The worn-out, dilapidated building near West Hill Chungam in the city does not in any way indicate the role it once played in ensuring affordable healthcare. That the structure housed Ayathan Clinic, a small private hospital where Kozhikode residents could get inexpensive medical treatment, is now only a memory.
“The hospital was run by Dr. A.V. Subbarao, who was very popular among the people here. It was shut down after Dr. Rao passed away around two decades ago,” recalled Thankamani, who runs a tea shop nearby.
Travel a couple of kilometres towards the city, you will stumble upon an empty building near the Kanakalaya Bank bus stop which used to house another small private hospital equally known for cost-effective medical care. It had to be closed down around five years ago.
KASC claim
These are just some of the relatively small healthcare institutions that are falling by the wayside unable to withstand the test of time. Functionaries of the Kerala Association of Small Hospitals and Clinics (KASC) claim that around 1,000 small hospitals have shut down in Kerala in the past 10 years alone, owing to various reasons.
Kozhikode has a history of small hospitals that people could bank on without emptying their pocket. Asoka Hospital near Mananchira, perhaps the first such institution in the region, was set up by Dr. V.A. Raman in 1930 and is still functioning. Rajendra Nursing Home founded by Dr. Balaram is another such institution. During the freedom struggle, there used to be a People’s Hospital in Chalappuram that took care of political activists who were subjected to police brutality. Manjunatha Rao, the first Mayor of Kozhikode, was among those who took the lead in setting it up, recall old-timers.
“There is something like a superspecialty syndrome or corporate syndrome engulfing the healthcare sector in the State. It is also an indication of the slow death of the concept of family doctor, who knows the healthcare history all your family members,” said Sushama Anil, State secretary, KASC.
She pointed out that with more people now opting for big corporate hospitals even for small health issues, small hospitals and clinics are facing a crisis. Another issue is adverse government policies, the latest being the Clinical Establishment (Registration and Regulation) Act whose guidelines they were unable to follow. “Small hospitals are often run by one or two individuals and their support staff. There is no support from the government. We find it difficult to get even permission to run generators. There are no tax concessions either,” Dr. Sushama claimed.
There were already around 50 laws to regulate the functioning of healthcare institutions in the State. However, this Act was being implemented without considering the plight of small hospitals.
Financial burden
Big hospitals could put in place the facilities being instructed in the Act without difficulty. Small hospitals, however, would be forced to spend a huge amount for that and would have to either pass on the financial burden to patients or shut down operations.
The recommendations suggested by a committee of medical experts set up by the government to classify clinical establishments were being sidelined. The demand to exclude 20-bed hospitals from within the ambit of the law had not been met, she alleged.
Another threat is the mob attack on doctors and hospitals following alleged instances of medical negligence.
“Often we find that there is no point in lodging complaints with the authorities. There is no immediate action and we have to bear with the financial loss,” Dr. Sushama said.
To tide over the crisis, the KASC has proposed a referral system in private hospitals too.
The patients should be recommended for specialty healthcare only after they are referred to from primary and secondary healthcare institutions. All the facilities in government hospitals should be for free too, the association suggested. This would reduce the treatment costs to a large extent and help small hospitals survive, KASC functionaries claimed.
