Garbage strewn at Rajendra surgical ward of Patna Medical College and Hospital. Picture by Deepak Kumar

Services at government hospitals have hardly changed even five years after outsourcing began.

Ask Sapna Sharma, a homemaker in Shahstri Nagar. “I feel rotten garbage dumped everywhere on the Patna Medical College and Hospital (PMCH) premises,” said Sapna, who had to put on a handkerchief on her face almost 72 hours she had to stay with her 10-year-old daughter Meena. Meena underwent a complicated knee surgery after falling off the roof of their house.

Incidentally, the government spends Rs 13 lakh per month just on cleaning the premier hospital. At PMCH alone, the total monthly payout for security, sanitation, laundry, generator and meals for indoor patients is about Rs 45 lakh.

As envisaged by National Rural Health Mission, the government awarded hospital maintenance services to private agencies five years ago. Quality of these services, however, has remained in a shambles even though the state’s annual expenditure incurred on this head has swollen to Rs 175 crore. “The work orders are given to private agencies through rate contracting system where bids are invited at district level and the lowest bidder is awarded the projectReviews of the health facilities have shown that much will have to be done,” said additional health secretary Rajendra Prasad Ojha.

The tragedy, said sources, lies in the fact that though companies bidding with dirt cheap rates bag the projects, quality of services is often compromised. In Motihari, an agency go the cleaning project at the rate of 6 paise per square feet against the minimum fixed rate of 35 paise per square feet.

In some districts, even civil surgeons said outsourcing had failed to bring desired changes. Darbhanga civil surgeon Uday Kumar Chaudhary said: “The agencies work arbitrarily and withdraw services if we try to maintain checks and balances over them.”

Against the prescribed rate of Rs 50 for per meal to each patient, the tender was given to the lowest bidder at the rate of Rs 25 in Motihari.

Patna district, which spends about Rs 1.25 lakh each on 23 PHCs and sub-divisional hospitals every month, recently decided to fix a range of minimum and maximum bid for agencies as their performance had remained largely dissatisfying.