The Chennai Corporation's effort to introduce a method to ensure better public health measures is hitting a roadblock as private healthcare institutions, including the Indian Medical Association, a nodal body for doctors, doubt the civic body's intentions.
In April this year, the Corporation brought out a form for registration of private hospitals and healthcare institutions, single-doctor clinics and nursing homes. The form is comprehensive and mandates healthcare institutions to provide details about facilities offered, infrastructure, maintenance modalities and the kinds of diseases treated.
According to the civic body, the aim is to get details of prevalence of any infectious disease. The information would help it take up containment measures and be prepared for emergencies. Corporation Commissioner D. Karthikeyan said, “Basically it is to get input on epidemics and not to collect revenue or boss over them or levy fees. It is only to ensure that we know the number of hospitals in each zone so that during an outbreak of epidemic or an emergency we can take immediate remedial measures.”
Elaborating, he said: “The Corporation is duty-bound to ensure its citizens' primary health. We need to know about the spread of infectious diseases to develop protocols to contain them.”
Of 531 healthcare institutions registered so far, 70 are large hospitals. A Health Department official explained that while registration of birth and death is mandatory, that of hospital is not. The civic body must have details of the number of beds, specialists and facilities they have.
According to the Corporation's Health Officer P. Kuganantham, as the authority invested with the care of public health, the Corporation should establish “regular contact” and collaborate with private healthcare providers for immunisation, notification of infectious diseases, infection control, biomedical and non-infectious waste disposal.
The municipal bodies in Delhi, Hyderabad, Mumbai and Surat have a similar rule in place for the last five years, Chennai Corporation is only following suit. Just as the civic body now maintains a record of births and deaths, it is necessary to do so for immunisation, sterilisation procedures and infectious diseases treated by private providers, he explained.
“Monitoring for all health activities is the mandate of the Corporation as around 50 per cent of the population seek treatment in corporate hospitals. During the outbreak of swine flu, it was the Corporation which provided the information on disease management to private hospitals,” Dr. Kuganantham added. “Of 1,800 patients suspected to have the flu, 750 tested positive.”
Online reporting
At present, only about 200 hospitals, including Apollo, KKCTH, Fortis Malar besides government hospitals, report online to the Public Health Department about diseases treated.
The system was launched last year. According to Apollo Hospitals' Managing Director Preetha Reddy, it is the responsibility of every healthcare facility to report infectious disease to the authorities concerned. “We have registered our hospital and send reports of diseases treated at our hospitals,” she said.
On the need for infection control, Dr. Kuganantham said: “We need to know the causative microbe and the microbial sensitivity, which will help to develop data on infections prevalent in the city and understand their microbial sensitivity. It will help to develop cost-effective containment measures.”
D. Thulasimala, who conducted mapping of dengue and malaria for the International Research and Development Organisation, had difficulty in finding information on treatment of these vector-borne diseases in private hospitals. But, she had no problem in interviewing 400 persons, who had been treated for these diseases in the Corporation-run dispensaries in the same area, she said.
IMA's objections
According to T.N. Ravisankar, national secretary, IMA CGP, the exercise is only a “lame excuse” for implementing the Clinical Establishment Act, which talks about giving all details of the hospitals to the government.
According to him, the Indian Medical Association would “take up the burden of notifying the diseases to the local administration. Any doctor who notices a disease can notify to a single point with the address of the doctor, the infection and the place of infection by SMS.”
The civic body also seeks to address the problem of biomedical waste disposal. Admitting to the presence of certain deficiencies on that front, Dr. Ravisankar said, “We are educating the staff in hospitals on proper disposal. It will only be a matter of time before they comply with the regulations.”
Even community medicine experts are sceptical of the Corporation's efforts. “What have they done so far in terms of ensuring potable drinking water and maintaining cleanliness and sanitation in the city,” asked a senior community medicine expert in a government hospital.
