The Telegraph
Saturday , March 1 , 2014
CIMA Gallary

SSKM blamed for no-refusal failure

A plan to ensure that SSKM does not turn away critical patients flopped because of lack of effort by the hospital administration and the reign of touts, said experts who had mooted the idea.

Following a suggestion from an expert group on public health service, the government created a 44-bedded emergency observation ward six months ago to accommodate critical patients who could not be allotted a bed immediately.

The plan was to keep such patients in the emergency observation ward for 72 hours — a crucial window for critical cases — and then shift them to the indoor ward concerned.

Had the government followed the protocol, doctors at SSKM should have kept Madhumita Halder, whose left leg was crushed under the wheels of a bus last Wednesday, in the emergency observation ward and stabilised her condition before shifting her to an indoor bed. Instead, they sent her away, defeating the purpose of creating the observation ward.

Officials said a percentage of indoor beds should be kept aside for patients being referred by the emergency observation ward. That will ensure that a certain number of beds in the observation ward are free on a given day to accommodate critical patients.

“That is not happening at SSKM, where the emergency observation has been unofficially converted into another indoor ward. Patients are staying there for the entire duration of their treatment, at times for weeks,” said an official.

Even when indoor beds are available, another official pointed out, the hospital administration prefers to allot them to patients being referred by the OPDs instead of those being sent by the emergency observation ward.

“Emergency observation wards should function in the way they are supposed to. That will ensure that beds are continuously made available for new patients either by transferring old patients to the wards or by discharging them after treatment. Critical patients will be denied treatment if emergency observation wards are treated as another general ward,” said critical care expert Subrata Maitra, the chairman of the expert committee on public health service that had mooted the plan of setting up emergency observation wards.

“It’s true that the OPDs refer a large number of patients for admission, but a certain percentage of beds has to be reserved for patients from the emergency observation wards. The hospital authorities have to devise a mechanism for that,” Mitra pointed out.

Sources said 10-15 per cent of indoor beds, including a few in private cabins, become vacant everyday. “Because of lack of synchronisation, not a single bed is allotted to a patient from the emergency observation ward. Another reason for beds not being allotted to patients from the observation ward are the touts, who have a significant say in admission,” said a senior SSKM official.

“The pressure of referral patients is too much on SSKM and long stay of patients make it even more difficult for us to implement the system (to keep beds vacant),” said Pradip Mitra, the director of Institute of Post Graduate Medical Education and Research-SSKM.

A review meeting at Swastha Bhavan on Friday decided to appoint a nodal officer who would monitor the utilisation of the emergency observation wards and submit reports to the health department.

Chief minister Mamata Banerjee will inaugurate several facilities at SSKM on Saturday, including an intensive therapy unit. The hospital will also get another 81 beds. Health care experts, however, said merely adding beds would not cure the ailments of the largest state-run referral hospital.