong Kong to deter people from smoking. Brazil changes the pictures every five months.

Link: Original Article

September 20, 2010

IITs can undertake medical research

With the IIT Council giving its consent to the institutes to start courses in medicine, IITs can now undertake inter-disciplinary research in the field of medicine, bio-engineering, biotechnology and related subjects. The approval comes even as health ministry has not favoured IITs starting medical courses, suggesting instead that they consider starting PhD programmes, involving collaboration between engineering and medical science.

The council's nod to hiring foreign faculty will also require policy-level changes. Though there are 4,267 vacancies of which only 2,983 have been filled, security clearance is required ahead of hiring of a foreign national at a salary that is on a par with his Indian counterpart. "We will set up a mechanism the with home ministry so that the process can be done without any hiccups," HRD minister Kapil Sibal said.

Interestingly, the ministry's proposal for Innovation Universities says foreign nationals will be hired as faculty for which the Citizenship Act needs to be amended.

Lack of consensus on reforms in the JEE — proposed by the Damodar Acharya committee — led the IIT Council to set up another panel, under T Ramasami, secretary, science and technology, that will submit its report in three months.

On JEE was no consensus on an alternate model for the present system. Though there was agreement that class XII results should be given weightage, the Damodar Acharya panel report, which has suggested normalization of class XII results, did not find enough support. Directors of seven IITs felt that the existing system of test should continue as an add-on examination along with the marks in class XII and aptitude test.

Link: Original Article

Sweet prescription for cashless mediclaim

Patients who are undergoing treatment and have cashless medical policies can now breathe easy. Their existing policies will cover their expenses even if the hospital they are admitted to is no longer a part of the preferred provider network (PPN) of their insurer.

In a recent order, the Insurance Regulatory and Development Authority (Irda) asked all life and general insurance companies to allow cashless facility to patients who are already being treated.

“Being denied the benefits of a policy you have paid for while your close one is going through a medical emergency is the last thing you are prepared for,” says Bangalore-based A Shridhar, who faced this situation when his wife was admitted to a hospital. Like Shridhar, many policyholders were caught off-guard when the four public sector general insurers — United India Insurance, New India Assurance, Oriental Insurance and National Insurance — removed 300 hospitals from their PPN list. Issues of over-pricing is the crux of the tussle that began a couple of months ago.

Present scenario
Many insurers say the issue is on the verge of being resolved after various rounds of discussions between them and the hospitals. Yet, only the smaller hospitals have joined hands with the insurers. Under the agreement, the two sides have fixed prices for 42 procedures. The public sector insurers are also working on a premium cashless policy, but nothing has been finalised.

Irda has also asked insurers to keep policyholders informed about changes in their PPN lists. The order states, “The insurers are directed to inform policyholders the nearest alternative hospitals where the cashless facility is available.”

Reaching out to policyholders
Obeying Irda’s order, public sector general insurers say they are making arrangements to provide better services to policyholders. Insurance companies discourage policyholders from availing of cashless treatment in non-network hospitals. However, according to G Srinivasan, chairman and managing director, United India Insurance, the company has anyway extended the cashless facility to policyholders who are in the middle of treatment. “We have been giving advertisements saying emergency or trauma treatments can continue on a cashless basis even in non-network hospitals,” he says.

This is the first time the company is re-jigging its PPN list, also updated on the website. According to Srinivasan, “At present, 450 hospitals are part of this list, and many more will join soon. Any policyholder can check the website to spot the nearest hospital.”

The number of hospitals varies from city to city. At present, there are 110 hospitals in the PPN in Mumbai. The public sector companies have also resorted to advertising in newspapers to reach out to a large number of policyholders. “Besides, we are still in talks with hospitals and the list is being updated on a daily basis,” says a senior official at New India Assurance.

Their private sector counterparts, though not part of the PPN row anymore, are reaching out to policyholders individually.

Hemant Kaul, CEO and managing director, Bajaj Allianz General Insurance, says, “Our PPN list has hardly seen any change. But whenever there is any, we inform each policyholder.”

Insurance companies’ customer care centres can also be contacted to know more about hospitals offering the cashless facility. Life insurance companies, too, have a small health insurance portfolio, ranging from one to five per cent. Though most of them have tie-ups with third-party administrators, they claim to keep each policyholder updated about any slightest change in their policies and hospital tie-ups through electronic mails and newsletters.

Link: Original Article

September 19, 2010

New medical policy to ensure docs don’t over-drug patients

The government is soon going to chart out a National Standard Treatment Policy to ensure doctors use optimum medical procedures and prescribe limited drugs so that patients are neither overcharged nor over-drugged during treatment.

The government is likely to notify the policy under the Clinical Establishments Bill. The policy is being framed in consultation with the states.

Once the policy is in place, more than 2,000 medical conditions will be streamlined. However, to begin with, 20 to 30 prevalent morbidity conditions will be standardised at various levels of healthcare.

“Presently, different doctors use various medicines and measures for treatment and hospitals charge different rates for same the treatment. This cannot go on. There has to be some standardisation for which we are formulating this policy,” health secretary K Sujatha Rao said.

Dr Ranjit Roy Chowdhary, a leading clinical pharmacologist, who is part of the policy making team, said, “A disease can be treated in various ways and by using a variety of medicines. We plan to standardise this practice so that doctors use limited number of drugs which are cheaper and of good quality as well as follow a laid down procedure during treatment. This is important for better therapeutic effect and lesser side effects.”

Standard treatment guidelines are in place for cancer and cardiovascular diseases, he said.

The policy will reduce the cost of treatment since doctors will not be allowed to use unnecessary combinations of drugs for treatment, Dr Roy Chowdhary said.

“This policy will also be important for the health insurance sector which recently faced a lot of problems due to the lack of rationalisation of rates and standardisation of treatments,” the health secretary said.

The policy will also safeguard doctors.

“If a patient dies due to a drug which is not as per the schedule that we give, he/she can be in trouble. But for those who follow the policy, there will be a ring of protection since the medicines and treatments were as per standard policy prepared by experts from across the country,” Dr Roy Chowdhary said.

Link: Original Article

Budding docs may get a jab of arts

Literature, painting, music and other art forms could soon be a part of medical education curriculum as educationists slowly wake up to need of teaching humanities to budding doctors. The civic-run hospitals could be the first to usher in this change once the Medical Council of India (MCI) approves of the plan.

A day after the MCI incorporated a special module-Communication and Ethics-in the syllabus of the six upcoming AIIMS-like institutions, nearly 200 students and faculty from Seth GS Medical College, attached to KEM Hospital, attended an introductory lecture on medical humanities on Monday. "Humanities and ethics could soon be part of the national MBBS curriculum," said Ranjit Roy Chaudhury, member of the MCI's board of governors. "Indian doctors excel technically, but we need to work on the doctor-patient relationship," he said.

Academicians are gradually realizing that many medical students lose their sensitivity towards patients' woes by the time they finish their course. Many feel that aspiring doctors must also be trained on how to communicate better with patients, especially how to break the news of a patient's demise to his/her loved ones.

Director of medical education Dr Sanjay Oak said that he strongly supported inclusion of humanities and ethics in the curriculum. "I believe that three things- humanities and ethics, research methodology and health economy-should be taught to students over three years," he said, adding that a proposal has already been floated. "The final decision has to come from the MCI."

Chaudhary is optimistic that linking humanities with medical education will go a long way in curbing patient-doctor conflict. "The MCI is working on this issue seriously," he said.

Meanwhile, Dr Ravi Shankar, from Nepal-based KIST medical college, who addressed students on Monday, volunteered to help the BMC-run colleges conduct special exercises in humanities for budding doctors.

Link: Original Article

MoS for health moots separate cadre for health services

Continuing the tirade against bureaucrats in his department, Minister of State for Health Dinesh Trivedi on Monday said he doubted their efficiency and proposed a separate cadre for health services.

Trivedi, who has expressed his deep disappointment with the working of the bureaucracy in the health ministry on many occasions earlier, said the proposed cadre should be in line with the Railway services where "you grow in the ranks to reach the top level.

"I am not doubting their (bureaucracy's) sincerity, but their efficiency," he said of the current bureaucracy in the health ministry.

"This bureaucratic system works very well in other ministries, but health is an emergency ministry where you have to work 24x7," he said, adding, "A different bureaucratic system as far as the health ministry is concerned in line with the Railways can do the job."

Speaking at a seminar at FICCI here, the Minister also sought to focus on prevention aspect of health care instead of curative therapies.

He said that the government has till now meted out step-motherly treatment to the Ayush system of medicine. "We have to make an attempt to provide scientific basis to the alternate systems to market them abroad."

Last week, at a similar function the minister had expressed dissatisfaction over the working of his ministry, saying the present system cannot deliver.

He had said that the health ministry was in a mess and getting worse day by day.

The minister had added that everybody - whether it was ministers or officials - should be accountable. "The system needs a jolt", he said.

Trivedi had earlier targeted Health Secretary Sujatha Rao saying that she had put a spanner in his pet project of a national health portal.

Following this, the ministry had formed a committee to analyse the project further.

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HC clears decks for CBI probe against Pondy medical college

Paving the way for resumption of CBI probe into a Puducherry-based medical college's role in the multi-crore scam involving former MCI chairman Ketan Desai, the Madras high court has vacated an interim stay on the investigation.

On August 17, Justice CT Selvam had stayed the CBI investigation into a case involving Sri Lakshmi Narayana Institute of Medical Sciences, which had been named as accused along with Ketan Desai. On August 31, however, he vacated the stay, after the CBI's special public prosecutor N Chandrasekaran submitted that the central agency should be allowed to proceed with the investigation as it involved a powerful person like Desai, who has now been removed from the post.

On its part, the CBI gave an undertaking that the staff members, students and the management would not be harassed in any manner or called for an inquiry pending further hearing till September 7.

The CBI registered a criminal case against the college and Desai on May 21, under various provisions of IPC as well as the Prevention of Corruption Act. According to the FIR, the two accused colluded with each other, resulting in the grant of MCI approval for the institution despite 12 deficiencies pointed out by the inspection committee. They together had cheated the Government of India by not providing the minimum standard of medical education.

The college rushed to the high court for a stay on the investigation and to quash the FIR on the ground that the case had been registered based on a "mere source information, without any preliminary investigation/report."

The five-year-old college was inspected 10 times during the period, and the CBI had taken up the case without jurisdiction and usurping the powers of the Union health ministry, it said, adding that the grant of permission was not the act of a single person.

Assailing the interim order and explaining the seriousness of the case, the CBI's counter said the case was registered on the basis of investigation, which clearly indicated that the requisite infrastructural facilities were not available in the college. Noting that the investigating agency must be allowed to discharge its duties and file the final report, it said that during the investigating stage the agency should not be forced to rely upon only the selective documents submitted by the suspect.

The CBI probe so far has been done not only as per the established law and procedure, but also to protect the interests of students studying MBBS course and to prevent any possible injustice caused to the public, the counter said.

Link: Original Article

September 06, 2010

Eight 'Delhi superbug' docs in the dock

The notice has sought explanation why the doctors did not take mandatory permission from Indian Council of Medical Research (ICMR) to transfer the biomedical material outside the country. The eight doctors from Tamil Nadu, Haryana, West Bengal and Uttar Pradesh have been asked to respond within 15 days to the Drug Controller General of India (DCGI).

“It is a matter of concern if biomedical material can be transferred to foreign countries randomly. Like this, genetic mapping of our population can be done and exploited,” a senior health ministry official said, confirming that the DCGI sent the notice last week. Some see it as a move to armtwist and retaliate against the report and those who participated in the study. “There will obviously be political pressure to take action. But there is also a legitimate concern,” a senior industry executive said.

Dr Dharam Prakash, secretary general of the Indian Medical Association, said he cannot comment as he has not seen the notice. In a study published in The Lancet Infectious Diseases Journal on August 11, scientists said they had found a new gene — Delhi metallo-beta-lactamase (NDM-1) resistant to almost all antibiotics, including the most powerful class called carbapenems — in patients in South Asia and Britain. The patients in Britain had undergone treatment in the sub-continent, mainly in India.

The report warned NDM-1 could be a potential worldwide public health problem, but Indian health authorities and doctors ruled out such a possibility. The samples for the study were collected from hospital patients in Chennai and Haryana, and from patients referred to Britain’s national reference laboratory between 2007 and 2009.

Health experts, doctors and politicians alike have come out strongly against the report, particularly naming the bug after the Indian capital. This was seen by many as an attempt to malign the Indian healthcare sector, which is attracting foreign patients by providing healthcare services at cheap rates.

Such concerns are not new. Even in the pharmaceutical sector, Indian drugmakers have often refuted occasional reports of counterfeit drugs linked to India and have termed allegations that medicines made in India are of inferior quality, as an anti-tariff trade barrier to restrict Indian companies

Link: Original Article

September 04, 2010

Dengue worries world

With dengue cases in the Capital crossing the 1,000 mark on Wednesday, many countries participating in the Commonwealth Games have expressed concern. At least 20 countries have written to the Organising Committee (OC) of the Commonwealth Games inquiring about measures being taken to control the outbreak. The OC claimed there was nothing to worry.

"The government is doing all it can to contain dengue in Delhi. Dengue breaks out every year and it ebbs by September-end. There is nothing to worry as all measures are being taken to contain the outbreak," said Lalit Bhanot, OC Secretary General.

OC officials said the outbreak was a problem in the whole of South Asia right now.

"Bangkok, Malayasia and even Singapore, which is hosting the Youth Olympics right now, have reported far more cases than Delhi. So there is no need to view Delhi as a special case," said a senior OC official.

But Delhi residents have reasons to worry.

It is not the unauthorised colonies and low-lying areas in the city that have provided a perfect breeding ground for dengue-causing mosquitoes. Most cases of mosquito breeding have been detected from affluent areas and establishments.

Directorate of National Vector Borne Disease Control Programme (NVBDCP), an organisation responsible for monitoring the implementation of anti-larval measures in the national Capital, detected 40 per cent of the total breeding at various posh south and central Delhi colonies.

"Maximum breeding has been detected in areas such as Delhi Cantonment, All India Institute of Medical Sciences, Yusuf Sarai, Vasant Vihar and Vasant Kunj among others," said a senior official at NVBDCP, on condition of anonymity.

In its recent report, NVBDCP branded Delhi cantonment among the worst hit areas in Delhi, with the larvae of dengue-causing mosquitoes detected in about 25 per cent of the places inspected.

Some of the prominent private hospitals such as Apollo, Fortis - Vasant Kunj, Pushpawati Singhania Research Institute - Sheikh Sarai-II, apart from some government hospitals and medical colleges including All India Institute of Medical Sciences (AIIMS), GB Pant, Lady Hardinge Medical College (LHMC), have also been recently issued challans.

Large-scale mosquito breeding was found on their premises. The hospital currently has 16 dengue patients admitted.

"AIIMS has a separate dengue prevention programme but still breeding was found in 14.5 per cent of the places inspected, including its staff quarters," said Dr V.K. Monga, public health committee chairman, Municipal Corporation of Delhi. On Wednesday, 77 fresh dengue cases were reported.

Link: Original Article

September 03, 2010

M-phone technology for tele-health solutions in rural India

The telehealth solution is based on the twin elements of patient self-monitoring with immediate feedback, and targeted support from a healthcare professionals with full access to the patient data on a secure web page, he said. "Their mobile phone can allow patients not only to transmit self-monitoring data and diaries to a remote server but also to receive real-time feedback, which increases compliance with treatment regimes," the developer of the mPhone said. As part of the Indo-UK dialogue, he said he will discuss with the newly formed departments of Biosciences and Bioengineering at Indian Institute of Science, Bangalore and IIT-Mumbai on further improvements of mHealth for Indian requirements. Tarassenko said, this innovation is globally relevant as the healthcare cost has gone up enormously and it costs 1000 pounds per day for hospitalisation. It is also relevant at a time when the World Heath Organisation has recently predicted that chronic diseases will be the leading cause of disability by 2020. "With the growth of type 2 diabetes world-wide, for example, the number of people with diabetes is predicted to rise to 366 million by 2030. 298 million of these will be from developing countries," he said. Improved self-management, coupled with regular education and support, is seen as the best means of slowing the inexorable rise of healthcare spending on chronic diseases. "The challenge is to create sustainable, large-scale programmes capable of delivering both, which mhealth solutions can provide," he said. Tarassenko was here on behalf of the Research Councils UK Office in India, UK Science and Innovation Network and the Indian Institute of Science.

Link: Original Article

September 02, 2010

Irda asks health insurers to continue cashless facility

In a bid to give relief, the insurance regulator Irda has asked the general insurers to continue providing cashless facilities from hospital that are part of their preferred provider network (PPN) to customers who are undergoing treatment even if the general insurer discontinue its cashless service from the same hospital.

Where a policyholder has been issued a pre-authorisation for the conduct of a given procedure in a given hospital, or if the policyholder is already undergoing such treatment at a hospital, and such hospital is proposed to be removed from the list of PPN, then the insurers are directed to continue to provide the benefits of cashless facility for such policyholder as if such hospital continues to be in the PPN list Irda stated

In order to ensure that the interests of the policyholders are not adversely affected, at times when a change in PPN is effected, the insurers are directed to inform the policyholders at all times, the nearest possible alternative hospitals where the cashless facility is available and the conditions thereof, said Irda.

Medical insurance policies offered by different insurers to policyholders are contracts of reimbursement.

New panel to track reinsurance deals

Irda has formed a high powered committee to put in place a technology platform to track reinsurance and coinsurance placements. J Hari Narayan, chairman will head the committee.

The committee will suggest measures to to operationalise the new technology system within three months and the finalisation of the system shall be accomplished within six to nine months.

Link: Original Article

Guj turning a medical hub

Gujarat is fast emerging as the destination for medical training for doctors from all over the world with specialists coming to city hospitals to get training in specialised procedures like knee and hip replacement, endoscopy, IVF, embryology, kidney stone removal and other complex heart procedures.

This is a reverse trend of sorts as earlier most doctors from here used to go abroad for medical training. Currently, a team of five senior orthopaedic surgeons are in Shalby Hospital to get trained in knee and hip replacement surgeries.

Leader of the group Dr Alan Chuha said that they are surprised at the volume of surgeries that are conducted in this hospital which gives them the opportunity to learn more than anywhere else in the world.

"We came here as this centre is considered the best in India. An average 15 to 20 surgeries are performed here daily. This has given us lot of exposure in less time as repetition helps you pick up skills better," said Chuha. He said that their team chose Gujarat in India over other countries as the patient profile too here is similar to patients in their country.

"We perform large number of surgeries and last year 4,000 replacements were conducted, giving doctors the benefit of learning faster and better. In US, for instance, one-two replacements are done in a good centre daily while we do nearly 15 to 20," says Dr Vikram Shah of Shalby Hospital where doctors from almost all Asian and African countries come regularly for training.

Doctors say that skilled surgeons along with good infrastructure and huge numbers of patients is giving Gujarat the edge when in comes to training personnel from abroad. "We get large number of patients with stones which has given us more skill. We get urologists from Saudi Arabia, Libya, Sri Lanka, Turkey, Germany and even US to train in PCNL technique of stone removal," said leading urologist Dr Janak Desai of Samved Hospital.

Cardiologist Sameer Dani, who conducts training in procedures like balloon valvuloplasty and mitral valvuloplasty apart from cardiac and peripheral angioplasties says that the potential for medical training is immense.

"It is gratifying when we train doctors from France in procedures which I had learnt in France. We have an edge in terms of economic cost, skill and great infrastructure," said Dr Dani, who says that more structured programmes would follow as more doctors from abroad come here for training.

Pulse Women's Hospital, conducts open programmes throughout the year in IVF training for which doctors from African and Asian countries enrol regularly. Each programme is of two weeks.

"These people chose us over developed nations in European, US or UK as there they get to see just a few cases as observers while here they get exposure to a big number of cases," says Dr Manish Banker, who says that specialised workshops are also held in endoscopy. He says that there is a scope in this area and students get trained paying a fee of US $1,000 to $2,000.

Link: Original Article

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