Patricia Mukhim
No other health care provider is written about as much as the North East Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS). This is good because the management of this critical care centre can remain on their toes and not take things for granted. Sadly every central institution located here, however noble its intent, tends to fall by the wayside because of bureaucratic red tape, control by New Delhi and lack of leadership and vision required to run such institutions. A public institution whether it be a medical and health infrastructure or a university or a power supply utility are publicly-owned. This means they are funded from the public exchequer. Hence the public need to actively engage with these institutions and hold them to account. The institutions on their part should not feel that the public are encroaching on their rights when they raise questions or critique the institutions. In fact public criticism and CAG reports are the only two elements that can keep institutions on the right track.
The fact that NEIGRIHMS is overburdened with patients from across the seven states, including Assam, Manipur and Tripura which have their own medical colleges, means that the health care institutions in the above states are not functioning well or that NEIGRIHMS has established itself as a leader in some critical departments. I have met with several patients and their relatives who lodge at some of the guest houses/hotels and asked them why they have come all the way here and whether they have reliable health care facilities in their own states. The standard reply one gets is that the Cardiology Department of NEIGRIHMS is well known and has saved many lives. Some may disagree but the fact remains that the Cardiology Department is the flagship Department of NEIGRIHMS. Personally, I have only been to the Orthopaedics Department and found things to be working well here too. At one time I was given a guided tour of the Radiology Department and saw state of the art MRI and CT Scan machines including a modern X-Ray unit. One is impressed by the availability of such modern diagnostics services provided free of cost. My immediate concern was whether this is sustainable in the long run and if NEIGRIHMS has a revenue model for maintenance and repair of these machines if they do go kaput which is inevitable with such a huge population of patients requiring their services on a daily basis. I also learnt that the armed forces stationed in Shillong, also come to NEIGRIHMS for treatment and diagnosis. My question is: What about the Military Hospitals? Are they not able to cater to their own personnel? Can civilians get treatment at Military Hospitals? Similarly, should the armed forces personnel crowd a health facility meant for civilians?
Lest I be accused of leaving out other Departments of NEIGRIHMS which also play yeoman’s role in patient care, let me also place on record that the Departments of Medicine, Surgery, Gynaecology and Urology also have their aces and each is trying to perform to the best of its ability. There is a palliative care centre for cancer patients too which you would not see in a private hospital. Even if there is a palliative care unit in a private hospital you would have to pay through the nose. In fact, private hospitals today have become so mercenary that they automatically weed out those who are not capable of paying and cater only to the affluent. I often wonder how such exploitative models are encouraged in a poor country like India, and, what are the corporate social responsibilities (CSR) engaged in by private hospitals. It would be enlightening if we could see this in the public domain.
Coming back to NEIGRIHMS, it would be fair to say that every director who came in tried to do his best but a health and research centre requires a breadth of vision that few possess, least of all doctors coming in from the government sector. They have simply implemented blueprints coming from the top and mainly from bureaucrats or technocrats whose brief ends only with the brick and mortar part of the institution but not its heart – caring, healing and preventing illness. At one time NEIGRIHMS was supervised by the Prime Minister’s Office (PMO) because it took too long to kick-start. Now it is back with the Union Health Ministry which again is a problem since many of the things that directors would like to see implemented are killed by red tape. If NEIGRIHMS is ostensibly modeled along AIIMS, Delhi then why is it not given the autonomy that AIIMS enjoys?
Recently there have been news reports and letters to this newspaper complaining that the X-Ray unit gets heated up and patients and their attendants are kept waiting for hours. This means that there are not enough X-Ray units or that patients have far exceeded the numbers envisaged. I wonder how the Director is tackling this emergency because that is what it is. There are too many people in this country who cannot afford private health care. Government institutions will therefore continue to be overburdened. But this also means that NEIGRIHMS should speak out and tell us the exact position. Sweeping the dirt under the carpet will not help anyone!
I recently met the Director Dr Thappa who informed that he had kept a complaint/suggestion box outside his office so that complaints are addressed within the Institution instead of people running to media for every grievance. And that is a problem I wish to address in this article. NEIGRIHMS belongs to the public of this region. Instead of rushing to the media why don’t patients and their relatives meet the Director and lay out their grievances before him? On his part the Director is expected to be empathetic and not defensive. Heads of Institutions need to be exposed to the public so that they learn firsthand what is ailing the Institution. Every institution also has its share of internal politics. Where two or more individuals live and work together politics is inevitable but it need not be destructive. The Director is expected to embrace all shades of opinions and to set standards of behaviour that can be emulated by juniors and peers. Every institution also has its ethical standards which all are expected to follow, including the head of the institution.
The Director also informed that a 250 bedded, cancer unit and medical college is coming up adjacent to the administrative complex. This will be a great boon to the people of the region since cancer is a growing concern across states. However, what is worrying is the menu in the NEIGRIHMS canteen from where patients and their relatives usually get their food from. Since Dr Thappa joined the Institute, the canteen has stopped serving non-vegetarian cuisine. I brought this to the attention of Dr Thappa but he brushed the concern aside saying that no such directives were given to the canteen management. But the menu I managed to procure tells the real story. There is vegetable momo, vegetable patties, vegetable paratha and cup noodles (this last one is an unhealthy food item). The rest are cakes and muffins all of which have very little nutritional value and are not diabetic-friendly. The people of this region are not vegetarian by culinary choice. They get their proteins from meat. While it may be difficult for canteens to provide a choice of meat, they can at least serve fish and chicken which are normal fare. I can’t understand why a new menu should be introduced with the joining of a new Director.
Finally, as to whether NEIGRIHMS is an entitlement or a privilege, I would like to believe it is both. It is a privilege that we now have access to the best treatment within the region and don’t have to flock to Vellore, Delhi, Mumbai or Chennai for medical care. It saves time, money and undue stress for the patient and his/her family. As an entitlement, we get free or subsidized diagnostic facilities and treatment. Medicines may not be completely free but they are sold at rates that are lesser than marker rates.
Considering that NEIGRIHMS caters to the people of all eight states, it is incumbent upon all state chief ministers to take interest in this Institute and help it in its journey. Similarly, the Members of Parliament from the region ought to show a sense of ownership too and engage with the Union Government to give a fillip to NEIGHRIMS. As of today, NEIGRIHMS is an orphan out of whom much is expected but very little is given by the public.