A 23-year-old man with critical head injuries was allegedly refused admission by five state-run hospitals and a sixth discharged him after two nights, citing lack of facilities to treat blood clots in the brain.

Nirmalya Chowdhury, a resident of Sovabazar in north Calcutta, was among 30 passengers injured when the bus they were travelling in overturned near Uluberia on Sunday morning. He was returning to the city from his ancestral home in Ghatal, West Midnapore, after celebrating Durga Puja with his family.

The 23-year-old was unconscious and bleeding from the head and ears when he was taken to the ESI Hospital in Uluberia, which advised hospitalisation in a state-run facility in Calcutta.

Nirmalya's family scurried from one medical college to another over the next seven hours before Sambhu Nath Pandit Hospital in Bhowanipore took him in, only to issue a "referral discharge" two days later saying that his "intra-cranial haemorrhage" required "better management".

Since Wednesday, Nirmalya has been in the intensive therapy unit of Ramakrishna Mission Seva Prathisthan on Sarat Bose Road, his plight proving that little has changed in Bengal's ailing state-run health care system over the past four years of the Mamata Banerjee government.

According to Nirmalya's relatives, the only treatment he received in Uluberia was a bandage over his wound.

RG Kar Medical College and Hospital, off Shyambazar, was the family's first stop after being "referred" to Calcutta by the emergency unit of the ESI Hospital in Uluberia. "The doctors at RG Kar kept him for half an hour before telling us that they didn't have the facilities to treat the type of injury he has," Nirmalya's uncle Gopendra Chowdhury recounted.

The patient ticket issued in Nirmalya's name at RG Kar says: "Refer to NRS Medical College and Hospital for neurosurgical emergency."

When Nirmalya was taken to Nil Ratan Sircar Medical College, around 4km away, he was still bleeding. He was provided a bed in the emergency observation ward but sent away to SSKM, the state's largest referral hospital, soon after. The reason? Like RG Kar before it, NRS claimed it didn't have the facilities to treat the young man's head injury.

"A doctor said my nephew's condition would turn even more critical if we insisted on keeping him at NRS," Gopendra alleged.

Doctors at RG Kar and NRS, both teaching institutes that produce hundreds of health professionals every year, allegedly didn't do something as basic as a CT scan to find out whether there was any haemorrhage.

Nirmalya was wheeled into SSKM's emergency department around 12.45pm on Sunday and it was there that a CT scan was finally done, more than three hours after the accident.

One of the junior doctors in the emergency department then allegedly told the patient's family that he was fit to be treated at home. As Gopendra and his relatives mulled their options, a tout lurking outside the hospital promised to get Nirmalya admitted in exchange for money.

The family discussed whether they should pay a tout to get Nirmalya admitted before deciding to try the nearby Bangur Institute of Neurosciences.

There, a doctor examined Nirmalya and said there were blood clots in the brain that needed to be monitored. But the hospital didn't have a bed to spare. Gurneys were being used as beds and even the staircases had patients.

"No bed vacant... no floor space is available at present," a doctor wrote on the emergency ticket.

Around 7.30pm, Nirmalya, who was then barely conscious, was taken to Sambhu Nath Pandit Hospital, which admitted him. "We have beds but there is no facility to treat a neurology case," a doctor is quoted as telling the family.

The hospital agreed to keep Nirmalya under medical supervision after family members said they would try SSKM or Bangur Institute of Neurosciences again the next day.

On Tuesday morning, Sambhu Nath Pandit Hospital allegedly asked Nirmalya's family to take him away, mentioning in the official document that it was a "referral discharge".

Nirmalya was again taken to SSKM, where a second CT scan was done and a doctor examined him. But since the hospital couldn't give him a bed, he was taken to a relative's house in Chetla. On Wednesday, the 23-year-old cable television technician was admitted to Ramakrishna Mission Seva Prathisthan.

A doctor at the hospital on Sarat Bose Road said Nirmalya would need further scans and other tests and "a long stay" in the intensive therapy unit.

Metro had previously highlighted how a patient with a bullet lodged in his neck was turned away by two state-run hospitals last November. A third state-run hospital admitted Burdwan resident Sheikh Naser Ali but said no neurosurgeon was available to extract the bullet.

In 2010, a two-year-old boy struggling for breath with a one-rupee coin stuck in his respiratory tube had been denied treatment at three state-run hospitals.

Health secretary Moloy De admitted that the lack of state-run primary health care in Calcutta and the practice of referrals from the districts was to blame for many patients not getting the medical attention they require. "These two factors combined are causing the overcrowding. People go to a medical college even for treatment of viral fever," he said.

An expert committee set up by the state government with critical care specialist Subrata Maitra as its chairman had recommended several steps, including setting up emergency observation wards, bed bureaus and ITUs at district hospitals.

Emergency observation wards are supposed to admit patients for two to three days if there is no bed available or till such time admission can be arranged in another hospital.

While Nirmalya was kept in the emergency observation ward at NRS, he didn't get treatment because it didn't have facilities to treat his head injury, doctors claimed.

"The bed bureaus aren't functioning either. Nobody knows who to approach to find out whether a bed is available in any other hospital," said a senior official in the health department.