Health
Health is a priority sector, hence there is a need to increase the budgetary allocation to 5% of GDP. It is essential to strengthen the existing medical colleges and hospitals at all levels with adequate manpower. The focus should move from construction to creation of essential posts with exclusive budgetary support. Just mere equipment and buildings are not enough to deliver quality healthcare. At present, medical colleges are in excess, diluting the hands-on training opportunities, resulting in untrained doctors which is harmful to patient care. Bengaluru with 20-25% of the state population needs at least 350-bed multispeciality hospitals in each zone (East, West, North and South) so that timely treatment can be given in greater Bengaluru sectors.
Neurological services need special attention since NIMHANS has not expanded further. The state government should think of establishing a 500-bed autonomous institute of neurosciences on the lines of Jayadeva Hospital, Sanjay Gandhi and KIDWAI. It is a welcome move that many trauma and critical care health centres have been announced in the budget in district and rural areas attaching telemedicine and artificial intelligence (AI) technology. Nearly 13% of deaths are due to road traffic accidents, so they should be made fully functional. This will be able to treat severe trauma patients in the golden hour and it can bring down death rates.
Hub and spoke model in all taluk hospitals
It is a good decision to extend the hub and spoke model for treating heart attacks and stroke which accounts for 30-40% of total deaths in all taluk hospitals. Patients in rural areas will be immensely benefited. At present, streptokinase is used for thrombolysis. It is better to fast-track the procurement of Inj Tenecteplase since it is a more effective drug which can be administered in just 2-3 minutes.
Though the Ayushman Bharat-Arogya Karnataka scheme which is in place for BPL patients, it is not truly a universal scheme. It is said that the coverage is up to Rs 5 lakhs which is not for an individual patient but for the entire family. There is a need to revise the package rates scientifically and it has never been revised in the last five years. Also, many more procedures were to be added. The present package rate does not even meet the actual cost incurred particularly for tertiary care procedures. So this is on priority and needs additional grants for this revision. Otherwise, many private hospitals may not be empanelled and the entire burden falls on government hospitals which cannot cope with the patient load. Ultimately, quality care is also compromised and medical staff at a government hospital will end up with burnout syndrome.
The government’s decision to provide chemotherapy for cancer treatment in all district hospitals is a boon to patients.
The Medical Education Directorate has been upgraded to Commissionarate to bring more efficiency to the department. However, decentralisation and delegation mechanisms will fast-track academic decisions. There is a long-standing demand for Asha and Anganwadi workers for enhancement, which is worth allocating in the budget.
Dr CN Manjunath
Former director of Sri Jayadeva Institute of Cardiovascular Science & Research