Times of India
09 September 2010
By Durgesh Nandan Jha
New Delhi, India

Face Of Insufficient Healthcare Infrastructure, Docs Face Ire
The doctors’ strike at Safdarjung hospital may have drawn fairly unequivocal criticism but it is telling how a simple demand like security at the workplace remains forever unmet in a country otherwise obsessed with security. While it highlights once more the government’s failure to provide a safe work environment for its doctors, it is also symptomatic of a deeper malaise. That of insufficient healthcare infrastructure.

There are more than 100 cars per 1,000 population in Delhi but the number of hospital beds available for the same number of people is less than three. WHO recommendation is for five beds per 1,000 population. Delhi hospitals have about 43,250 beds and the population has touched 1.8 crore. In fact, since 1987, the number of beds per 1,000 population has been declining steadily in the city even though in absolute terms, the number of beds have nearly doubled.

If government officials are to be believed the ground situation in Delhi is actually worse. Said a senior official of the health department: "The pressure on health infrastructure is even higher because of the large number of people from surrounding towns and cities who come to the capital for treatment."

The bulk of the beds are in the private sector. Which means that the middle class – the class which has a voice – has almost stopped going to government hospitals. So while on the one hand their condition has been worsening because the matter is hardly raised in influential enough circles, the pressure on these hospitals is mounting thanks to the rising population.

In Government hospitals, two patients lying on the same bed and waiting endlessly for the doctor to come is not an uncommon sight. Emergency services remain the worst affected, especially at odd hours. And, there is no specialisation in the field of emergency medicine in the country yet.

An AIIMS doctor said, "We see at least 400 patients everyday in the casualty. There is one doctor for 20 patients. We still give our best." Deen Dayal Upadhyaya hospital medical superintendent Jiledhar Singh added, "In gynaecology department, we have 40 deliveries per day. You can estimate work pressure by this. There is 200 per cent occupancy in our hospital." The number of doctors in specialties like neurosurgery, cardiology and nephrology are also few.

"When there is one doctor and 20 patients – all emergency cases – waiting to be treated, one has to take a call on who needs immediate attention. But for each one of the attendants, his or her patient is more important. This mismatch between infrastructure and patient workload is the root cause of the instances of scuffle," said Dr Chandra Bhan, president of the Resident Doctor’s Association of Safdarjung hospital. He added that while number of beds or doctors cannot be increased overnight, security upgradation is should be made a priority.