October 31, 2011

Docs to spend more time with patients soon

The Medical Council of India (MCI) may soon specify how much time doctors should spend with their patients so that the regimen of medicines being prescribed to them is clear. A recent World Medicines Situation 2011 report brought out by the World Health Organization (WHO) — as reported by TOI first — had recently said that doctors, on an average, in developing countries spend less than 60 seconds in prescribing medicines and explaining the regimen to their patients. Consequently, only half of the patients receive any advice on how to take their medicines and about one-third of them don't know how to take drugs immediately on leaving the facility. Union health minister Ghulam Nabi Azad said on Friday that the government proposes to issue an advisory to the MCI to disseminate appropriate instructions among all registered medical practitioners. According to WHO, the dispensing process greatly influences how medicines are used. The WHO database shows that the dispensing time is a minute. "In such circumstances it is not surprising that patient adherence to medicines is poor," the report said. Azad said, "The doctor population ratio is not favourable in our country. Hence, there is tremendous pressure on the doctors serving in public sector hospitals. This may be the major reason for patients getting less than adequate time for consultation." MCI's own assessment says India has just one doctor for 1,700 people. In comparison, the doctor population ratio globally is 1.5:1,000. MCI has set a target to have 1 doctor for 1,000 people by 2031. The assessment note, available with TOI, also looked at the situation in other countries. Somalia has one doctor for 10, 000; Pakistan has 1:1,923 and Egypt 1: 1,484. China's doctor population ratio stands at 1:1,063; South Korea 1:951; Brazil 1:844, Singapore 1:714, Japan 1:606; Thailand 1:500; UK 1:469; the US 1:350 and Germany 1:296. Kathleen Holloway from WHO's department of essential medicines and pharmaceutical policies said, "Irrational use of medicines is a serious global problem that is wasteful and harmful. In developing countries, in primary care, less than 40% of patients in public sector and 30% of patients in private sector are treated in accordance with standard treatment guidelines." The report cites, only about 60% countries train their medical students on various aspects of prescribing medicines and only about 50% require any form of continuing medical education. The basic training for nurses and paramedical staff, who often do a bulk of prescribing, was even less — only about 40% of countries give them any basic training on how to prescribe. The report shows, though around 80% of all prescribed medicines are dispensed — usually, they are done by untrained personnel — and as many as 20%–50% of medicines dispensed are not labelled. WHO feels many countries are making relatively little investment in promoting rational use of medicines. The report had also said that two-thirds of all antibiotics are sold without prescription through unregulated private sectors. Low adherence levels by patients are common and many patients are taking antibiotics in less than the prescribed dose or for a shortened duration — like three instead of five days. Link: Original Article

October 29, 2011

Govt. concerned over exodus of doctors: Health Min

Government on Friday expressed concern over the growing exodus of doctors from the country and maintained that appropriate measures, including relaxing norms for opening new medical colleges, to meet the shortage are being taken. Health Minister Ghulam Nabi Azad informed the Lok Sabha during Question Hour that 3,600 doctors had left the country to work abroad in the last three years. “There is an overall shortage of doctors in the country. So private sector will try to attract the doctors from the public sector,” Mr. Azad said. He said most of these doctors who were working for the private sector or had gone to countries like the U.S. and the U.K. were specialists and super-specialists. Mr. Azad claimed that the government was taking measures to deal with the situation. “Enhancing human resources for health particularly in the rural areas is one of the focal areas of the government. It has been taking measures like relaxing norms for opening new medical colleges and providing central assistance for upgrading and strengthening of existing state medical colleges,” the minister said. Other steps being taken are multi-skilling of doctors to overcome shortage of specialists and providing incentives to serve in rural areas and augmenting human resources in health to improve the overall health delivery system. Link: Original Article

October 27, 2011

Outsourcing education: Malaysian doctors will be made in Belgaum

While organisations are known to outsource IT projects and various works to other countries, here is a case you might not have heard of: University of Science Malaysia (USM) has outsourced the entire process of education to a medical college in Belgaum, which caters exclusively to students from the south-east Asian nation. KLE Group of Institutions has set up a college on a 10-acre campus in Belgaum that imparts medical education exclusively to students from south-east Asian countries, mainly Malaysia. Prabhakar Kore, chairman of the group, told DNA that they started the college after USM approached them in this regard. “We will provide good teaching along with infrastructure but the examination and curriculum is as per their (USM) syllabus,” Kore said. He informed that USM would select the students. The five-year course, called MD, is different from Indian syllabus. How it happened Kore said USM wanted to start a college in Malaysia itself but could not do so because of various hurdles posed by local rules. He said Malaysia has few teachers for medical stream and hiring Indian teachers is not practical either because getting a local licence for it is tough. Further, he said, even his group cannot set up a college there because of the rules. However, he said the KLE Group could cater to the needs of the foreign students with their existing infrastructure in India. He said they have been getting students from other countries since 1965. Shifting his attention to the college that is being started in association with USM, he said from this academic year they would be getting 100 students in every batch. About fees, Kore said it was not finalised yet and a call on it would be taken after considering expenditures on lab, faculty, building, hostel and other infrastructure. Link: Original Article

October 25, 2011

India records highest number of new born deaths: UN

More new born babies die in India annually than in any other country, even though the number of neonatal deaths around the world has seen a slow decline, a new study by the World Health Organisation (WHO) has said. New born deaths decreased from 4.6 million in 1990 to 3.3 million in 2009, and fell slightly faster in the years since 2000, according to the study led by researchers from WHO, Save the Children and the London School of Hygiene and Tropical Medicine. The study, which covers a 20-year-period and all the 193 WHO member states, found that new born deaths - characterised as deaths in the first four weeks of life (neonatal period) – account for 41 % of all child deaths before the age of five. Almost 99 % of the newborn deaths occur in the developing world, with more than half taking place in the five large countries of India, Nigeria, Pakistan, China and Congo. "India alone has more than 900,000 newborn deaths per year, nearly 28 % of the global total," WHO said, adding that India had the largest number of neonatal deaths throughout the study. Nigeria, the world's seventh most populous country, ranked second in new born deaths – up from fifth in 1990. Three quarters of neonatal deaths around the world are caused by pre-term delivery, asphyxia and severe infections, such as sepsis and pneumonia. WHO pointed out that two thirds or more of these deaths can be prevented with existing interventions. Link: Original Article

October 22, 2011

CBI decodes scam, nails ex-MCI chief Ketan Desai

One and a half years after the don of the Medical Council of India, Ketan Desai was arrested for taking a bribe of Rs 2 crore, the Central Bureau of Investigation is finally ready with a chargesheet. CNN-IBN has accessed the confidential papers that document how the deal was struck, rules bent, quality of medical education compromised and how money changed hands. The CBI decoded the modus operandi of former MCI chief Ketan Desai and his tout JP Singh. Sources say that Desai used code words like 'Badal' for Punjab colleges and 'Mamata' for West Bengal colleges. The Key characters in the conspiracy were: Dr Ketan Desai, President of the Medical Council of India Dr Sukhvinder Singh, Vice Chairman of Gian Sagar Charitable Trust JP Singh, Tout According to the CBI, Desai entered into a conspiracy with JP Singh and Sukhwinder Singh to grant permission to Gian Sagar Medical College in Patiala for admission of students for 2010-2011 for different courses for which the college did not have the required facilities. Conversation tapped by the CBI: Here's the transcript of a phone conversation tapped by the CBI on the day the executive committee of the MCI was to examine Gyan Sagar Medical College. Ketan Desai: I will be late today…there is a meeting of the Exective Committee. JP Singh: yes but you've already decided to help those poor people. Ketan Desai: yes but there are a lot of problems, its only cement and steel. JP Singh: okay. Ketan Desai: It will be very difficult for me. Ten days later JP Singh struck a deal with the Vice Chairman of Gyan Sagar Medical College, Sukhvinder Singh. JP Singh: Its just a mandatory requirement(second inspection). We have to get it done. Sukhwinder Singh: okay. JP Singh: you have to show an updated version of the report. The person who did not have choley bature will be there again. Sukhwinder Singh: the same inspector? JP Singh: Yes, He will get the work done. During a re-inspection on March 22, 2010, the MCI again said that there was no auditorium. The college authorities gave an undertaking to complete the construction within one week. The Executive Committee of the MCI on Arpil 5, 2010, suddenly approved the college and recommended the government that permission be granted for admitting fourth year MBBS students. Desai then called JP Singh using code language to say that a deal had been agreed upon. Ketan Desai: 'Badal's' relatives were here today. JP Singh: There was a blockage, he needed an angioplasty. Ketan Desai: Yes, I put in a stent, now it is okay. He will not need surgery. Based on these tapped conversations the CBI raided JP Singh's residence in Vasant Kunj on the April 23 and recovered a sum of Rs 2 crore, sent by Sukhwinder Singh, meant to be delivered to Desai. In the course of its investigation, the CBI got the voice samples of Desai and others verified. After Desai's arrest, CNN-IBN conducted a series of investigations that exposed how Desai ran the Medical Council of India like a cartel, extorting money from private colleges to grant them permission. While the government is struggling to clean the mess left behind by him - Desai today is out on bail. But the evidence against him is too strong to ignore now. Link: Original Article

October 21, 2011

Cabinet nod for amendments to NIMHANS Bill

Bangalore-based NIMHANS is all set to be re-constituted as a body corporate with all properties currently with the Union health ministry being transferred to the institute. The Union Cabinet, at a meeting chaired by Prime Minister Manmohan Singh, approved the amendments to the NIMHANS, Bangalore Bill 2010 based on the recommendations of the Parliamentary Standing Committee on Health and Family Welfare. While the Cabinet rejected the Committee's suggestion against incorporation of the institute as a body corporate, it accepted the suggestions on composition of the institute. "No change in Clause 4 (Incorporation of Institute) of the Bill is proposed in view of the legal advice obtained from the Department of Legal Affairs," Information and Broadcasting Minister Ambika Soni told reporters here. She said the Central Government will nominate the president of the institute from among the members other than the director. The original Bill had proposed that the Union Health Minister be the president of the institute, a proposal opposed by the Parliamentary Standing Committee which stressed that a political person should not head the institute. The National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore Bill 2010, which was introduced in the Rajya Sabha on December 7 last year, proposes to declare the institute as an institution of national importance. As per the amendments approved by the Cabinet, the institute shall consist of the chief secretary or his nominee, not below the rank of secretary, to the government of Karnataka, ex-officio. Link: Original Article

October 20, 2011

Hospitals ‘mint' money on heart stents

Company-cardiologist nexus leaves patients high and dry The stents, meant to unclog arteries of the heart, have become a major source to make a fast buck for many hospitals in the capital. With no mechanism to regulate the sale or use of stents, hospitals have developed a profit generating commission system at the cost of patients, with the tacit approval of cardiologists and stent manufacturing companies. There is no strong regulatory body such as the US Food and Drug Administration (USFDA) to monitor and regulate stents industry in India. As a result, Indian stents, according to experts familiar with the industry, although good in quality, are seldom prescribed and used on patients. Only imported stents are used and this opens up opportunities for the hospital management to charge exorbitantly. The government does not have a ‘pricing' control system of stents; as a result, patients are forced to pay hefty amounts. The commission system of stents works in an intricate way. “Suppose, there are four imported stent companies vying for a ‘contract' with a hospital. The company that supplies an imported stent at a very low price than the others is recommended by the cardiologist and chosen by the hospital. Only that stent will be used for a fixed period of time on all the patients by the hospital. Thanks to no regulatory body in India, these companies compromise on quality because they can't maintain quality standards at such cheap prices,” reveals a doctor close to the system. The stent manufacturing company first ‘ropes in' the cardiologist by coming into an agreement over the commission. After that, the company takes the cardiologist-approved stent to the hospital management for approval and eventually fixes commission to the hospital. “Unfortunately, the hospital and the doctors act like middlemen in a vegetable market who make money at the cost of patients. The Maximum Retail Price (MRP) of the stents will be hefty but the actual rate at which the hospitals purchase the stents will be very low. On some category of stents, hospitals make 100 per cent profit,” doctors concede. As a result of these commission schemes, the hapless patient ends up paying hefty amounts. “It all boils down to ethics. Nobody can question the surgeon on what kind of stent they are using on the operation table,” senior doctors say. In addition to charging the stents at MRP, corporate hospitals have introduced a system of imposing ‘handling charges' in the final medical bill. “In addition to the MRP, on an average, hospitals charge an extra 15 to 20 per cent on each stent towards handling charges. The government has literally turned a blind eye towards this malpractice,” officials close to the system said. Link: Original Article

October 18, 2011

Indian generic drug firms - pharma MNC patent fight to determine price of medicines

Last month, former Solicitor General Gopal Subramanium launched an impassioned argument in the Supreme Court against the rejection of a patent to Glivec, a leukemia drug made by pharma MNC Novartis. His appeal, which ran for three successive days, was directed at a controversial provision in the country's patent laws that have largely favoured domestic drugmakers. A week earlier, Natco Pharma had filed the country's first compulsory licensing application, a provision that allows a generic drugmaker to make and sell a cheaper version of a patented drug by paying royalties. The Indian company was taking aim at German firm Bayer AG's patented cancer drug Nexavar. In Natco's case, the government will decide if its application deserves merit. Whichever way the cases go, their outcomes will have far-reaching implications on the country's patent regime, which is at a tipping point thanks to a long-running battle between global drugmakers on one side and local companies and health activists on the other. The verdicts are also expected to bring clarity on a contentious issue and influence the plans of drug MNCs in India. Final Word Both sides are hopeful that the verdicts will go their way. "A loud and clear statement [will go out] to all that for India, nothing is more important than its people," says Dilip G Shah, secretary general at Indian Pharmaceutical Alliance, which lobbies for big Indian generic firms. But leading intellectual property lawyer Pravin Anand, who represents several foreign drugmakers, says the government and industry have not given due respect to innovations or patents. "For years, we have been saying we are not ready. It is time we bite the bullet," says Anand. In any case, the cases will have a significant bearing on the grant of patents in the country, thereby affecting the cost of treatment. Generic medicines produced by Indian companies are cheaper by up to 35 times than foreign drugs. Novartis is seeking clarity on the interpretation of Section 3(d) of the patent law, a provision that rejects patent claims for incremental innovation unless it provides significantly enhanced thereupatic efficacy over known compounds. The provision has long been the cause of the rejection of several patent claims in India's four patent offices and courts. The case centres on the legal interpretation of certain terms in the section such as "efficacy" and "known substances". Novartis has faced two reversals related to the drug in lower courts. The case, now in the final leg, is due to be heard afresh after one of the judges recused himself. Natco's application will decide the government's policy on allowing generic firms to market their version in public interest, dreaded words for a patent holder. Natco says Bayer's drug, at about `2.85 lakh for a month's dose, is unaffordable for patients. The company wants the government to force Bayer to grant a licence to sell its own version at `8,900, or 32 times cheaper. Industry watchers have dubbed the move as a small step for Natco but a giant leap for the Indian generic industry. Amit Sengupta of the People's Health Movement says a favourable verdict will encourage more Indian companies to knock on the government's doors. Weak Regime? Despite reservations from some quarters, India adopted a new patent regime in 2005 that gives a patent holder 20 years exclusive rights to sell its products in a country where about a third lives below poverty line and cost of health care is among the main causes of indebtedness. Until then, India followed a patent regime . adopted by the Indira Gandhiled government in 1971 . that allowed local firms to make generic copies of patented products as long as they used a different process. The new patent regime also ushered in a growing number of patent disputes between global drugmakers and Indian generic companies. MNCs have been calling for stricter enforcement and interpretation of some its clauses. Their dismay stems from the practice of lower courts typically siding with Indian companies, bearing in mind public interest. "There are some issues that need to be addressed such as the interpretation of Section 3(d) and issue of data exclusivity," says Tapan J Ray, director general at Organisation of Pharmaceutical Producers of India (OPPI). But Pratibha Singh, another Delhibased lawyer, says the IPR implementation since 2005 has been 'absolutely perfect'. The objections of a few pharma firms do not mean the implementation is ineffective. Still, some independent experts say though India's patent regime appears fairly sound on paper, there is room for improvement. ''There are still several gaps in terms of its actual implementation,'' says Shamnad Basheer, professor in IP Law at National University of Juridical Sciences. This includes a shortage of well-qualified patent professionals, limited capacity at patent office and courts, among other constraints. What is now clear is that India Inc, in particular the drug industry, will have to live with patent disputes for at least 50 years as is in the developed markets, says Singh. Global MNCs, meanwhile, have threatened to halt their investments in India, particularly in R&D. Firms such as Novartis have shown that it is no empty threat. According to Shah, it's a trade-off between FDI and public health. The Indian pharmaceutical industry has emerged as a global player on its own and it is capable of judging its interests, he says. The key concern of the government and health activists is that a weak patent regime would make drugs unaffordable. If Novartis wins, India may end up granting far more patents than required under international trade rules or envisioned by India's lawmakers, says Geneva-based NGO Medicines Sans Frontiers. The best way for the government to balance promoting innovations and access to drugs is by limiting grant of patents to deserving inventions, say experts. ''Compulsory licensing is a key tool in this balance between innovation incentives and access to medicines as it ensures easy availability of affordable medicines and also compensating the innovator,'' says Basheer. Link: Original Article

October 16, 2011

Delhi docs at heart of UK medical insurance scam

Indian doctors and their touts providing false medical certificates as part of an insurance scam for visiting foreign tourists have been named and shamed by investigating journalists of a British newspaper. UK medical insurers estimate that India accounts for at least six cases of medical insurance fraud every month worth lakhs of rupees. India is not the only South Asian country to which medical insurance scams are sourced. Earlier this year, a Pakistani-origin businesswoman, Rozeena Butt, tried to claim £2.2 million from insurers after pretending to die from dehydration in Pakistan. She was exposed when police investigators found her own fingerprints on her death certificate! India-centred scams are often promoted by touts operating from commercial centres like Connaught Place in Delhi, who work hand-in-glove with corrupt doctors, and in one case, even with the owner of an ambulance service. London's Sunday Times newspaper has identified a clinic in South Delhi where the doctor in-charge fabricated nine medical bills worth Rs 1,80,220 before demanding his cut of around 20 per cent. He even drove the visiting reporter to a cash machine so that he could collect his share of the bogus transaction. Afterwards, he commented, "Buy a bottle of beer and drink on the street. That's the best thing you can do in India." Although the doctor’s corrupt behaviour was captured on video, he subsequently denied he had done anything wrong, including given a false medical report. He told the Sunday Times, "It’s not possible on earth. It did not happen. We have a very strict system here. When a patient comes here we see what are the symptoms. I remember that guy (the reporter); he was having serious food poisoning. He had come from some other country, I don't remember from which place he had come. Try to understand, he had that disease… he was suffering from loose motions or something. Food poisoning is a serious disease in India." The newspaper also names a dentist based at a clinic in Delhi's Palam area close to the international airport. He also handed over fabricated medical documents falsely claiming that the newspaper's reporter had been hospitalised for six days suffering from dengue fever. The newspaper goes on to quote the dentist as saying, "There is an MD, medicine, at a hospital. I can get stuff made there. We can show you were admitted there for a few days. Kidney stones is one thing that cannot be proved, nothing show up (afterwards) for six days. The doctor charges 20,000 rupees and I will take some, at least 5,000 rupees. And we will show 1,50,000 rupees." DOCTORED MOVES India accounts for at least six cases of medical insurance fraud every month Scams often promoted by touts operating from commercial centres like Delhi’s Connaught Place FALSE DEATH CERTIFICATES TOO! The newspaper says there is an even more lucrative scam operated by the owner of a Delhi ambulance service. He charges Rs 60,000 for providing false death certificates. The ambulance service owner is quoted as saying, "It (the certificate) will be original, not a fake one. The certificate is prepared by an officer. A senior doctor will sign it with his own hands. It will all be genuine. These are official, government-approved documents." Link: Original Article

October 15, 2011

1 doc for 1,000 people not before 2028

India will take at least 17 more years before it can reach the World Health Organization's (WHO) recommended norm of one doctor per 1,000 people. The Planning Commission's high-level expert group (HLEG) on universal health coverage (UHC) — headed by Dr K Srinath Reddy — has predicted the availability of one allopathic doctor per 1,000 people by 2028. It has suggested setting up 187 medical colleges in 17 high-focus states during the 12and 13five-year Plan to achieve the target. HLEG estimates that the number of allopathic doctors registered with the Medical Council of India (MCI) has increased since 1974 to 6.12 lakhs in 2011 — a ratio of one doctor for 1,953 people or a density of 0.5 doctors per 1,000 people . The nation has a density of one medical college per 38.41 lakhs. There are 315 medical colleges that are located in 188 of 642 districts. There is only one medical college for a population of 115 lakhs in Bihar, UP (95 lakhs), MP (73 lakhs) and Rajasthan (68 lakhs). Kerala, Karnataka and Tamil Nadu each have one medical college for a population of 15 lakhs, 16 lakhs and 19 lakhs, respectively. The HLEG has proposed a phased addition of 187 colleges. It expects that by 2015, under phase A, 59 new medical colleges will admit students in 15 states like Assam, Bihar, Chhattisgarh, Gujarat, Haryana , J&K , Jharkhand, MP, Maharashtra , Meghalaya, Orissa, Punjab, Rajasthan, UP and West Bengal. By 2017, 13 of these states will have an additional 70 medical colleges, and by 2022, another 58 institutes will be built in two additional phases (2017-2020 and 2020-2022 ). By 2022, India will have one medical college per 25 lakh population in all states except Bihar, UP and West Bengal. The implementation of HLEG's recommendations will enable the additional availability of 1.2 lakh doctors by 2017, and another 1.9 lakh doctors between 2017 and 2022. "With this rate of growth, it is expected that the HLEG target of one doctor per 1,000 will be achieved by 2028," the report says. It recommends that along with establishment of new medical colleges, the admission capacities of existing colleges in the public sector should also be increased. Partnerships with the private sector should be encouraged, with conditional reservation of 50% of seats for local candidates, fixed admission fees and government reimbursement of fees for local candidates. The World Health Statistics Report (2011) says, the density of doctors in India is six for a population of 10,000. India is ranked 52 among 57 countries facing human resource crunch in healthcare. The nation has the largest number of medical colleges in the world, with an annual churning rate of over 30,000 doctors and 18,000 specialists. The average annual output is 100 graduates per medical college in comparison to 110 in North America and Central Europe (125). China, which has 188 colleges , produces 1,75, 000 doctors annually, with an average of 930 graduates per institute. Link: Original Article

October 13, 2011

MCI issues migration guidelines for medical students

The Medical Council of India has issued guidelines on inter-college mig-ration of MBBS students. Migration of students from one medical college to another would be restricted to five per cent of the sanctioned intake of the college during the year. No migration will be permitted from one college to another located within the same city. Migration of students is permissible only if both the colleges are recognised by the Centre under Section 11(2) of the Indian Medical Council Act 1956 and further subject to the condition that it shall not result in increase in the sanctioned intake capacity. The candidate shall be eligible to apply for migration only after qualifying in the first professional MBBS exams. Migration during clinical course of study shall not be allowed. An applicant candidate shall first obtain a NoC from the college where he/she is studying and the university to which that college is affiliated and also from the college to which the migration is sought and the university it is affiliated to. He/she shall submit the application for migration within a period of one month of passing along with the above cited NoCs to: (a) the director of medical education of the state, if migration is sought within the state or (b) the MCI, if the migration is sought from one college to another outside the state. Link: Original Article

October 11, 2011

Rs75-90 lakh can turn you into a doctor too

The rot is setting into the medical education system. On the one hand, the lure of money is encouraging miscreants to cheat gullible students and parents; while, on the other, the lure of a lucrative profession is seeing undeserving medical students from rich families becoming doctors as they are able to pay huge amounts to agents (or miscreants) for seats in reputed medical institutions. In both cases, it is the miscreants and their supporters, from within college managements, who run all the way to the banks – unless, they are nabbed. And that’s what Central Crime Branch (CCB) police did on Monday while busting two such gangs involved in cheating students and their parents for huge amounts of money. CCB police have arrested eight persons — including a doctor — in connection with the sale of returned seats for medical students. The arrested were cheating the students to get the returned seats across the state and also in other states. The gang extracted letters of seat rejections from students who passed the Common Entrance Test (CET) and COMED-K exams and got seats in the respective college based on their merit for mediocre students. The police said the letters were received just before the seat distribution on promising the merit students huge amounts of money.The letters were taken to the students struggling to get seats, and promised to have those seats allotted to them by charging as high as Rs75 lakh to `90 lakh per seat. Preliminary investigations revealed that some of the institution administrators and brokers are also involved in this business. Police received a tip-off that such a business is being run by a member of administration board of Kempegowda Institute of Medical Sciences (KIMS), named A Prasad. A case was registered with Central Police Station. The arrested were taken into police custody after producing in the court. They have been identified as Dr Ibrahim Pasha, 40, a resident of 10th cross, Wilson Garden; Rafath Mallik, 53, a resident of fifth cross, fifth block, HBR layout; Sheik Abdul Farooq alias Farooq, 40, second main, BK Nagar, Yeshwanthpur; Ramachandrasa, 32, a resident of third cross, KR Garden; KZ Vaheem Ahamed alias Faheem, 32, a resident of Gandhinagar, Chickmagalur; Syed Abrahar, 32, a resident of RT Nagar; Istiyaq Ahamed alias Istiyaq Pailwan, 40, a resident of Shivajinagar; and Rajagopala Reddy, 60, a resident of 7th Cross, Koramangala. The police have seized applications filed from the students, marks cards, Comed-K hall tickets, Rs3.72 lakh, Rs7 lakh which they have received through demand drafts, eight mobile phones, and a car. The CCB has said if anyone has been cheated by this gang, they can contact police inspector S Hanumantharaya on 9480801061 or assistant commissioner of police Ajjappa on 9480801029. In another case, the CCB police arrested three persons – Nagaraju, 42, a resident of Yalahanka New Town; Ananda, 45, a resident of KR Puram; and KG Basavaiah, 39, a resident of Malleswaram – for cheating a native of Tamil Nadu, Mahalakshmi, daughter of Channayan, an employee of horticulture department in Tamil Nadu of `18 lakh against a promise of getting her a medical seat in Dr Ambedkar Medical College in Bangalore for the academic year 2011-12. Channayan paid them the advance amount, which included Rs3.25 lakh though demand draft. But the accused later demanded a total payment of Rs42 lakh, saying that the rates for the medical seats had shot up. M Singham, Mahalakshmi's uncle, filed a complaint with Pulakeshinagar police station on September 30. The police have seized a car and Rs16 lakh from the three. Probe revealed that the trio had cheated over a hundred gullible students. The CCB police have said if anyone has been cheated by this gang they can contact Police Inspector SR Tanveer, (9480801425) or assistant commissioner of police SY Hadimuni (9480801030). Blocking rampant Medical seat aspirants take many entrance tests conducted by Medical Council of India (MCI), Rajiv Gandhi University of Health Sciences (RGUHS) and Comed-K. For example, some candidates who have got top ranks in both MCI and Comed-K entrance get contacted by agents. Agents convince the candidates to attend counselling and block the seat. For this they pay about Rs10 lakh to 15 lakh. The agents then go to that particular college for which the seat has been blocked and bring some Non-Karnataka candidates and transfer that blocked seat to them for Rs30 lakh to Rs40 lakh for their "services". The college managements, too, get a share. Cost lures profit The business of starting a medical college is taking new dimensions every year. "A deposit of Rs5 crore has to be paid to the joint account of the Medical Council of India for the college management to get a licence. The college should have 10 acres and an over 200-bed hospital to take in 50 students a year. The intake of students can increase along with the increase in the number of beds in the teaching hospital. If the hospital attached to the medical college has more than 350 beds, the student intake can be 80 and 100 students for 600 beds," said one of the board of directors of a newly-established medical college, on conditions of anonymity. He said the cost involved to start a medical college will be around `350 crore. The "side business" of luring mediocre students by charging them high amount only acts a faster mechanism to keep profits rolling in. "This is purely a business. You invest and get your money back with premium. Most institutions one can find are under some educational trust. No individual starts a college as there will be hurdles like income tax," said one of the trustees of a medical college. What Comed-K says A top official of Comed-K told DNA: "I don't know where the system failed in the case of blocking of seats. But there are agencies like universities, the MCI and Directorate of Medical Education and so on that keep tabs on errant colleges." Link: Original Article

October 09, 2011

Overseas doctors to undergo language test for UK

Foreign doctors coming to Britain seeking employment will now have to undertake a mandatory English test before being allowed to work in the Nation Health Service (NHS). The General Medical Council is to get new powers to take action over concerns about a doctor's ability to speak English, the Daily Express reported. Health Secretary Andrew Lansley will use his keynote conference speech to unveil the measures Tuesday. The step follows widespread concern that many patients are struggling to make themselves understood by foreign-born doctors in hospitals, clinics and General Practitioners' surgeries. Lansley will announce mandatory language tests at a local level for doctors recruited to the NHS in England from overseas. All doctors will have to prove they can speak a good level of English before they are allowed to work in England. The proposals will ensure patients are treated by doctors who they understand and who understand them. NHS rules will be amended so health chiefs responsible for ensuring medical staff are trained and qualified have a duty to check English language skills. On Monday night, Lansley said: "There is considerable anxiety among the public about the ability of doctors to speak English properly. "After 13 years of inaction from Labour to tighten up language controls, we will amend the legislation to prevent all foreign doctors with a poor grasp of English from working in England. "If you can't speak adequate English, you can't treat patients." Link: Original Article

October 08, 2011

Aarogyasri lays thrust on govt hospitals

The Aarogyasri Health Care Trust, set up by the Andhra Pradesh government four years ago to facilitate implementation of health insurance to the poor, is planning to focus more on government hospitals over private hospitals. The trust has already de-listed 97 private hospitals due to lack of infrastructure facilities and for not following the stipulated guidelines. Under the Aarogyasri scheme, the state government allocates Rs 1,400 crore every year, of which 40 per cent is mandated to be spent on government hospitals and the rest on private hospitals. The ratio of allocation of the budget to government and private hospitals was 17:83 last year. It has been increased to 27:73 in the last two-three months. “We are aiming at achieving the target of 40:60 ratio by the end this financial year,” said N Srikanth, chief executive officer of the trust. The Aarogyasri scheme covers 938 therapies for the 80-million population of the state. Around 350 hospitals in the state were registered under the scheme, of which 240 are private. Around 75 per cent of the country’s total population live in small towns and rural areas, whereas more than 80 per cent of medical care facilities are in urban areas. And, 90 per cent people need primary healthcare. Healthcare and administrative costs have gone up in recent years, and it would be difficult to sustain the scheme with the budget, Srikanth said. To address the future issues, the state government has proposals to rope in the Administrative Staff College of India or the Public Health Foundation of India to do the feasible study and come up with a sustainable report to reduce costs. “We are making a questionnaire to mandate the study. We will finalise the organisation in the next 7-8 months,” Srikanth said. Link: Original Article

October 07, 2011

Supreme Court directs pvt hospitals to treat poor free

The Supreme Court on Thursday asked all private hospitals in Delhi to earmark 25% of their out-patient department capacity and 10% in-patient department capacity for free treatment of poor and directed the Delhi government to discuss with hospitals to evolve a guideline on high-cost health care. When a bench comprising Justices R V Raveedran and A K Patnaik was highly critical of the Delhi government for not holding meaningful discussions with the private hospitals on free treatment of poor patients, Dr R N Das of the directorate of health services stood up and answered each query. He said that of the 40 identified multi-specialty hospitals in Delhi, 27 are extending free treatment to poor as per the Delhi High Court's direction. Three had claimed that they did not get land at concessional rate and hence were not obliged to extend free treatment to poor. Of the remaining 10, three -- Bhagwati Hospital and two Max Super Specialty Hospitals -- have agreed to implement the HC judgment, he said. On a question from the bench, Dr Das said that the nodal agency for poor patients was in constant touch with all hospitals for vacancy in beds and accordingly referring them there. Advocate Ashok Aggarwal said even Sir Gangaram Hospital and Batra Hospital, which were as good as any other super-specialty hospital, were providing treatment to poor patients completely free of cost as per the HC order. After hearing Dr Das and Aggarwal, the bench said: "If 27 hospitals are providing free treatment to poor, then the other 10 cannot claim to fall in a different category." However, senior advocate Mukul Rohatgi said that Dharamshila Hospital was specialising in treating cancer patients, which was a costly affair. The bench agreed and asked the Delhi government to examine whether any relaxation could be made for those hospitals which specialise in one branch of treatment and also to lay down guidelines on high-cost treatments. The Delhi government had rejected the proposals from private hospitals seeking dilution of the norm for free treatment of poor which they were obliged to give because of allotment of land at very cheap rates. Though the lease agreement provided for treatment of poor patients up to 25% capacity in both IPD and OPD, the Delhi High Court in March 2007 had reduced the quantum of free treatment to poor patients to 10% IPD and 25% OPD in all respects. Link: Original Article

October 06, 2011

Gujarat to soon have govt medical stores

After the success of its 108 emergency services, the Gujarat government is now proposing setting up medical stores across the state to sell medicines at subsidised rates. Speaking at the inaugural ceremony of Pharmac India 2011, state minister for health and tourism, Jaynarayan Vyas said that the state government would set up medical stores that would sell generic unbranded medicines. Held by the Indian Drug Manufacturers Association (IDMA), Pharmac India 2011 is the second international exhibition of India's prominent pharma and healthcare industry "Government would buy these generic medicines directly from manufacturers under its purchase program. The idea is to offer affordable medicines to consumers across the state," said Vyas. Elaborating on the proposed plan, Vyas said that a generic medicine like paracetamol will be sold in an unbranded version at one-third of its market price. Vyas, however, did not comment on the number of such proposed stores across the state. Similarly, talking about more such plans, Vyas said that the government is also proposing to offer 104 services, on the lines of the 108 emergency services. Under this, the government would hire medical doctors who would be available round-the-clock for offering medical advice on phone for common diseases. Later, speaking at the inaugural ceremony, Maheshwar Sahu, principal secretary, industry and mines, Government of Gujarat invited the pharma industry body IDMA to hold the third edition of Pharmac India at the Vibrant Gujarat Global Investors' Summit (VGGIS) in 2013. According to KS Chhabra, secretary, IDMA Gujarat Chapter, about 300 stalls have been set up at the three-day exhibition which is expected to see 20,000 footfalls this year. "When held alongwith VGGIS 2013, we are expecting over 1,000 stalls, given the response this year from participants," said Chhabra. While nationally IDMA has over 750 members, around 180 of these are from Gujarat. Link: Original Article

NABH & BD Collaborate to develop quality standards for hospitals in India

NABH (National Accreditation Board for Hospitals & Healthcare Providers) and BD (Becton, Dickinson and Company) signed a Memorandum of Understanding (MoU) to support hospitals in attaining quality-of-care standards for infection control. This collaboration is an effort to strengthen health systems in India and promote continuous quality improvement to ensure quality care for patients when visiting hospitals with effective infection control practices in place. With the wider rollout of community health insurance initiatives, there is an increased demand for bed capacity. Existing small and medium-size hospitals, estimated to account for more than two-thirds of all beds need to strengthen the quality systems and these hospitals can achieve quality-of-care systems by standardizing and adopting necessary infection control practices to ensure patient and healthcare worker safety. Speaking on the occasion of the signing, Dr Giridhar J Gyani, Quality Council of India, Secretary General and CEO, NABH said: “Our objective is to develop a basic infection-control standard for all hospitals delivering healthcare in India. The association with BD will enable us to provide on- and off-site technical support to collaborating institutions for upgrading their infection control practices.” NABH has recommended quality toward safe injection practices, waste management and infusion safety, to name a few, as minimum requirements across hospitals in India, following the lead of several facilities undertaking these processes. Most of these hospitals are high in volume and have the bandwidth as well as the desire to improve clinical outcomes; whereas the quality of care in smaller hospitals, especially which are government empanelled is much more varied in terms of infection control practices. NABH is currently operating in India with nearly 500 hospitals in various phases of accreditation, and nearly 100 hospitals are already accredited. Said Mr Manoj Gopalakrishna, Managing Director, BD - India: “BD has always worked toward achieving our purpose of ‘Helping all people live healthy lives’. The MoU with NABH is an innovative collaboration for enhancing patient safety and healthcare worker safety in India. BD will leverage our global experiences in implementing infection control programs by supporting NABH to enhance infection control standards in the hospitals of India.” This collaboration will have three phases. During Phase One, initial workshops would be carried out across hospitals in India to ensure the SAFE-ISM program is adopted by hospitals as a stepping stone towards achieving quality. This will be followed by the second phase where Centers of Excellence (CoE) and Health Economic models will be developed for the benefit of Indian Healthcare after dissemination of Safe-I program. The last phase will augment national capability of standards dissemination by developing additional CoE (or suggest spelling it out in both instances). SAFE-ISMcertification will be viewed as a precursor for preparing HCO (Healthcare organisations) or SHCO (Small healthcare organisations) for NABH accreditation. Through its experienced field force, BD will guide applicant hospitals toward SAFE-ISM preparation and other relevant training and development workshops. Link: Original Article

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