Sheekha Bureau
Port Blair, Nov 09: The Director-Professor of Maulana Azad Medical College, Dr. Naresh Gupta, one of the best medicine man of India, has said that for a place like Andamans, Government alone should run Medical College. Dr. Gupta was in Port Blair to conduct interview for the post of Doctors as an expert in UPSC team. On Saturday Andaman Sheekha interviewed Dr. Gupta to know about his views about the health scenario of Andaman and Nicobar Islands, Medical College etc.
Expressing his satisfaction over the present health scenario of Andaman and Nicobar Islands, Dr. Gupta said that considering the present set up of Health Infrastructure in Andaman and Nicobar Islands, Government alone should run the medical College here. He said that PPP mode has proved to be a failure in Health sector. Here is the full transcript of the interview.
Andaman Sheekha: What is your general Impression about Health Scenario of Andaman and Nicobar Islands?
See the health scenario in whole country is nothing that we can be proud of. It is much better than what it used to be but it is not something to be proud of. We don’t have requisite number of doctors, WHO wants we should have one doctor for 700 people, we have one doctor for 11,00 to 15,00. There is always a great demand for doctors and how do you meet these demands, may be you come up with more Medical colleges but Medical Colleges may not be all solution. We have to provide services. Most of the basic services are provided through PHCs, which is the health care fabric of this country.
Andaman Nicobar has 22 Primary Health Services. I have interacted with these doctors in PHCs, they are so committed and dedicated that I am really impressed. We need doctors who do good, we are not interested in big doctors who can’t do good. These Doctors are very compassionate and they have total devotion.
I think the services in Andaman and Nicobar Islands are very good and I also understand that everything is available when it comes to medication and facilities, every drug, even if it is an expensive drug it is freely available. Services are good but we should also keep in mind that these Islands have a large area and density of population could be very small in certain area so we have to make sure how to provide the services.
Andaman Sheekha: About the proposed Medical College of Andaman, Do you think government should run it or it should be run in Private Public Partnership (PPP) mode?
I think when it comes to running a medical college government alone should run medical college here. The First medical college here must be run by government; I will give you many reasons for this. There is a need for medical college I don’t deny that.
Creation of a Medical College, is not just providing them with facilities for heart attack or diabetes or hypertension, creating a medical college is creating a whole new hub of infrastructure like Services, activities, employment, socials services, empowerment of public.
There are larger issues many of them are social issues, no profit issues, those are linked with medical college. In our country as of today there are over 400 medical colleges, more than half of them are private. We are producing more than 50,000 Doctors every year now. Most of the bulk has been added by private colleges and when you had a college like that you don’t look at the social needs. You know in Union Territory of Pondicherry there are more than one dozen medical colleges. You can’t even get patients. Why somebody wants to open so many Medical college. They have a benefit, it is a profitable business that’s why it is private.
In this place it is only government doctors, who go to far flung PHCs and never complain. Nobody cuts corners in government colleges. The private colleges, with so many coming up and making profit, have never inspire confidence.
In Delhi, capital city, imagine there are no private medical colleges, we don’t allow. And the reason is that we find larger benefit to the population, to the person who needs it, can come only come from government medical colleges. It is very easy to complain and say that government is not doing this or that.
The private hospital do not allow patients to enter certain doors, in government even you can enter inside ICU, you do even know what is happening there inside private medical colleges. I have not seen social charity in Private Medical Colleges.
When you look at the PPP, then you must look at these aspects. And if you look at the way these private colleges have come up, half of the Private College are in only four states of India, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra. I have given example, Pondicherry you have a dozen, you can’t get patient, how do you run it? Obviously they have to become institution for churning out degrees. If you want to generate a place, where the number of degrees will increase after few years, then private are the best. They are the best printing press.
But if you think these persons, who have come out, they stay on and they do good then we need doctors with commitment, otherwise these persons will get just degree and move on.
In Private colleges you go around you will find that they have issues with faculty, with training because their primary interest is profit.
When you have a medical college coming up, every country has a system of care. In our country, you have a sub centre, then PHC, then CHC and you have District Health Centre, then you go to G B Pant or Medical College. This is a referral system and integrated system. Somebody has been doing the basic services for many many years in these Islands.
PHCs have been done, CHCs have been done they know the problem they also know about practical problems and when you have a medical college it has to be linked in with the system.
Now, PPP has come in a big way in last 15 years and PPP has made some good success but what our experience has been, in the health field is that in health field PPP has been a failure, at medical college level and at super specialty level.
In Delhi we have two super specialty hospitals, High end fully equipped all structure provided by the government. The Government said we have been running for many years let us run it in PPP model. So lets us give it and give a good competition.
The Infrastructures were there, OTs were there, equipment were there and all machines were there, they were asked to run it. More than one decade they were not able to run it even they fail to accept the challenge. Infact we went to the extent that ok we will provide you the staffs also.
They have come and backed out, come and backed out eventually the Government accepted that they won’t be able to run it because they have delayed it for more than a decade and it has given back to our own specialists. This is what happening in Delhi, think about Andamans, why would they?
All these doctors from where do they come from, they come from government intuitions. All doctors in Delhi, who are the high end, whether they are cardiac surgeon, they come from government
institutions.
Lakshadweep had similar problem and there also they gave the transport of these patients from Lakshadweep to nearby state to a private institution in Kochi, I would not like you to give the name, for several lakhs, obviously it did not inspire too much confidence.
Who will not exploit a person, it is only the government of India. We have seen in North East that running this is best when you engage local community. I think regarding medical college in Andaman, we should not have two thought going to government in a set up like this.
Andaman Sheekha: Many demand that these Islands should have a PG College (Specialty) College first and not MBBS college, what do you think regarding this demand.
Andaman Sheekha: Have you ever seen a child whom we say you don’t walk you start running first. You walk first and then you become good runner. Medical Council of India has now said that unless you have Medical college, which teach under graduates in the medical school, you shall not have any specialty. The PGI in Chandighar, who were allowed these specialty courses, long time back, are now exception.
What are you talking about American Concept. In India we spent 1.2 percent of our GDP on health it used to under 1 percent in previous 5 years plan. America is spending close to 20 percent 1/5 of their money is going on health. They have only Specialists who practice everywhere. They don’t have so many specialists they need. They take MBBS doctors from India and train them. They can afford that high end, because they are spending 20 percent money of GDP.
We want to train our doctors in a manner which is good for our country. For primary health centre do you need specialists, No. We have a fabric of PHCs which needs MBBS Doctors.
Presently, we are producing more specialist than we can accommodate. We need only given number of specialists and we are already having specialists. I ask this guys (Private Medical College) nobody is stopping you from running a private Specialty Hospital here why you want to grab this medical college.
Super Specialty, there is a Conundrum, in our thinking in our practice. But once you have a college running here, Medical Council of India will come and inspect and take it from me, automatically your specialist will be coming because the specialist required for CHCs are Internal Medicine, General Surgery, Gynaecology / obstetrics and paediatrics. So take it from me, it is a standard thing which we have seen, these four specialists will come in no time. These four are the basic crux, where you look for 99 percent of need. You can never be a runner without become a walker.
