If one visits the Goa medical college hospital, especially the outpatient departments’ one is ready for a cultural shock. The first impressions one gets seeing those old, sick or wounded patients mostly senior citizens, women and children, standing crushed in queues after queues at every stage, makes one wonder is Goa still an occupied territory, and certainly the facilities are at least twenty years behind, considering especially that Goa had governments which always spoke about developments, digitalization, modernization etc and etc. One realizes that all these talk about progress and development is mere rhetoric. One can only hope that at least with the elections which are just over some genuinely concerned persons get elected and consider revamping all those outmoded systems of issue of chits, long queues at registrations at every departments, and provide comfort and solace to all those old, frail, injured, wounded and sick patients, some basic facilities like proper sitting arrangements, avoid long and uncertain waiting, drinking water etc.
There seems to be total disinterest and lack of thinking on the part of the policy makers and the Health administrative set up of the State. The health Ministry of the State should realize that it is not every day or even ones a year that people visit hospitals. It is only when it becomes inevitable. The Doctors, Para medics and other staff might be so used to the system that they are not likely to perceive any anomaly or malfunctioning but for a patient, who is either sick, old or wounded, it is mostly a first time visit and he or she is visiting to seek quick relief from their pain and suffering, but the queues and the inconvenience at every stage makes them further sick or helpless. It is not that the facilities should have been expanded based on the overall increase in the number of patients, though that would have been ideal, but there is need for at least a thought of reducing patents inconveniences, ones they enter the campus.
A Patient entering the campus is first faced with the traffic chaos, with vehicles both two wheelers and four wheelers parked haphazard, even at the entrances to most departments, with no proper sign boards directing them to parking facilities, and no facility for dropping a patient to the point where he can reach his place of treatment, it is all utter confusion. Then comes making of what is called the OPD slip/registration, one faces long queues and lethargic staff, who seem to be least affected by the confusion and noise outside their counter, where a patient according to his ailments is asked to go to a particular room with certain numbers, but where are those rooms?, how to reach there? , are all riddles they face, with absolutely no sign boards or directions. Then after reaching the particular room one is again faced with long queues, token numbers, sick and sicker people standing around all anxiously waiting to meet the doctor, no place to stand, the few seats are often occupied by the patient escorts most of the time. Then after meeting the Doctor if the Doctor asks for further investigation like, X ray, blood test , urine tests, echocardiogram, ECG etc, the patent is given just the room numbers, it is for the patient to find where these facilities are ,and each of these places will have again long queues for registration, tokens etc. The only persons who can function smoothly in such a system are the doctors, paramedics, and few professional patients, but what about the large number of ailing people, for them mostly it is their first visit to the hospital, that too in conditions in which any inconvenience and delay would aggravate their ailments. No thought is given of such persons by anybody. It would be unfair to blame the Doctors and paramedics who themselves function in these pressing conditions with often less than the minimum required facilities. Not even the senior Doctors are given a comfortable consulting/examination rooms, all their facilities to function are just primitive and minimal
Most of these patient miseries could be much reduced by a computerized system of patient registration and a system. No doubt these are areas involving financial transaction, and the departments and the authorities will be keen to get involved. But what about the patient convenience and facilities? May be since most of the elected representatives and the ministers would fly to Mumbai for their treatments, the concern of the common man is not their concern at all?
After all we are supposed to be living in a welfare state, where each citizen is important not just for voting but their well being as well. That is why the basic document of governance of the Nation , The Constitution of India, has specifically spelt out the responsibility of the state towards its citizens health, in Articles: 38, 39,41, and 47 of the Constitution. The Supreme Court of India has further interpreted right to health as a fundamental right included under article 21, which speaks about the right to life. Thus making it as of paramount importance and the responsibility of the State to ensure suitable health services to its citizens.
The Supreme Court, in Paschim Banga Khet mazdoor Samity & ors v. State of West Bengal & ors, and many other cases have held that it is , the primary duty of the government is to secure the welfare of the people. Providing adequate medical facilities for the people, is an obligation undertaken by the government in a welfare state and that failure on the part of a government hospital to provide timely medical treatment to a person in need of such treatment, results in violation of his right to life guaranteed under Article21. The Court also made certain additional directions including that State level hospitals, should have a centralized communication system.
In the constitutional scheme of division of powers health care facilities is under the State List, at Clause No.6 and therefore the primary responsibility to provide suitable health facilities is on the State government and that is why there is a ministry of health, which is often headed by a senior minster.
(The writer is a Professor of Law)
