The Hindu : Kerala / Thiruvananthapuram News : Lack of centralised system plagues MCH

Online edition of India's National Newspaper
Friday, Jan 07, 2005

Kerala

Kerala - Thiruvananthapuram

Lack of centralised system plagues MCH

By C. Maya

THIRUVANANTHAPURAM, JAN. 6. Timely and regular maintenance of equipment in the Medical College Hospital (MCH) is turning out to be a headache for the authorities in the absence of a centralised system for taking care of malfunctioning equipment as soon as the fault is reported.

Every time a machine develops a snag, it may take weeks or months before it is made functional, putting poor patients to hardships. It has only been four months since the CT scanner here became operational after a six-month gap.

The Echocardiogram at the Cardiology Department went phut two days ago, while the Holter machine, another device for detecting abnormalities of the heart, has been in disuse for over a year.

The Arterial Blood Gas analyser or the ABG machine in the 24-hour emergency lab run by the Bio-chemistry Department has remained out of use for the past five months, putting patients to a lot of trouble. A sophisticated machine imported from UK, it is used for conducting crucial blood tests, within five minutes of drawing the sample.

Blood samples

The Cardio-thoracic unit has a similar machine that has fallen into disuse for over two years now. Poor patients now have to rush with blood samples in an ice pack to private labs, where Rs. 360 is charged for a sample.

Authorities admit that the machines have fallen into disuse for so long that fungus attack has set in, necessitating the purchase of a new one. Other equipment lying in disuse here include a laminar flow chamber used for preparing uncontaminated samples in the Microbiology Department, semi/fully auto analysers and autoclaves (sterilisers). Apart from these, only two out of the five power laundry machines are functional.

The MCH has a central workshop that is supposed to take care of the maintenance of basic gadgets, including instruments like trolleys, wheel chairs and the like. For all hi-tech instruments, the authorities have since 1995 been following the system of annual maintenance contract (AMC) with the company that supplies the machine. The AMC comes into effect once the warranty period of two years expires.

Settling bills

However, because of the long delay in getting bills settled, most companies are not too keen on responding promptly every time there is a distress call, MCH sources said. In the case of sophisticated machines, the delay is often caused by the lack of spare parts or the absence of the technical expert.

"There is no single system in place for purchasing quality equipment and to ensure that the repairs are carried out systematically. We already have pending bills of over Rs. 3 crores of several companies because of which firms are not interested in doing repair," a senior doctor said.

Repair of equipment bought by the hospital development society is taken up via the Superintendent, while the work on those sourced using Government funds is the Principal's responsibility. Agencies like the Kerala Health Research and Welfare Society or the Dhanwantari also has installed machines, the repair of which is a different matter altogether. This is the crux of all maintenance problems at MCH, it has been pointed out.

Quality specifications

In the absence of a centralised system for fixing quality specifications of equipment, the hospital, as a rule, buys the lowest priced machines. "The accent is on low price and not necessarily quality. This is a major handicap of our purchase system," according to a doctor.

MCH, with its patient overload, works most of the machines overtime. This increases wear and tear and often, there are no stand-by arrangements in the eventuality of breakdowns.

"In a major multi-speciality and teaching hospital like the MCH, a separate biomedical engineering division is a must. This division should be in charge of purchasing quality machines and maintaining them," says C.G. Bahuleyan, the Cardiology chief at MCH.

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