This year, Tamil Nadu’s public health sector saw an equal share of achievements and debacles.
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The State had 23 government medical colleges at the start of 2019 and added nine more in a span of two months towards the latter part of the year. For the government, this was no less than a “historical achievement”, but the government will also be remembered for the way it quelled a State-wide government doctors’ protest through threats, transfers and disciplinary charges, and a massive exercise to “restructure” posts of doctors in medical college hospitals as per Medical Council of India norms.
The impact of the restructuring / refitment of doctor posts – a move that several government doctors objected to -- has started to show, and the coming year might throw a clear picture, a section of doctors say. Many term the exercise a “disaster” that will go a long way in affecting patient care in a State that had bettered its public health services over a period of time. The posting of specialists in departments other than their own and associate professors of six key departments being instructed to perform 24-hour duty due to a shortfall are only the beginning of problems, they say.
As a fall-out of the State-wide protest by the Federation of Government Doctors Association for demands including pay band - 4 and restructuring of doctors posts according to patient care, the government transferred nearly 100 doctors to distant hospitals. Among them were specialists, who were transferred from tertiary care institutions.
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The year however saw Tamil Nadu maintaining its track record in certain health indicators. It succeeded in further reducing its Infant Mortality Rate and Maternal Mortality Ratio.
The public health sector got a shot in the arm during the UK visit of Chief Minister Edappadi K. Palaniswami and Health Minister C. Vijayabaskar. It marked the signing of agreements including for improving the skills of nurses and doctors and vector-borne disease control. It was announced that the State would facilitate the establishment of a flagship hospital of the King’s College hospital, London in the State.
Tamil Nadu also bagged the ‘Best State Award’ from the National Organ and Tissue Transplant Organisation (NOTTO) for the fifth consecutive year. While the Transplant Authority of Tamil Nadu brought in a number of reforms including streamlining the waiting list of organs, the NOTTO’s interference cropped up in a few ways, and is expected to increase in the coming year.
But it was NITI Aayog’s health index – Healthy States Progressive India -- that came as a blow for the State as it slipped six places from third in 2015-2016 to ninth in 2017-2018. Though the State had registered its objections citing data discrepancies and interpretation of indicators, the report recorded a decline in full immunisation coverage, institutional deliveries and proportion of low birth weight among newborns.
While 2020 will witness the construction of the new medical colleges with 60% Centre funding, work for the All India Institute of Medical Sciences in Madurai is still in the early stages. The year might also see how the government will implement the Tamil Nadu Health System Reform Programme with funding support from the World Bank covering areas including non- communicable diseases as well as reproductive and child health services.