The Hindu : Tamil Nadu News : Public healthcare system comes to aid of the poor

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Monday, Jul 07, 2008
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Tamil Nadu

Tamil Nadu

Public healthcare system comes to aid of the poor

Free medical care for the poor is a boon to scores of below poverty line families in Coimbatore District that cannot afford the costs at private hospitals, writes K. V. Prasad

Photo: M. Periasamy.

TO THEIR RESCUE: Poor people queue up at the pharmacy of the Coimbatore Medical College Hospital for free medicines. —

Despite problems in maintenance and complaints of poor service, the benefits of the public healthcare system seem to be coming into better focus at a time when inflation keeps rising.

Delivered properly, free medical care for the poor is a boon to scores of below poverty line families in Coimbatore District who cannot afford the costs at private hospitals.

Touted to be a medical tourism destination, Coimbatore has a Government healthcare apparatus that seeks to serve a population of 42 lakh. But, the lack of specialised care, such as cardiac surgery or kidney transplantation, drives the poor to private hospitals or to Government hospitals in Chennai or Madurai or wait for destiny to take its course.

But, for treatment in many other areas, the Coimbatore Medical College Hospital sees a huge inflow of patients every day. This is a tertiary referral unit hospital that serves Coimbatore, Erode and the Nilgiris districts. It has a daily out-patient flow of around 7,000 and more than 1,000 in-patients. The hospital says that these patients undergo free treatment. And, there is substantial savings made on the cost of medicines.

The Government’s healthcare system, including the one at the medical college, is of great help to the low income groups, points out Dean (in-charge) of the CMCH V. Kumaran. “For persons with a monthly income of up to Rs.999, surgeries are done free of cost,” he says.

At the higher income level, those earning above Rs.7,000 need to pay Rs.40,000, as per charges fixed in 1995.

A computed tomography plain scan costs Rs.350 for in-patients and Rs.500 for out-patients who belong to income groups for which free treatment is not available. Private hospitals admit they charge more. But, they also point out that the Government absorbs a lot of the healthcare expenditure that its institutions incur.

Barring special schemes such as the one for cardiac surgery for poor children, there is not much of Government grant for private hospitals to do free surgery. When the cost of consumables (in modern diagnostic or surgical apparatus) rises owing to various factors, it will have to be loaded in the charges the patients have to pay.

But, this is where the Government hospitals have the advantage of keeping the cost of facilities low or even offer these free of cost, they point out.

The Dean points out that even cases referred from private hospitals to the CMCH for scanning are charged only according to their income.

Apart from the medical college hospital, Coimbatore has Government Hospitals in sub-divisions such as Tirupur (now a Corporation), Mettupalayam, Pollachi, Udumalpet and Periyanaickenpalayam.

The district also has 68 primary health centres (PHC) and 469 sub-centres spread across 21 blocks. Apart from handling accident, burns or other emergencies, all these hospitals and health centres handle a number of delivery cases. The PHCs alone handle 350 cases a month, says Deputy Director of Health Services R.T. Porkai Pandian. Institutionalised delivery had been low and this had been changed with a campaign among the rural masses on the safe delivery in health centres or hospitals. Health officials say that the mother and child get better care free of cost at the centres than risk infant and maternal mortality because of delivery at home.,Another area in which the poor is benefited is preventive medicine. Officials point out that the Government’s Varumun Kappom scheme screens thousands of people in the rural and urban areas for various disorders.

Basic tests that the poor cannot afford are done free of cost. Surgery cases are referred to the medical college hospital. The lack of doctors and paramedical staff sometimes hit services in the Government hospitals and health centres. But, these are the only hope for healthcare among the poor sections who are grappling with rising prices on other fronts.

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