Public Hospitals are government health institutions that provide free of cost health care to the people through specialized medical and nursing staff, medical equipment and diagnostic facilities. Hospital may be a general hospital or a speciality one depending upon the nature of services it renders and type of patients it caters to. Hospitals are categorized as general hospitals, women’s hospitals, children hospitals, psychiatry hospital and bone and joint or orthopaedic hospitals and few more. In our valley all specialty hospitals are located in and around Srinagar city. Hospitals in all other district headquarters and major towns are of general category and are equipped only to provide services of primary nature. Obviously the situation in smaller towns is all the more worse.
Government hospitals provide all general, specific and specialized treatment to majority of the valley’s population who are not in a position to meet exorbitant costs in the private health sector. All public hospitals are adequately staffed with professional physicians, surgeons, nurses, and allied health practitioners in addition to para medical staff. These hospitals function by the coordinated work of all these professionals who work tirelessly round the clock to provide relief to the thousands of patients who throng them all hours of the day and night.
Kashmir valley has a number of general, speciality and super speciality hospitals, majority of them located in the capital city of Srinagar. The hospitals cater to the healthcare needs of a huge population, entertaining patients from all corners of the valley. The hospitals thus remain alive round the clock all around the year without any lull or respite. Owing to the continuous rush of the patients, the facilities generally remain stretched to the brim at all the centres as people keep on thronging the hospitals for diagnosis, treatment and therapies. The uncontrolled rush thus invariably creates occasional ruckus and commotions between the staff and the attendants which sometimes turn ugly resulting in strikes and demonstrations.
All public hospitals in the valley are funded by the government and the facilities are forwarded to the patients almost free of cost or at a nominal cost to make these services more accessible to lower and middle classes of the society. That is the reason that the government hospitals remain always overcrowded, but ever-ready to provide the services to the people. The capacity constraints do not prevent people who need treatment from landing in the hospitals and getting entertained.
One of the most talked about hospitals of paramount importance is the Women’s Maternity Hospital, also known as Lal Ded, or simple the LD hospital in Srinagar. The hospital delivers maternity services to almost entire valley providing emergency and urgent care to the expecting mothers and those who suffer from various types of complication during the course of pregnancy and other related ailments. The hospital is doing a tireless and mostly thankless work 24 hours a day, receiving and treating thousands of patients both in the OPD and the indoors. Any person who has had an opportunity of visiting the hospital will stand witness to the nonstop work being rendered by all sections of this health care facility. With no let-up in patients’ influx to the hospital, one can easily infer that the hospital is doing its job well and providing desired services to those who need them and visit the hospital for the purpose.
However hospital does have its share of incidences of negligence by the medical staff, mainly the doctors, and sometimes other para medical and the security staff as well. Consequently incidents of commotion and confrontations between the attendants and the hospital staff do take place which sometimes get blown out of proportions, throwing the good work done by the hospital to the trash bin.
One thing which we as the public and doctors as the staff generally ignore is that we are in a government-run hospital which provides the services almost free of cost to the public and pays adequately to the serving staff. It is thus not rational that the patients and their attendants should expect the services to be like that of a corporate hospital. Even the doctors forget that they are employed and are not working in a corporate hospital but a general government-run hospital which carries all the inherent limitations and lacunae with it. There is the dire need for the patients and the attendants to remain conscious to the realities, and those working in the hospital, particularly the doctors also need to shed off arrogance and the pseudo sense of high esteem which might come in their way while delivering quality services. The medical staff ought to be proud on rendering quality services in a submissive manner, not with arrogance and or as a charity. Patients as well as the doctors must believe in what we have, and not what we ought to have or what we need or what we wish to have, and at the same time acknowledge the continuous improvement of services at all levels by the authorities.
Recent case of alleged negligence in the LD hospital was unfortunate one and rightly condemned by all sections of society. Whereas there is little room for such type of negligence in the medical care sector as the margin of error is always very little, possibility of occasional misjudgement and even incompetence cannot be ruled out. However isolated incidence of such negligence should not be used to malign the otherwise hard work of the entire institution. Authorities have rightly ordered a probe and it is hoped that the responsibility will be fixed and proper action initiated against the erring person or personnel.
Strife between doctors and attendants is not a new phenomenon. It is routine in all government run intuitions, sometimes even in private hospitals as well. The main reason behind such incidents is that all the parties put themselves at the wrong threshold and develop unjustified expectations. If both the parties understand and recognise their respective positions, chances of the verbal as well as the physical braw will no doubt minimise. It is however very painful that sometimes the attendants cross the limits thus bringing disrespect to the entire society. They forget that patient violence towards hospital workers threatens employee health and safety and is invariably associated with decreased productivity and poor quality of care.
Unfortunately, more often than not the reaction of the doctors also does not fit their stature. I remember an earlier episode in the same LD hospital when one female doctor was physically assaulted by some attendants. The act was condemnable and was condemned by one and all and the matter was rightly handed over to police for proper action against the unruly people. However more hurting was the reaction from one of the doctors, probably from the same hospital who took to social media in expressing his anguish over the incident.
Displaying his phenomenal rage, he crossed all limits of decency and civilization while reacting to the unfortunate incident. He spit venom against the entire civil community and used such shameful abuses and untoward remarks against the society that one felt nauseated and made rethink whether the action of the attendants who created ruckus at the hospital was right. If you abuse in response to an abuse, you don’t deserve sympathy. If the unruly behaviour of the patients or their attendants is unacceptable, so is the negligence and arrogance on parts of doctors and other staff as well. Correction is needed at both the places. We all must realize that our hospitals do not compete on profitability, but are driven by the volume and quality of services they provide to the public.
While it is necessary that all parties understand and accept their respective positions at the government run hospital, the origin of the problem also needs an objective analysis by the authorities. One principal factor behind all such unhealthy incidents at the health institutions is the unending rush of the patients stretching the system to the seams. This obviously reflects the deficiencies in the healthcare not only at the block level, but also at sub district and district levels as well. Unless the facilities at least in the district level institutions are enhanced, Srinagar hospitals will remain overcrowded and brawls will continue to occur. Equally important is to develop effective discipline strategies at all the hospitals which must be binding to the staff as well as the patients.
In the era of health care reform, public hospitals in the valley face strong pressure to be more sensitive to social responsibility. It is unlikely that these hospitals will experience dramatic changes in near future. Hence the hospital managers and health policy makers should focus more on organizational culture and its implications for hospital performance and those availing the facilities must do so with the sense of gratitude and appreciation.