Following a representation by the medical directors of 14 private hospitals (which the Delhi Government had declared 100 per cent Covid facilities) with the Delhi Health Minister Satyendar Jain, the government tweaked its earlier order. Now, the 14 hospitals have to cumulatively provide 3,553 beds for covid patients, while the rest of the beds can be used for non-covid patients.
These hospitals have been allowed to increase their bed capacity temporarily by 35 per cent, so that non-covid serious patients can avail of beds. The Association of Healthcare Providers-India (AHPI) had urged the government to reconsider its earlier decision, which had not gone down well with the private healthcare providers. That order, they say, would have seriously compromised the treatment of non-covid serious patients (cancer, heart diseases, liver diseases etc), and put their lives at risk.
“It was a hasty decision, taken without any consultation with hospitals and doctors, and without understanding its implications. We are happy the government listened to us, and now these top rung hospitals have only 60 per cent reservation for covid patients. Also, they can increase bed capacity without any approvals or applications by another 35 per cent, which means non-covid capacity remains the same,”says Dr Shuchin Bajaj, Founder & Director, Ujala Cygnus Group of Hospitals.
As things stand today, in addition, in 19 other premier private hospitals, 80 per cent ICU beds have been reserved for Covid-19 treatment while 82 private hospitals have been directed to reserve 60 per cent ICU beds for the same. Significantly, the first (14) and the second (19) category of hospitals are quaternary care hospitals (BL Kapoor, Indraprastha Apollo, Fortis, Max Ganga Ram, etc.) considered among the best ones for treating highly critical care specialties.
The AHPI contention is that the lives of non-Covid patients are equally important. AHPI Director General Dr Girdhar Gyani says, “The treatment protocols for Covid are well established and do not need expertise which may require reserving these quaternary care hospitals. In fact, depriving other serious patients head injury from an accident, cardiac arrest, stroke, transplant, etc., — would harm a larger number of patients as compared to saving from Covid, which can be taken care of in any secondary care hospital.”
Stating that it was an ill-thought-out decision, Dr Gyani says, “Highly specialised surgeries (liver, spine, etc.) happen at these quaternary care hospitals, and patients from all across India book surgeries much in advance. How could one turn them back?”
The healthcare professionals also say that it is not just beds but the infrastructure which needs to be streamlined. The need is for equipment, doctors, nursing and para-medic staff to tackle the enormity of Covid. “What purpose will increasing the number of beds serve? We have a paucity of doctors, nursing staff, and paramedics about which no one is talking,” says Dr Gurpreet Sandhu, President, Council for Healthcare and Pharma (CHP). “We should actually have dedicated infrastructure, dedicated zones in all hospitals to take care of covid patients. The Delhi Government had created one at Chhatarpur, we need more of such facilities,” he adds.
Agrees Dr Gyani: “Covid treatment can be provided by any junior doctor. What is important for Covid is infrastructure, beds, oxygen beds, ICU beds — all of which you can get from any other hospital, even smaller nursing homes. All secondary care hospitals have these facilities.” “Our governments, be it the Central or the state ones, have not awakened to the extremity of the situation as in the West, even in our neighbouring countries like China, Korea and Bangladesh. They all have created dedicated zones, which have complete infrastructure in place for covid treatment,” says Dr Sandhu.
Adding further, Dr Gyani says, “The Delhi government has 12,000 beds, but these were not in operation during the first wave of Covid-19 as there were no adequate doctors and nurses. The government should have overcome this shortcoming by now but there is so much procedural delay. It couldn’t fix its own problems, and was transferring these to the private sector.”
Agrees Dr Bajaj: “The government has not been able to scale up the healthcare facilities. It is still dependent on existing hospitals. It even disbanded the temporary facilities it built thinking perhaps that a second wave wouldn’t come — a classic case of pigeon closing its eyes thinking a cat won’t be able to see it. But we all know what happens, the cat pounces and the pigeon dies. “