In an interaction with TNIE, minister UT Khader, who is handling the health portfolio for the second time, speaks on various issues related to the healthcare sector. From starting a helpline functioning out of his office to recruitment of medical staff, he has set priorities. He also speaks on the change of guard in the state. Excerpts...
As soon as the cabinet was formed, you’ve hit the ground running. Were you fully prepared?
Yes, because the post is not important, our work is. This is the opportunity to show our department that they should be alert. We understand the actual picture of the department when we witness, in person, how hospitals are functioning. It is necessary to see problems stemming from all sides.
For example, at night, it is important to find out in hospitals if the receptionist, the doctors, the nurses and the minimum staff are present or if the patients are made to wait for long. It is important to see if cleanliness is maintained after evening hours, whether the doctors and nurses are carrying out their duties fearlessly or if there are any disruptions, and if the surrounding organisations and associations are being cooperative. This is an appropriate time to gain a detailed understanding of these things.
What are the major changes you wish to carry out in six months?
First, we have to work towards attracting doctors, specifically newcomers who are still young. This can be done by ensuring that they are issued appointment letters quickly, and it is the District Health Officer’s responsibility to carry this out within a week once the application is received. Job security is also important, so we should make the positions permanent after five years of good work from doctors.
Second, we should also ensure that they get to do their post-graduation. If their ambition to pursue postgraduate studies are not encouraged, it will further dissuade them from joining. Third, we need to pay greater attention to hospitals in border areas. The rule now is that doctors in city areas get an extra Rs 8,000 in their salaries whereas those in villages get Rs 8,000 less, because rent is higher in cities.
By increasing the salaries of those in border areas by Rs 15,000, we can attract more doctors. Another recommendation, apart from these three, is to allow doctors, who retire after 60, to work till 70-75 as contract doctors, if they are deemed mentally and physically fit by the medical board. Another thing that is important is the manpower of lab technicians and pharmacists who should be selected, if not permanently, on contract basis. When the National Health Mission (NHM) has given the provision to select manpower on contract basis, the department should wisely think about who to appoint, since NHM guidelines state that more than 50% of the amount cannot go to salaries.
Will better salaries be paid to government doctors to attract better talent?
Yes, we are planning. We will have a meeting with the chief minister and finance department. In the Health Department there are about 36 programmes which are inclusive of both central and state government grants.
What about infrastructure, be it buildings or equipment?
We will fulfill whatever the requirement is for buildings and equipment. Secondly, we have to streamline the tenders for pharmacies and take it forward. I am planning to call all builders to a meeting to ask them what their grievances are so that we can rectify them. My plan is to do this year’s and next year’s tenders now.
What about ambulances?
We have to restructure them completely. They need to be clean and movable. When I was out of the ministry, they changed the software. Earlier, software and operations were maintained by GVK. Now the software is ours and GVK takes care of the operations. The cleaning of ambulances was assigned to Karnataka State Road Transport Corporation (KSRTC) hubs. It is tough for them to clean their own buses, so what is the use of giving them ambulances as well? We are thinking of what to do with that. Buying an ambulance is easy, but maintaining it is hard. So we need to develop a system, district-wise, and schedule weekly maintenance.
Have you heard of reports from nurses, regarding their status?
I have heard from all nurses, private and government. Nurses are important for a healthy society, and they are the foundation of healthcare. They are currently unorganised, and we want to bring a law which helps them organise, like doctors. We want to fix a minimum pay scale for all nurses. Right now, it is up to hospitals. We will be the first state to implement this security for nurses.
Is there any plan about mental health?
We are going to have a mental health advisory committee. Earlier when I was health minister, Dr KA Ashok Pai from Manasa would suggest many things. He used to tour on his own money. On his advice, the government started ‘Super Tuesday’ where every PHC (Primary Health Centre) and taluk hospitals counselled psychiatric patients. Whatever medicine was needed, it should be available that day. Then it turned into Manasvini. In Bengaluru, an NGO is looking after the homeless with mental health conditions and the government is paying it Rs 30 lakh. We want good NGOs to take care of such people in every district.
Is tele-counselling being considered in rural areas?
We have Sanjeevini for tele-counselling. We will get a new app not only for counselling, but also for other benefits where the concerned can call directly. If the app is downloaded, they can interact directly with the doctors free of cost. The government pays the doctor Rs 25 for each case.
Will there be more facilities for those who come for health tourism?
Karnataka is not only the health hub of the country, but even at the global level we are the health facilitators at a low cost. We should have visa on arrival. Both the Centre and state must work together and build a policy and make it easy and fast for patients coming for treatment. Those who visit, do not come only for treatment, but also for tourism. They will be accompanied by their family. It benefits both the Centre and state economically.
Is the Ayushman Bharat scheme implemented effectively?
It is implemented. It is not an insurance scheme, it is an assurance scheme. A budget allocation is made for it, and money is given to hospitals that treat the patients under the scheme. We cannot force hospitals to treat patients under this scheme. Most hospitals have accepted the scheme. Once hospital treats patients, hospitals send the bill within a fortnight and the amount is given to hospitals within a month. If the amount is not paid on time to hospitals, we give them interest. If the money is given to hospitals within the stipulated time, hospitals will treat the patients under this scheme.
Patients visiting hospitals will have a lot of doubts and complaints, but staff at hospitals are not willing to talk on most occasions. How is the government planning to address the issue?
The Health Department plans to launch a 24x7 helpline operating from the minister’s office to address complaints. The number will be displayed at all hospitals. Patients facing issues such as delayed enrolment by Arogya Mitras or demands for out-of-pocket payments can contact the helpline. Beneficiaries should not be charged any amount under the scheme and Arogya Mitras are responsible for resolving disputes with hospitals. The department also plans to display advertisements in hospitals informing patients that no additional payments are required and we will introduce the system in the coming weeks.
Are you planning to introduce midwives in Karnataka’s public health system?
I had introduced midwives during my earlier tenure, but need to review the current status of the programme. Several innovative healthcare initiatives launched in the past, including bike ambulances, Danta Bhagya and cochlear implant programmes, lost momentum after leadership changes. Additionally, schemes that need to reach the public are not successful despite being reported as successful.
Should not the government put a cap on the cost of heart surgeries?
The Ayushman scheme has a cap on charges and hospitals should not exceed them. There are other schemes such as the Sanjeevini-Puneeth Rajkumar scheme, under which ECGs, injections, angiograms and angioplasty procedures are provided free of cost in many cases. The government is examining ways to expand free angiogram facilities and improve healthcare delivery. Some existing schemes may be consolidated to create a few stronger and more effective programmes.
What is the government doing to improve organ transplant services?
The government plans to digitise the organ transplant system, replacing manual records with a centralised database of donors, recipients and hospital-wise cases to enable faster matching, transparency and communication.
What is your take on the merger plan of PHCs and CHCs?
It should not be a mere administrative matter. We will see whether a merger is necessary and practical. A doctor from a CHC can be shifted to a taluk hospital on deputation. But the post cannot be shifted. This creates a vacuum for future doctors. Ultimately, there is a need to see what benefit people get.
What are the plans to upgrade Kidwai hospital?
Usually when services offered at hospitals are good, the load increases. No matter how much we develop, the rush will continue. Development is a continuous process.
How are you going to improve facilities in North Karnataka?
The problem, especially of man-power, is everywhere. Earlier, people were reluctant to go there. But now things have changed. Infrastructure and education is also good. Earlier, there were only two or three government medical colleges. The Siddaramaiah government announced that every district should have a medical college.
What about fake doctors in North Karnataka?
In villages, people will not verify a doctor’s background. We are taking strict measures whenever we get complaints. Despite the presence of medical colleges, North Karnataka, as compared to Bengaluru, Mysuru and Mangaluru, has the issue of fake doctors. The situation now is better as many hospitals have come up in North Karnataka.
What is the state of mortuaries in the state? Is there enough manpower? Are they overworked?
Mortuaries cannot run without manpower. In Mangaluru, I noticed that if anyone dies and their body is kept in a mortuary, the family does not have a place to sit outside. They used to sit under a tree and cry as there is no bench for them to sit. The place is filled with mosquitoes. Doctors don’t come all the time. The police used to sit outside and write in the shade of a tree. To facilitate relatives and the police, 22 mortuary rooms with facilities were added. We are going to review the facilities at all mortuaries and take action accordingly.
There are concerns about the quality of food served at hotels. How are the food safety officials addressing it?
They have to take strict action. Evidence should be given. I have told the food commission to take strict action. A meeting with either a regional or a national food safety department will be held, and we will adopt the best practices they use in different places. We have to streamline and come out with a model for officers. The Food Safety Act is very powerful, but the problem is with our officers. They have limited themselves to only giving licences. People should also be mindful while eating outside.
Any plans for alternative medicine?
We have to promote alternative medicinal practices like Ayurveda, yoga and others. India is the best in the world. It is not only the government’s responsibility to promote it, but also of those who study it. The problem is that 90% of those who study Ayurveda give English medicine. How will Ayurveda improve in such a situation? Doctors should be more active. We have to give importance to Ayush Mela now. The first choice for people should be Ayurveda.
How are you going to address online pharmacy issues?
There is more disadvantage than advantage. Only a small section of people who cannot go out to get medicine will be benefited. But the issue on the other side is bigger. They supply medicines without prescriptions. When we can go to shops and markets to buy groceries and vegetables, why cannot one go to medical shops? Online pharmacy is a sensitive issue. I will meet drug and pharmaceutical company members and resolve the issue.
How do you address the Jan Aushadi Kendra issue?
We need to streamline Jan Aushadi Kendras. Here, stock of prescribed medicines should be available. Generic medicines are available at these kendras. Who will supply generic medicines at low cost? It is obviously the lowest bidder. This may compromise the quality. Also, continuous supply of medicine should be taken care of.
When it comes to public health, Kerala and Tamil Nadu are ahead...
Karnataka healthcare is also good. Index in Kerala may be better because of the population.
When can we expect Cabinet expansion?
The high command and party leaders will decide on that.
Will the change in guard improve the prospects of Congress returning to power in 2028?
It is a political transition. This is not a ‘change of government’ but a transfer of leadership within the same Congress government. The work done under Siddaramaiah will continue under DK Shivakumar. Existing programmes will continue and new programmes will be introduced. We believe people will appreciate the government’s work and support Congress again in the next election.
Siddaramaiah will not be the CM face in the next polls, will AHINDA remain relevant?
Congress, with Shivakumar’s leadership and Siddaramaiah’s guidance, will continue to work for all sections of society in accordance with the Constitution. Any government that governs according to the Constitution will earn the people’s support.
Coastal Karnataka continues to be a stronghold of BJP...
In coastal Karnataka, Congress has had mixed electoral results. At one point, we had seven seats and BJP had one. At another point the reverse happened. Now we have two seats, while BJP has six. We need stronger organisation at the booth level to communicate both the achievements of the state government and the shortcomings of previous BJP administrations.
Despite the high literacy rate in the region, why coastal Karnataka witnesses frequent incidents of communalism?
Education alone does not solve every social problem. Highly educated societies can also face corruption, crime and extremism. Education by itself is not the sole answer.
How was your experience as a Speaker?
It was excellent. Every MLA should ideally serve as Speaker once in their lifetime as it provides a deep understanding of parliamentary procedures, opportunities to build knowledge and reputation, and connections at national and international levels. The role is largely non-partisan and allows meaningful interaction with Speakers from across the country. It was a valuable three-year experience.