Today’s Times of India (Mumbai edition) carries a story on paucity of medical teaching staff in medical colleges across Maharashtra and the situation surely sounded grim. The scenario maybe similar in many other states too. This problem is more grave than it sounds and let me share with you a true story that happened with us. About 4 years ago, we were mandated by a large industrial house in India to make a business plan to set up 20,000 beds in India in a span of 5-7 years. Low cost high volume models were studied carefully to understand the economies of scale and it was decided to set up either 5 hospitals of 2000 beds each or 10 hospitals of 1000 beds each across the country. Detailed financials were prepared and subjected to various sensitivity analysis and was found to be a robust model in terms of sustainability. It would have been akin to launching a nano car…
The model was shared with all company top brass and found to be exciting enough to be taken forward. There was a final presentation to the board and the Chairman asked as to whether we have enough medical and para-medical manpower in the country to service these beds?? There was a stunned silence in the room and even I was embarrassed as in the zeal of making the project viable, we had not given serious thought on availability of sufficient human resource. We were faced with the harsh reality and the project is still stalled for want of an answer to the question posed.
The problem is faced by almost all major hospital chains in the country and becomes more acute when we talk about rural hinterlands of India. I remember when we commissioned Mahavir Cardiac Hospital in Surat, we had a tough time finding a full time cardiac surgeon, cardiologists and even cath-lab technicians and perfusionists for cardiac surgeries. Maybe the recent proposal for relaxation in norms for setting up medical college wherein up to 10 acres of land is enough in metro cities and 20 acres in other cities will help create more medical colleges along with opening up of the policy which private corporate bodies to invest in such institutions. We need to understand that it takes 5 years to train a doctor and at least 3 years to train a nurse. This will be a long drawn process and India needs to move faster than it is currently doing in these areas of creating qualified pool of trained professionals. In fact the thought mooted to restart training for the Registered Medical Practitioner (RMP) courses is also welcome as we will need manpower to treat patients in rural areas where Doctor’s are unwilling to relocate. The concept is similar to the Village Doctor (Barefoot Doctor) concept prevalent in China. Even the Bhore committee report prepared post independence had strongly recommended the RMP professionals to tackle the problem of unavailability of trained medical manpower in rural parts of the country. Things would surely have been different if we would have continued to train RMPs. Anyway it is better late than never and hopefully we will have some solution to face the problem of shortage of trained human resource.
Shortage of healthcare manpower seems obvious when a physician or surgeon or super specialist turns down to attend a newly commissioned hospital.This has remained a concern last few decades and have been a headache for the hospital management cadre.But the issue is more grave. There was a time when there was huge brain drain to europe and USA . This has come under control with the health professional councils or registration boards having stringent rules and regulations and not many physicians relocating, but still , as far as nurse immigration is concerned the number is big. Currently the major nurse sourcing destinations are countries in middle east, Western Europe, USA , Singapore, Malaysia. Indian physicians and nurses are overworked, salary is not big, these factors also discourage the new generation to consider healthcare as a career.The nurses and physicians are not only concern, there is shortage of OT technicians, CSSD technicians, ICU technicians, Radiology technicians, MRD techinicians, ( the list goes on ) . The hospitals somehow manage the show with under trained staff or staff who have worked in other hospitals and have learnt on the job but their credential is not verified regularly , On one hand we stress on National level accreditation. and other hand we have to manage the show with limited resource, The staff who deal with life and death situations are over worked and underpaid, The situation is grave. Few days back there was committee made ( national level) and big personalities were members, but nothing else is heard on media after that on the same . Hope the solution is being baked. Except IMC no other healthcare professional council is that strong to speak up of their needs and get a hike in Salary for government services, and most of the times the other associations seem to be shadowed by several factors, this is really unfortunate, Second thing is IMC being a stronger organisation needs to foster the other healthcare professionals’ association which is apparently absent. There is need from all levels to raise concern and create awareness for stronger actions, to standardize educational requirements, and salary and other facilities for healthcare professionals.There is a huge disparity between how different healthcare professionals are paid, There may be difference but not huge gap .
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