The Deen Dayal Swasthya Seva Yojana (DDSSY) has been in the eye of the storm ever since it was announced and the private hospitals were up in arms against the decision to give them only selective procedures and the rates.
Bowing to this government announced all 447 interventions would be given to private hospitals.
All said and done, Deen Dayal Swasthya Seva Yojana (DDSSY) is a laudable initiative aimed at providing quality healthcare to those residing in Goa for five or more years, irrespective of their financial status.
But it appears that a thorough study of the scheme has not been made and it is again the rush that may take its toll.
Apprehensions are whether the scheme will impact GMC? Will the conditions deteriorate due to less footfalls of the patients.
Initially DDSSY provided for only 176 procedures to be shared with private sector.
But all of a sudden, possibly under pressure from private hospitals, all 447 procedures have been opened also to private sector.
Since people are likely to opt for private hospitals, with better amenities and facilities, the in-patient and out-patient turnover at GMC will drop drastically, say doctors and students.
The quality of doctors graduating from GMC will be hit due to lack of exposure and experience, in absence of patients and GMC will resemble private, deemed teaching institutes, producing sound doctors with no exposure.
The additional 50 MBBS and 22 PG seats approved recently are based on GMC’s present bed occupancy of 79-81% and daily OPD of around 1400-1600 — 75% and 1200 being minimum. Even minor decrease in patients could result in de-recognition and withdrawal of approval of additional seats or even reduction, after the MCI inspection due in January.
GMC ranks among the 50 top Medical Colleges in the country, has a better doctor-patient ratio than most hospitals and caters to 25% of all deliveries in Goa, 20,000 major surgeries annually and innumerable minor procedures stand testimony to the skills and dedicated care of its staff.
Prominent doctor and social activist Dr Oscar Rebello says the medical care might see an improvement but the scheme would hit medical education.
“To a certain extent, it would affect the functioning of GMC. On the basis of emergency care, we understand the scheme would help but you cannot increase the number of medical students per year because patients would be less in number,” he says.
“The students need to learn through patients arriving at the hospital (under the guidance of senior doctors). But once the patients are routed to private hospitals, not many will be seen in GMC. On what basis we will ask for further increase in seats?” he stated.
At the same time, he apprehended that it would lead to duplication of health costs in the State. “The government is already funding primary health centres and other State-run medical institutions. With this scheme, it will have to also fund private hospitals… In real sense, the scheme will balloon the health budget,” he commented.
On the other hand, free health scheme has the support from a large section of private practitioners who claim it will bring respite to overworked doctors in the State-run Goa Medical College and Hospital as they will be in a far better position to give attention to their respective patients.
These senior doctors have rubbished arguments that the scheme will have negative impact on the Asia’s oldest hospital.
“It will not affect the functioning of GMC. The scheme will rather reduce the work of overworked doctors, who are unable to carry out their routine medical activity in the present scenario. The quality of work will thus improve, especially with the GMC recently equipped with super specialty and trauma care centres,” Dr Vithal Mardolkar, who runs a maternity hospital at Bicholim, told Herald.
His views were backed by Margao-based Dr Shailesh Kamat stating that long wait of patients seeking treatment for serious ailments like heart problems would be cut short. “The scheme is designed in such a way that GMC’s workload is simplified. Moreover, patients with serious health issues will not have to wait long because the situation at present is that patients are forced to wait for one month or more for appointments (for surgery or treatment). The waiting list is long…” he stated explaining that doctors would also get enough time to concentrate on the academics, which is currently ignored owing to the work pressure on the teaching faculty.
Dr Mardolkar also added the scheme will allow more time to deal with seriously ill patients.
Dr Chandrakant Shetye of Vision Multispecialty Hospital, Mapusa echoed Dr Kamat’s opinion that academics will be greatly improved with the implementation of the scheme. “There is hardly any research carried out in the college-cum-hospital basically because the doctors have no time as a result of the increasing workload. The medical students should be able to learn their subjects thoroughly because doctors will pass out from this institution and not private hospitals,” he mentioned.
On the claim of others that the scheme would affect the hospital’s recognition, Dr Kamat has denied this myth stating as per Medical Council of India’s guidelines, the bed coverage has to be 75 per cent of 700 beds for 150 MBBS seats (525 beds). While GMC’s bed capacity is 1160, he added, ruling out fear of decrease in medical seats.
Renowned gynaecologist Dr Eugene Da Silva is, however, not confident that the scheme will last long stating it is not viable in terms of finances.
“It is a non workable scheme and unlikely to be a popular one… I don’t think it will last for even six months. The mathematics of the scheme will not work out,” he explained.
He went on to state that insurance companies are not charitable organisations as it would not make 100 per cent funding to the private companies for medical procedures. Part of the bill payment, he added, will have to be borne by the patients at private hospitals.
