An efficient public health system providing quality patient care can be a market regulator for healthcare in the country, said C.N. Manjunath, director of the State-run Sri Jayadeva Institute of Cardiovascular Sciences and Research.
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Dr. Manjunath, who is retiring this month-end after a career of 35 years at Jayadeva, told The Hindu that the rising healthcare costs in private hospitals can be checked only if public hospitals are able to provide quality and affordable care. “This itself can be a market regulator,” he said.
The institute has recorded an overall growth of 500% and the bed strength has increased from 330 in 2006 to over 2,000 beds now (Bengaluru, Mysuru, and Kalaburagi facilities put together) exclusively for cardiac care, offering 24 hours ICCU management, interventions in cardiology and cardiothoracic surgery.
It is one of the largest heart care centre in the South East Asian Region performing about 55,000 cardiac cathlab procedures and 5,500 open heart surgeries annually. In the last 16 years, the institute has overall done eight lakh procedures and treated 75 lakh out patients.
Success story
“In my opinion, we cannot deliver quality services with just buildings and equipment. We need to create an excellent working atmosphere, nurture talent and develop a culture of hard work and discipline among the workforce. The biggest challenge is to manage the manpower because each one has a different mindset,” said the doctor, who was awarded Padma Shri in 2007. He underlined the importance of proper communication with patients by the first point of contact, beginning with group ‘D’ workers.
“We introduced three slogans - ‘Treatment first, payment next’, ‘Life is more important than the file’, and ‘Humanity is priority’ and have been following these slogans literally,” he said, chronicling how Jayadeva was built as a model facility.
With 120 cardiologists, 65 cardiothoracic surgeons, 48 cardiac anaesthetists, and six vascular surgeons who run its 18 cathlabs and 17 operation theatres, the institute sees nearly 1,700 walk-in patients every day and 80% of them are below poverty line.
Eyeball assessment
Asserting that poor families with no BPL cards or those who have lost the cards should not be deprived of free treatment, Dr. Manjunath said: “Rules say a BPL card is a must for free treatment. I raised the issue in the governing council in 2007 and got an authorisation for the director to identify the poor for free treatment through an eyeball assessment... My assessment has only grown stronger as I see poverty and helplessness in their eyes before I diagnose the disease,” the doctor said.
Realising that a corpus fund was important for this, Dr. Manjunath requested his employees to donate a day’s salary before requesting help from government and charitable organisations. “With the help of 45 charitable organisations, NGOs, and philanthropic bodies, we managed to raise a corpus fund of ₹150 crore and have been providing free treatment to the poor, who cannot be covered under the government health schemes, through this fund,” he explained.
This affordable and high-quality cardiac care model has been appreciated by IIM, Bengaluru, London School of Economics, Leadership School of Singapore, Yale University, USA, and former U.S. president Barack Obama.
Who is the owner?
Recently, 14 members of the Parliamentary Standing Committee on Health, who visited the main Jayadeva institute to study the implementation of the Ayushman Bharat Arogya Karnataka (AB-ArK) scheme, were impressed by the quality of services provided to patients.
“The delegation, led by Bhubaneshwar Kalita, could not believe that the institute is a State-run facility. In fact, they asked me who the owner of the hospital was and were shocked to learn it is a government hospital,” he said.
Till date, Dr. Manjunath has performed around 55,000 cardiac interventions. He innovated a new technique of balloon mitral valvuloplasty (an intervention to open up a thickened heart valve) which is now called ‘Manjunath’s technique’. The left atrial thrombus classification is done according to a scheme proposed by Manjunath, called ‘Manjunath classification’. He has trained cardiologists from the US, France, the U.K., China and Vietnam in valvuloplasty procedures.
Asked what governments should do to make quality and affordable healthcare possible, he said, “Non-interference in the functioning of the tertiary and super-speciality hospitals and moving from construction of buildings to creation of posts.”
Any incomplete project? Dr. Manjunath said, “I wish the 371-bed hospital complex on the new Jayadeva campus at Kalaburagi which is likely to be completed in three months should have been commissioned during my tenure.”
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