Kerala - Thiruvananthapuram   

Call to decentralise health care system

Creating awareness: An exhibit at the 20th Kerala Science Congress in Thiruvananthapuram highlights the threat posed by mosquitoes.

THIRUVANANTHAPURAM: Kerala’s health policy should be reoriented with the thrust on decentralisation and community involvement, according to Dr. B.Ekbal, former Vice-Chancellor, University of Kerala.

Delivering the keynote address on the second day of the 20th Kerala Science Congress here on Tuesday, Dr.Ekbal, a consultant neurosurgeon, stressed the need for financial and administrative decentralisation of the health services department. “The basis of the health policy should be on reinstating the primacy of government health services. The primary health care sector should be the priority area. The community should play a key role in formulating and implementing health care programmes and reforms".

Dr. Ekbal called for revamping the primary and secondary level health care facilities with local bodies in control. “The control of infectious diseases and prevention, early detection and management of lifestyle diseases can be achieved with better community involvement. A participatory health service funded and operated by local bodies with the technical assistance of health professionals should be the objective. Community participation will also solve the problem of resource constraint and make health care more affordable.”

He mooted the establishment of a health surveillance and health information system to continuously gather detailed information regarding morbidity and other health indicators.

Dr. Ekbal proposed a social control system to make private medical institutions more accountable to society. He called for better integration between local bodies and the health department in planning and executing health projects and improving the facilities in public health centres and district hospitals.

Dr. Ekbal proposed facilities for comprehensive geriatric and palliative care in all hospitals and a system to ensure that all hospitals are equipped with a minimum level of infrastructure, medicines and medical staff. He urged local bodies to take up a campaign to reduce the morbidity related to life style diseases such as diabetes and hypertension. Such, a campaign, he suggested, could focus on early detection, life style changes and protocol- based management.

Another major proposal put forward by Dr. Ekbal was to establish trauma care facilities in all district and taluk hospitals and selected community health centres. He proposed a targeted system to provide primary health care facilities for marginalised groups like tribal communities.

The presentation also focussed on administrative autonomy to medical colleges and setting up departments of geriatric care in all medical colleges. It highlighted the need to bring all medical colleges, nursing colleges and paramedical training centres in Kerala under a Medical University and start new PG courses in Geriatrics, Palliative care, family medicine, general practice, emergency medicine, trauma care, acute care and hospital management.

Dr.Ekbal called for a ban on private practice of medical college teachers, with revision of pay and allowances on par with all India institutes. “No more self financing medical institutions should be established in Kerala. The functioning of the existing colleges should be subjected to a detailed study by an expert team.” He stressed the need to set up a modern drug research institute in the States with financial support from the Union government.

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