ASSIGNMENT -3 RECENT ADVANCES

STUDY OF DELHI STATE GOVERNMENT

SUBMITTED TO SUBMITTED BY

Swapnarag sir Gaurav Ojha

Lecturer 1907A02

INTRODUCTION:-

In Delhi, health care facilities are being provided by various Government & Non-Government
Organizations.

Directorate of Health Services (DHS) Government of NCT of Delhi is the major agency
committed to delivery of health care, it co-ordinates with other Govt. & Non-Government
organizations for the improvement of the health of the citizens of Delhi. Services provided by the
Directorate of Health Services. This Directorate co-ordinates the implementation of various
National and State Health Programmes.

Main health regulatory bodies of delhi

The Department of Health and Family Welfare, GNCTD

Health & Family Welfare Department of Govt. of NCT of Delhi has tremendous health care
responsibilities. The Department of Health & Family Welfare of Government of NCT of Delhi is
headed by the
Principal Secretary. He is the controlling authority for Directorate of Health Services,
Department of Health & Family Welfare
Health care delivery system in Delhi

Delhi has fairly well established infrastructure for its people with one of the highest bed
capacity (2.14 beds2/1000 persons) compared to the national average of about 0.7 beds per
1000 persons. Public Health expenditure of the Government of Delhi has consistently
remained above 6 per cent of the total plan budget during the last 20 years reaching up to
10.35 per cent of the plan outlay for the 10th plan (2002-07) – the highest for any state
government in the country. Delhi’s per capita expenditure on health is Rs. 685 against the
all India expenditure of Rs. 260 per annum.1
However, there is multiplicity of agencies operating their health care outlets in different
areas or for defined subset of populations in different areas like Delhi Government, MCD,
NDMC, CGHS, DGHS, ESI and Army etc. leading to some overlaps/duplications of services
with wastage of efforts and resources on one hand and deficient services on the other.

HEALTH INDICATORS OF DELHI

 The Total Fertility Rate of the State is 2.1.

 The Infant Mortality Rate is 37
 Maternal Mortality Ratio is NA (SRS 2001 - 03).
 The Sex Ratio in the State is 821 (as compared to 933 for the country).

Table I: Demographic, Socio-economic and Health profile of Delhi State as compared to India
figures

S. No. Item Delhi India

1 Total population (Census 2001) (in million) 13.85 1028.61
2 Decadal Growth (Census 2001) (%) 47.02 21.54
3 Crude Birth Rate (SRS 2007) 18.4 23.5
4 Crude Death Rate (SRS 2007) 4.7 7.5
5 Total Fertility Rate (SRS 2006) 2.1 2.9
6 Infant Mortality Rate (SRS 2007) 37 57
7 Maternal Mortality Ratio (SRS 2001 - 2003) NA 301
8 Sex Ratio (Census 2001) 821 933
 9 Population below Poverty line (%) 8.23 26.10
10 Schedule Caste population (in million) 2.34 166.64
11 Schedule Tribe population (in million) 0 84.33
12 Female Literacy Rate (Census 2001) (%) 74.7 53.7

 Table II: Health Infrastructure of Delhi 

Particulars Required In position shortfall

Sub-centre 188 41 147
Primary Health Centre 31 8 23
Community Health Centre 7 0 7
Multipurpose worker (Female)/ANM at Sub 49 51 -
Centres & PHCs
Health Worker (Male) MPW(M) at Sub Centres 41 0 41
Health Assistant (Female)/LHV at PHCs 8 19 -
Health Assistant (Male) at PHCs 8 NA NA
Doctor at PHCs 8 23 -
Pharmacist 8 11 -
Laboratory Technicians 8 5 3
Nurse/Midwife 8 4 4

The other Health Institution in the State are detailed as under: 

Health Institution Number

Medical College 5
District Hospitals 9
Ayurvedic Hospitals 10
Ayurvedic Dispensaries 148
Unani Hospitals 2
Unani Dispensaries 25
Homeopathic Hospitals 2
Homeopathic Dispensary 98

CURRENT STATUS (UPTO2002) OF DELHI IN TERMS OF

The 10th 5 year plan focuses on improvement in the quality of care at all levels and settings by
evolving and implementing a whole range of comprehensive norms for service delivery,
prescribing minimum requirements of qualified staff, conditions for carrying out specialised
interventions and a set of established procedures for quality assurance.

HEALTH CARE DELIEVERY SYSTEM

S.No. Activity 1998-99 1999-00 2000-01 2001-02
1. No. of OPD Attendance        

         

    Dispensaries 3682813 3823689 6381712 7032010

    Hospitals 1751968 2293298 2647161 3133511

    Mobile Health Clinics 1005382 1236535 1620393 1773820

    School Health Clinics 109478 148707 177285 185876

        

Grand Total 6549641 7502229 10826551 12125217

2. No. of IPD Attendance in 13614 42115 68165 77145
Hospitals
3. No. of Laboratory Tests        

         

    Dispensaries 134419 145437 238183 313554

    Hospitals 338639 355233 514321 711916

         

Grand Total 473058 500670 752504 1025470

4. No. of X-Rays 26790 48077 94025 151812

5. No. of Hospitals 13 15 11 11

6. No. of Beds in Hospitals 294* 549** 531*** 701***

7. Beds Occupancy Rate**** 75% 76% 85% 88%

8. No. of Dispensaries 139 139 155 167

9. No. of Dispensaries Opened 4 0 16 12

 Include 189 observation beds of 7 colony hospitals.

 Include 219 observation beds of 7 colony hospitals & ASJ Hospital.
 Include 101 observation beds of 3 colony hospitals & ASJ Hospital.
 Does not include observation beds.

HEALTH OUTLETS
 S.No. HEALTH OUTLETS 1998-99 1999-00 2000-01 2001-02

1. Number of Dispensaries 139 139 155 167

2. Number of Hospitals 13 15 11 11

3. Number of Mobile Health Clinics 62 62 73 73

4. Number of School Health Clinics 63 63 64 64

There are many activities, plans and policies are set by Delhi Government to provide proper
health care delivery to there state, government focused on some national schemes also.

The current activities on which Delhi Government focusing are as follows:-

HOSPITAL:-

The establishment of different hospitals under this Directorate is being taken care of by Hospital
Cell functioning in this Directorate under direct supervision of Director, Health Services.

The financial aspect of these upcoming hospitals are also being taken care of by Hospital Cell
like preparation of SFC Memo for cost estimates of Hospital which include estimates of
manpower, equipments and other vital components required for establishment of hospital. In
addition to above Hospital Cell is also involve in broad management of functioning hospitals of
this Directorate.

In the year 1993, there were only four hospitals was functioning under Directorate of Health
Services. But now at present, there are eleven hospitals functioning under DHS. These hospitals
are providing primary and secondary level care in different specialties like medicine, surgery,
obstetrics & gynecology, pediatrics, ENT, Ophthalmology, Skin, and Orthopedics etc to the
people in the catchments areas of the respective hospitals.

These hospitals are also acting as referral centers for various dispensaries/health centers
functioning in the area.
 PROGRAMMES LAUNCHED IN DELHI

The 11TH Five Year Plan does not allow any vertical structures to be created below district level
under different programmes. The existing programmes will be integrated horizontally at the
district level, as the emphasis during the Plan would be systemcentric rather than disease centric.

SCHOOL HEALTH SCHMES

School Health Scheme under the Health Services, Govt of Delhi, was launched in 1979 to
provide comprehensive health care services to the school going children. The scheme started
with six school health clinics established in the school premises itself.

School Health Clinics School Referral Centre

STAFFING PATTERN

Sanctioned Existing
-One Medical Officer One Medical Officer
-One Public Health Nurse One Public He alth Nurse
-One Pharmacist .
-Two attendents One attendent

REPORTS AND RECORD MAINTAINED

Reports

 Monthly Report

 Annual Report

 Any Other Special Report

Records

1. Cumulative Health Record Card

2. Medical Examination Register
3. Immunization Register
4. OPD Register
5. Referral and Follow Up Register
6. Health Education Register
7. Main Stock and Sub Stock Register
8. Various other Register

There are two school health schemes

a. Health checkup programmes

b. Flurosis mitigation programmes

Health Checkup Programmes

Under this Programme all children of primary classes of Govt. / Aided schools of Delhi were
screened for various pre-identified diseases like Refractory errors, Anemia, Dental caries,
Scabies, Pyoderma, Intestinal worms, Ear discharge, & Night blindness. Although this
Programme was conducted as a one time National Programme in 1996, Delhi Govt. decided to
continue this Programme every year. On the success of this Programme, the " Special Health
Checkup Programme for School Children " has been included in the Plan Scheme w.e.f. 1998-
99.

Components of programmes

Screening - One teacher will be expected to participate in screening of about 250 students.The
follow-up of all referred cases shall be done by repeated visits at monthly intervals, proper
proformas are devised.The programme will be monitored by core group members for the whole
duration of the programme.

Target Age Group:Students from Primary classes of all Govt./Aided schools in the age group 6-
10 years will constitute the Target group of this Programme. The students will be from schools
under different agencies like MCD, NDMC, Cantt. Board, and Govt. of Delhi.
Target Number of Children:The number of schools and approximate number of students as per
information from Directorate of Education Department is given below:

S NO. Agency Schools Students

1 Govt. of Delhi 423 1,50,000

2 MCD 1826 9,06,000

3 NDMC 80 30,000

4 Cantt. Board 6 3,500

Mass Deworming Programme

A large number of students have hidden burden of worm infestation leading to anemia and
growth failure. Therefore the mass deworming of children with a single dose Albendazole tablet
will also be undertaken in this programme.

Prevention of Hearing Impairment

Repeated ear discharge can lead to deafness. ENT Proformas designed by ENT specialists will
therefore also be filled for those students who have any such history.

Screening for Leprosy

Childrens are targeted for screening for leprosy also in current year.

Training Load

Agency No. of Teachers No. of sessions Master Trainers

MCD 2400 150 15

NDMC 250 10 2

Cantt Board 50 2 2

Govt of Delhi 700 50 4

Content of Training
The training will be aimed at equipping the teachers with skills to conduct the screening of
students. So the training will include :

 Brief details about all the diseases for which screening is to be done.
 The Modus Operandi of the Programme
 The system of Referral
 The system of Follow up
 Reporting system adopted during the Programme
 Monitoring of the Programme
 Distribution of Albendazole tablets & system adopted for this.

Flourosis Mitigation Programme

School Health Scheme, Govt. of NCT of Delhi, is catering to a large number of school going
children. Early detection of Dental Fluorosis may not therefore be a difficult task especially for
school covered by these agencies. However, it may be wise to cover schools in high risk Districts
as a pilot project, which may be extended to all the schools of Delhi subsequently

Components are

(I) SCREENING:About 67,200 students from 60 schools (table 1) of High Risk Districts will be
screened by school teachers trained for this purpose. Forty-two teachers will be trained from
each school.

One teacher will be expected to participate in screening of about 50 students. An average of

nearly 42 teachers will be trained from each participating school. Therefore a total of about 2520
teachers will have to be trained.

TARGET AGE GROUP:Students from class VI to XII ( above 10 years of age) of 60 selected
Govt schools will constitute the Target group of this Programme.

TARGET NUMBER OF CHILDREN:Approximately 67,200 students will be screened for signs

of Fluorosis.
DURATION OF THE PROGRAMME:The screening will be completed in two working days.
Further course of action will be taken up by Health staff & Delhi Jal Board.

(II) TRAINING:

The School Health Scheme, DHS, Govt of Delhi will organize the training for the Trainers
(Medical Officers, Public Health Nurses). The trainers will further train teachers in their
respective Zones in coordination with Education Department.

S.No. NO OF TEACHERS and HEALTH NO OF SESSIONS

WORKERS
1 Teachers: 2520 60
2 Health Staff: 250 5
Total 2770 65

Mobile health schemes

Today about 35% of Delhi population is living in the J.J.Clusters and unauthorised colonies.
Civic bodies are not able to do provide required civic amenities as they are all settled in the area
labelled as unauthorised by civic authorities themselves.

Newly formed Government of Delhi took a serious note of poor health status of residents of
J.J.Clusters and decided to strengthen Mobile Health Scheme to provide primary health care to
the residents at their door-step according to their felt needs. To start with a fleet of 20mobile
dispensaries was launched covering different J.J. Clusters all over Delhi on weakly basis. Due to
paucity to resources, and keep interest shown by some NGO’s Delhi Government invited NGO
sector to participate in the scheme and as a result, a fleet of 68 mobile Dispensaries started
providing health care to the J.J.Clusters.

As a result, the present status of Mobile Health Scheme is as follows:-

1. Mobile Health Scheme has been strengthened to a fleet of 68 mobile vans.

2. Mobile Health Scheme has become a major force in the success of Pulse Polio
programme during the last few years.
 3. Mobile Health Scheme has participated in the implementation of all the relevant health
programmes like special measles vaccination programme, Matri Suraksha Abhiyan,
National Blindness Control programme etc.
4. Mobile Health Scheme providing health care facilities to thousand and lakhs of people
attending religious and social get together etc.

Mobile Health Scheme at a glance year 2001

Head Office Delhi Admn. Dispensary building, B-Block,

Prashant Vihar Delhi-110085
Zones of Mobile Health . Contract No.
Scheme
North Zone Sahazada Bagh 3658644
East Zone Dilshad 2289954
Garden         
West Zone Prashant Vihar 7868242
South Zone Ber Sarai       6521771

Drug store of Mobile Health Scheme Prashant Vihar

Number of mobile dispensaries running 68

DHS run 39
NGO run 29
Number of NGOs working in Mobile Health Scheme 23
Number of JJ Clusters covered 420

One vehicle is allotted to one assembly constituency

Staff position

Name of post Sanctione Filled Vacant          Detailed Physically

d present
Medical 35 29 6 1 28
Officers
PHN 20 8 12 - 8
ANM 15 15 - - 15
Pharmacist 35 35 0 2 33
Dresser          35 15 20 1 14
Peon 35 19 16 - 19

Operational Procedure —

Vehicles start from zonal office/colony hospitals/ peripheral hospitals/ dispensary cell zonal
offices/NGOs office and one mobile dispensary visits 2 JJ Clusters in a day. One vehicle covers
total of 6 JJ Clusters and each cluster is visited twice a week and medicines are issued for 3 days.
Mobile Health Scheme teams collect medicines from central store Prashant Vihar once a month.

Constitution of medical team    Medical Officer, Pharmacist, PHN/ANM, Dresser, Attendant

Budget Allocation for 2000-2001 Rs.364.40 lacks

Expenditure in 1999-2000 Rs.301.36 lacks
Number of patients attended in 1999 12,24,557
Number of patients attended in 2000 13,95,465

Cost of treatment per patient for 3 days Rs 24.60

Delhi Government Health Scheme

Delhi Government Health Scheme was launched in April 1997 with a view to provide medical
facilities to Delhi Government employees and pensioners on the pattern of Central Government
Health Scheme on the basis of monthly contribution.

For this purpose, the Directorate of Health Services is providing Health cards to all the Delhi
Government Departments/ Offices on receiving their requirement

For the purpose of providing medical facilities, eight dispensaries have been identified so far
which will shortly function for twelve hours. The dispensaries are located in

 Paschim Vihar
 Vikaspuri
 Model Town
 Timarpur
 Gulabi Bagh
 Mayur Vihar
 Kalyan Vas
 Karkardoma

The hospitals recognized for providing free admission and treatment facilities are :

 Lok Nayak Hospital

 GB Pant Hospital
 GTB Hospital
 DDU Hospital
 BJRM Hospital
 LBS Hospital
 Sanjay Gandhi Memorial Hospital
 Guru Govind Singh Govt. Hospital
 Aruna Asaf Ali Hospital
 NC Joshi Hospital

In addition, the following referral Hospitals have been recognized for the following specialized
treatments:

Coronary By Pass Surgery Batra Hospital and Medical Research Center, Tughlakabad
Escorts Heart Institute and Research Center, Okhla Road
National Heart Institute and Research Center, East of Kailash
Cancer treatment Dharamshila Cancer Hospital, Vasundhara Enclave
MRI & CT scanning Indian Spinal Injuries Center, Sector C, Vasant Kunj

Antismoking campaign

Delhi Prohibition of Smoking and Non-Smoker's Health Protection Act, 1996 was enforced in
Delhi w.e.f. 26.1.1997. Total 239 IEC activities (which induce Health Education lectures,
Seminars, Exhibitions, Rallies, Radio/TV interview) Painting and Essay competitions were
carried out. 115 Hoarding and 200 Railings were placed in various places of Delhi. More than 18
lacs leaflets were distributed Section 8 and Section 9 of the above act had been notified by Delhi
Govt. and is made effective w.e.f. 1.1.2001 under which sale of cigarette, bidies and other
Smoking substances to below 18 years of age and Sale, storage and distribution of above
substances, 100 metres in and around of school/ colleges and other educational institutions is
legally banned and pursuable with fine / imprisonment.

Anti-Quackery Activities

To, control the quacks and undesired medical practitioners special anti-quackery cell has been
appropriate action against the quacks. About 180 clinics of quacks have been raided. Out, of
which 17.quacks were arrested by police and rest of the clinics were found closed.  

Motia Bind Mukti Abhiyan

This Programme was launched by Government of Delhi to clear backlog of Cataract cases.  
Shravan Shakti Abhiyan

This programme aims at providing hearing aid to senior citizen of Delhi free of cost and till date
about 3,000 hearing aids have been distributed.

State Health Intelligence Bureau

State Health Intelligence Bureau has been established under the Plan Scheme of Directorate of
Health Services with prime objective of maintaining health related data. The data is collected
from various Govt. and non-govt. agencies. The collected health related data is compiled,
analysed and published. During the Current Financial Year, the State Health Intelligence Bureau
already published/prepared the following documents.

 Medical Telephone Directory, 2002.

 Assembly Constituency - wise medical facilities in Delhi.
 Annual Report of Directorate of Health Services.
 DHS at a glance
In addition to above, State Health Intelligence Bureau is also responsible for collection and
further forwarding the answer of Parliament/Assembly Questions from different branches of
Directorate of Health Services.

NATIONAL PROGRAMME

 National AIDS Control Programme 

To reduce the spread of HIV infection & strengthen the capacity to respond to HIV/AIDS on
long term basis.

National Cancer Control Programme

In the Ten YearPlan scheme “Setting up of Cancer Control Cell“ was started for carrying out the
various activities related to cancer. The Directorate of Health Services through the Plan scheme
“Setting up of Cancer Control Cell“ is coordinating and implementing the various facets of the
problem of cancer. The scheme is continued in the 11th five year plan.

Cancer Control Cell has been established in Directorate of Health Services, Karkardooma and is
being looked after by State Programme Officer. Advisor, Cancer Control Programme for Govt.
of Delhi guides in implementation of the activities under the programme from time to time.

Activities presently pursued

1.       Cancer Detection Clinics are now functioning in all hospitals of Delhi Government on
Twice weekly basis (Tuesdays and Fridays) for preventive, promotive, early detection
and palliative activities.

There are Nine District Cancer detection centres are currently functioning in the
following Hospital

1. Babu Jagjiwan Ram Hospital, Jahangirpuri, Delhi

2. Dr. N.C. Joshi Memorial Hospital, Karol Bagh, N.Delhi

 3. Guru Gobind Singh Hospital, Raghubir Nagar, Delhi

4. Lal Bahadur Shastri Hospital, Khichripur, Delhi

5. Rao Tula Ram Hospital, Jaffarpur, Delhi

6. Malviya Nagar Colony Hospital, Delhi

7. Sanjay Gandhi Memorial hospital, Mangol Puri, Delhi

8. Charak Palika Hospital, Moti Bagh, New Delhi

9. Aruna Asaf Ali Hospital, Rajpur Road, Delhi

Grant in Aids to NGOs

This directorate invites NGOs proposals for Grant in aid through newspaper advertisement at the
beginning of every year. GIA proposals are considered for improvement of medical services in
charitable dispensary/ hospitals run by NGOs. Besides that, GIA has also been considered for
Tuberculosis control activities among people in slums and pavement, fluorosis mitigation, anti-
smoking awareness activities etc.

Nursing Home Cell

Nursing Home Cell was established in DHS (HQ) with a view to monitor the working of private
nursing homes and to scrutinize the proposals before recommending the case for land allotment.
The Nursing Homes cell registers the private nursing homes in Delhi after proper inspection and
if they meet the basis standards yardstick, and found fit for registration as per Delhi Nursing
Home act.

  In addition to the above, Nursing Homes Cell also examines the proposal and recommend
the cases of medical reimbursement claims of Delhi Government employees from different
departments. During the year 2001-02 505 case as compared to 200 cases in 2000-2001, were
received and spl. Advice was given to different Department for disposal of reimbursement cases.
 Delhi Arogya Nidhi (Delhi Illness Assistance Fund)

RULES AND REGULATIONS

Name of the Society

The DELHI ILLNESS ASSISTANCE FUND would be managed as a Society and would be
known as Delhi Arogya Nidhi (DAN).

Governing Body

The Governing Body shall consist of the following :-

a. Health Minister, Government of Delhi Chairman

b. Principal Secretary , Government of Delhi
c. Secretary (Finance), Government of Delhi.
d. Director, Indian System of Medicine, Government of Delhi.
e. Director Health Services, Government of Delhi- Member Secretary.

Information for Emergency Medical Care

Guidelines for Citizens

Regarding Trauma ( Accidents and Injuries) Burns, Drowning and Medical Emergencies

Accidents and Injuries (Trauma)

In case of major injury or accident where the person need immediate first aid, either call
Centralized Accidents & Trauma Services (CATS) or Police control room or the
Ambulance or take the person to the nearest hospital or to Sushruta Trauma Centre behind IP
College. Major Hospitals where CT scan with intensive care (ICU) facilities with ventilator
support are available:
  Lok Nayak Hospital, Delhi Gate
 GB Pant Hospital, Jawahar Lal Nehru Marg
 Ram Manohar Lohia Hospital
 Safdarjang Hospital
 AIIMS
 Hindu Rao Hospital, Civil Lines
 Deen Dayal Hospital, Hari Nagar
 Sushruta Trauma Centre, behind IP College
 In Guru Teg Bahadur Hospital, Dilshad Garden (intensive care facilities with ventilator
support without CT scan)
 GuruNanak Eye Centre - for Eye related trauma

Burns

In case of Burns, take the patient to any of these hospitals :

 Lok Nayak Hospital, Delhi Gate

 Ram Manohar Lohia Hospital, New Delhi
 Safdarjang Hospital
 AIIMS
 Hindu Rao Hospital, Civil Lines
 ESI Hospital, Basai Darapur
 Deen Dayal Hospital, Hari Nagar
 Guru Teg Bahadur Hospital, Dilshad Garden

Drowning

In case of drowning, call the Fire Service (101) or Police Control Room (100) or Centralised
Ambulance and Trauma Services (1099) for help and take the patient to any one of the above
hospitals.

For Minor injuries or accident one may also contact :

  Swami Dayanand Hospital, Shahdara
 Sanjay Gandhi Memorial Hospital, Rohini
 RaoTula Ram Hospital, Jafar Pur Kalan
 Babu Jagjivan Ram Hospital, Jahangir Puri
 Lal Bahadur Hospital, Khichdi Pur
 Aruna Asaf Ali Hospital, Civil Lines
 Guru Gobind Singh Hospital, Raghubir Nagar
 Charak Palika Hospital, Moti Bagh

RECOMMENDATIONS
1. Create a trustworthy and interlinked for providing the proper healthcare.
The National Capital Territory of Delhi has a “healthy” network of healthcare centers; 31
hospitals including 3 hospitals under ISM&H (Indian System of Medicine and Homeopathy),
174 Allopathic Dispensaries, 70 Mobile Van Dispensaries, 433 School Health Clinics, 20
Ayurvedic Dispensaries, 62 Homeopathic Dispensaries and 8 Unani Dispensaries.
However, these centers are far from networked. There are two aspects of this problem, which are
not necessarily mutually exclusive.
Firstly, there is a lack of trust in the system. Out of the host of centers mentioned above, many
lie underutilized with as low as 40% occupancy rates, on account of lack of facilities, medicines
and doctors. On the other hand, there are centers with as much as 200% occupancy rate, with
patients sharing beds and lying on the floor. The reason clearly is the variability in services
provided
Secondly, the aspect, which is very closely related to the first, is the lack of links between these
centers. In case of unavailability of medical personnel, equipment etc. at any one center, the
patient is asked to leave for another hospital, which has the required facilities.

2. There should be a proper resource distribution in healthcare

The distribution and allocation of resources undoubtedly results from the great pressure on
tertiary care center.
To counter this problem some points are
a. All primary care centers must be upgraded to a specified standard; they must be
capable of assessing the need of the patient, stabilizing emergencies if any, and send
patients to secondary or tertiary centers only if needed.
b. One way to capitalize on these assets is to make the patient the responsibility of the
system the moment he enters it. At the point of entry, the details of the patient, the
illness/accident etc. are collected. If he/she must be shifted to another center
transport must be provided and transfer with all records must be done, with proper
information flow from the physician sending the patient to the one receiving
him/her.
3. Professional management of Government hospitals is essential for better
efficiency of services and duly qualified hospital administrators should be placed
head of institutions and selection should be based on performance, efficiency,
skill, dynamism, vision and ideas and not merely on length of service or seniority
basis34. A step in this direction could be para/non medical management working
a) under the guidance and b) according to the requirements of the medical staff.
This would help in the following ways:
 Reduce the burden on the doctors
 Provide specialized administration in government hospitals and
 Bring in the attitude of ethical and competitive practice by the private
hospital and
4. There is a need for higher proportion of public spending on health – it is merely
0.9 per cent of GDP in India, which ranks at poor 171st position out of the 175
countries studie This is in contrast to the figures of 8.1 per cent of GDP for
Germany, 7.3 per cent for France, 6.2 per cent for USA, 3.2 per cent for Brazil
and 2.0 per cent for China on Health. On the other hand, private spending on
health in India is 4.2 per cent of GDP and ranks 18th in the world tally, which is
disproportionately high as compared to public health spending for a country like
ours which is home to so many poor people.
5. Encourage development of high class health care infrastructure in NCR towns as
well as in the neighboring states of Delhi through incentives and/or soft loans ton
entrepreneurs ensuring comparable quality at competitive costs.
6. Inclusion of health related topics in school and college curricula.
7. Control of stray dogs and stray animals to minimize traffic hazards/accidents and
to reduce the cost of superfluous use of Anti Rabies Vaccine, besides indirect
saving on man hours – Annually 3-5 crores are spent on ARV in GNCTD
hospitals.
8. Management Information System should be strengthened at all levels for tracking
status of supplies, monitoring suppliers, monitoring installation of equipments
within prescribed time schedule and for ensuring compliance with terms and
conditions of agreements. A copy of full rate contract of all hospitals may be
displayed on the department’s website for ensuring procurement of drugs
economically.