The Telegraph
Wednesday , July 30 , 2014
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Referral despite empty beds

- Patients made needless trip: Official

Calcutta, July 29: The health department is probing charges that several critical patients of suspected Japanese Encephalitis had to make long and arduous journeys after being told to go to North Bengal Medical College and Hospital by at least two district hospitals that had critical-care beds vacant then.

Swastha Bhavan officials said an initial probe has shown that over a hundred people with symptoms similar to Japanese Encephalitis, some of whom later died, could have been treated at Jalpaiguri District Hospital and MJN Hospital in Cooch Behar.

Instead, they were referred to NBMCH, which is an over-four-hour trip from Cooch Behar and about an hour and a half away from Jalpaiguri.

The superintendent of Jalpaiguri district hospital refused comment. His counterpart in Cooch Behar could not be contacted over phone.

Each of the two district hospitals has 10 CCU beds with ventilator facility meant primarily for Japanese Encephalitis patients.

The principal secretary of the state health and family welfare department, Moloy Kumar De, has started a probe into the allegations that over 100 patients were “unnecessarily” sent from these two hospitals to NBMCH.

Doctors have said that the treatment for Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES) — the umbrella term being used to categorise all patients whose tests have not confirmed Japanese Encephalitis — is symptomatic and supportive.

“In case of Japanese Encephalitis, patients can suffer convulsions. If the convulsions are acute then they need ventilator support. But with too many patients being referred to the medical college (in Siliguri), there is overcrowding,” said an official.

“Also, conditions of many patients became critical after travelling five to six hours on bad roads,” he said.

Last week, chief minister Mamata Banerjee, also the state health minister, had suspended three senior officials — the chief medical officers of health of Jalpaiguri and Darjeeling and also the medical superintendent of NBMCH.

“We first came to know about so many referrals last week when a team of health officials from Calcutta visited the medical college in Siliguri. We found that more than a hundred patients suffering from JE, many of them having convulsions, were sent in a critical state to the medical college when there were beds available in CCUs of these two hospitals,” said a senior health department official.

The Telegraph has earlier reported how the referral system caused overcrowding in medical colleges where patients are turned away because of lack of beds, while at smaller hospitals beds are vacant.

Swastha Bhavan officials said that they had found out that some of the patients were initially admitted to these district hospitals but after their condition turned critical they were told to go to NBMCH.

The hospital documents of Jalpaiguri and Cooch Behar show that on the days when the patients were referred to NBMCH, the beds in the CCUs in these two district hospitals were vacant, the official informed.

“Once the probe is over, if the doctors are found guilty of unnecessary referrals, then action will be taken against them,” said the official. “Some of these hospital officials claimed there were no neurologists to treat the patients. But in most cases, the patients needed to be stabilised and MBBS doctors can do that. If required, they could have called up neurologists at NBMCH and sought their help,” said a health official.

According to health department sources, the 10-bed CCUs with ventilators in both the hospitals were set up after chief minister Mamata Banerjee came to power in 2011.

Each CCU was set up at a cost of Rs 2.5 crore from the JE/AES fund provided by the Union health ministry. According to health ministry guidelines, CCUs in hospitals in Japanese Encephalitis-endemic regions were to be set up with this fund. “Priority is to be given to such patients in the CCUs,” said an official.

Sushanta Roy, the superintendent of Jalpaiguri district hospital, refused comment. “Please ask the director of health services about this,” he said. The cellphone of Joydeb Burman, the superintendent of MJN Hospital, was switched off when this newspaper called.