RF_COM_H_66_C__SUDHA.pdf
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RF_COM_H_66_C__SUDHA
Task Force on Health and Family Welfare
Phone
Extn
Fax
E-mail
1.
080-2271021,2277390, 2274883
2245041,2245042
225
080 - 2277389
Dr. H. Sudarshan
PHI Building Annex,
Ground Floor, Seshadri Road,
Bangalore - 560 001.
Ref No. TFHFW/5/2000.
Jan. 2000.
Chairman
PRESS RELEASE
2.
Sri. P. Padmanabha
Member
3.
Dr. Chandrashekar Shetty
Member
4.
Dr. Suresh B. Kulkarni
President. IMA (K), Member
5.
Dr. Jacob John
Member
The State of Karnataka has endeavoured to develop itself into
a welfare state. The bold initiatives taken during under the princely
state of Mysore has been a precursor for many national level
endeavours: The Urban Family Welfare Centres, the five-year plans,
the primary health units, water and sanitation, Electrification, Local
self governments. The state has experimented with and has
mplemented the Panchayathi Raj system for promoting
decentralised governance.
The Government of Karnataka has constituted the Taskforce on
Health and Family Welfare (vide Government order Health and
7amily Welfare 545 CGM 99, Bangalore dated 14-12-99). The terms
if reference are broad. These include the following:
a)
6.
Dr. C. M. Francis
Member
7.
Dr. S. Nagalotimutt
Suggestions for delineating policy measure for improving
the Public Health Care system in the state. There is a
need to strengthen the Primary Health Care Dellivery system,
making it more accessible to the poor and the poorest of the
poor. We need to think, develop and implement services and
systems that respond to the needs and aspirations of the
larger sections of the society.
Member
b)
8.
Dr. Latha Jagannathan
Member
9.
Dr. Jayaprakash Narayan
Member
10. Sri Swami Japananda
Member
11. Dr. M. Maiya
Member
12. Dr. S. Subramanya
Member Convenor
Suggestions for improvement in the management and
administration of the Department of Health and Family
Welfare.
c) Recommend changes in the Health and Medical
Education system so that it fulfils the requirements of the
people at the grass rot level and simultaneously keeping up
with the ever expanding vista of science and Technology, so
that it could sincerely contribute to the Human Resources
Development
In achieving its endeavour the task force intends to document the
current health status of the people of Karnataka, review the
s ituation with experts and different stakeholders and derive
Task Force on Health and Family Welfare
Phone
:
Extn
Fax
E-mail
:
1.
080-2271021,2277390,2274883
2245041,2245042
225
080 - 2277389
PHI Building Annex,
Ground Floor, Seshadri Road,
Bangalore - 560 001.
:
Dr. H. Sudarshan
Ref. No. :
’2 ‘
Date ..............................
Chairman
2.
Sri. P. Padmanabha
Member
3.
Dr. Chandrashekar Shetty
Member
4.
5.
6.
The members of the Taskforce have initiated the process of
consultations. In this context we would like to request concerned
President. IMA (K), Member
individuals / organisations / institutions / Citizen groups /
Professional bodies and all the people of the state to contribute
towards the recommendations of the Task Force. The opinions /
Dr. Jacob John
suggestions
/ comments / notes / thoughts or any related matter
Member
may be kindly be sent to the following address:
Dr. Suresh B. Kulkarni
Dr. C. M. Francis
Member
7.
Dr. S. Nagalotimutt
Member
8.
Dr. Latha Jagannathan
Member
9.
suitable, appropriate, pragmatic and meaningful recommendations
so as to improve the quality of life of the people of Karnataka not
just in the short term, but also in the long run. The terms of
reference give the Task Force the mandate to monitor the
implementation of its recommendations. The Task Force also plans
to produce a draft health policy for the state in consonance with the
National Health Policy and the new revised draft National Health
Policy.
Dr. H Sudarshan,
Chairman, Task Force on Health and Family Welfare,
Ground Floor, PHI Building Annexe,
Sheshadri Road, Bangalore - 560 001
Ph: Extension 225 of (+80) 2271021 / 2277390 / 2274883 /
2245041 / 2245042
Fax: (+80) 2277389 ;
Email: khsdp@vsnl.com
healthtaskforce@indiatimes. com
We would appreciate if the responses are sent by 30th January
2000.
Dr. Jayaprakash Narayan
Member
- Sd-
10. Sri Swami Japananda
Member
11. Dr. M. Maiya
Member
12. Dr. S. Subramanya
Member Convenor
(Dr. Sudarshan)
Chairman - Taskforce on Health
(Dr. S. Subramanya)
Member - Convenor
Task Force on Health and Family Welfare
Phone
:
Extn
Fax
E-mail
:
:
1.
080-2271021,2277390,2274683
2245041,2245042
225
080 - 2277389
Dr. H. Sudarshan
PHI Building Annex,
Ground Floor, Seshadri Road,
Bangalore - 560 001.
Ref. No. : TF
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Chairman
2.
Sri. P. Padmanabha
Member
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.‘^iiiODUCTtON;-
Medicat Education debarteiefftof’G<?va|nnient Or KarnatekS' Isiwniiu! •
telif Medical'Colleges' and one Ueiital'CoSea*’teife-r-ursine Collet;? »”d- •
on? !’|»a'm?cy CoUpcio for impeding undergraduate and postei'aiterite
ipcontch WK.’! afUOxse <yyi csuv^a d(-JW=V- V
ai’ft
C.W
i n ■./■T.m.’-q mmiy roitecies w°te cfnH-a/i !(t tha fj^vate ^avdbf'Tpa'd’l'C !.C: ' " •
■■■iinmicn ,7T i=ar|||t]t; V->c*>1.V ?l.’d .:?jtj«.’os-- •?? «te?sds; de
of mtfa ar? »rwig
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/,!!(;>.' ■?>dUCnUO!.‘.
CO-’OCli Qi i:i.(!ig.. •’iH-isp ' IltrsiUG-COUliC:!
ffifiuc;) (»> bulk).
yiywid-il.ie steiVJa.’cis
b«.s;.
■■i >nnili(;oi-oc}i:< •.•.bo;>- n)U< *!!=<«•
•..." S'J jtlO!ILS. ’>’,ilP,'3>!'>' = l.i.;-
te-iiter- iteitg ai'd »3 »;>v ? * m ’-ate or ;sk<?. are'conslanlly diybsy ■ojnaifi^ip..
.->:•,<! pnh3ti<;a Uie (iiipiiiv ••>.' uipdical ecii!r.!?il'v.,.j. as 5i!so
o. -;i"
t-mriUjl ,9:;io<«cns ni«’ "il
SOlHfj(sw.jQS ills iikil) Ct.’Ull
tfiSDi!O. '.d.liils.
k"ipl6i.o-f.y til".: 3l„‘P'9!’'<: CoVft
hm/g '/?
‘■’tsr/?!;? ragarjing arhnissk’”'8-WO f»o sUvctiirgc
vniious councils and local inspeciion coinnuliees of the Universities
have pointed-wl• certain denciencies regarf)»»»g ii)iTasiii.idi.ne, .nianpowei',
euiri.ntnQiiis and olher iacililies. leading in u!aslic.ciHs in intake of
?<udents io undeiGraduate and noskii dli.iate courses. Cn ceitein nccasioijs
;,co ■:>;;<> nril 1-go Xii'isHlt.1 ■ ’ '
i.vgi<■' ibrogin <m" rimor«'<i|>iiir>n •"< l i
■■teoroes in yiew o'dlsis tee Medica! Eduoatete tipoaEriue’if. o>' ‘^everutnste •>'
^r-r.nnteka teo'Kihl ;t !<• le coosiiiute q crHntniitee o< exveits 'ii.llte 'no’ci'
;i; .fiBic I ppn Io paifiiii;) top SiltiCrtioo Annivs:" and i !ee,J.O../\SS.eSS!!iei|i..;.!l'
teiJowinc- ii.slitetious
ecopMiiei’daiJons.
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eospiteis,
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-'fiaio?
;’>e~.ess?;v
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- • • ■•■
Etengntete Modicnl ikiltepte IjhiigafC’e
and rdlaciied liosniieis
2. Mysore jVtedicai Coil'nis, Mysore
and alteched hosoitaiy
ftislib.ite of Medical rte'enco",
!;i<hli. onr| altecknil- brjqiulni':
’fii"r|/".b'|aur,r7i 'till'd
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G'j'rnt;in!<>;;| :.'qitr?i C'nite’.IO
GoveriUllf’ilt fter’ten.! Col’ocie.
Governine!!' dlnuninry r.t?!!o'b"
■■
•■
METHODOLOGY ADOPTED
The committee has made a great effort iirvisilincralhiost allllie ■
departments of the medical teaching institutions, Attached hospitals, and
students' hostels, continuously over a- period'of 2-'.veeks-from'23!-d’ June^QiB.
Situation-analysis and needs assessment of all [he departments in
pailicular and institutions in general. The Committee field intensive interaction "
with all the administrators, Heads of Denailments’ Students and other officials.
Strengths and Weaknesses of the instil aliens were assessed in i elation
io regulations of tfie controlling bodies such as M.U.f. D.C'.I etc., and in
relation to service delivery.
The Committee has looked into administrative- ■sirticiuie. aiid-pay. &
allowances of the Teaching faculty. Ft ecommendations- ai-e. made, regarding.
■nfrdslriicttire, Manpower ano Management
Development program,
administrative structure, pay scales and monitoring- evaluation systems-, to
enhance the quaiify of teaching, training and service delivery to Keep pace-with
the rapid progress made-in- the field of- Medical. 3.cjej1c.e..tlie wot Id oyer. .....
E XE C U T1V E
81? MMAR 7
STRBHG'l'HS AND WJ&AK3ESSE3' OF TEACHING
INSTITUTION AND ATTACHED 'HOSPITALS; - '
t. STRENGTHS:
.}. All Institutions are 25 to 75 years of stan.dkia.and supporl.e.d.by.,
Government budget for long term sustainability.
2. Institutions have been running undergraduate and postgraduate courses
for a considerable length of time with good track record.
3.
Consists of very senior and experienced teachers and clinicians.
4.
Availability, of clinical material in abundance and belter.opportunities
for hands on training.
5.
The cream of student community with higher common.-entrance, test
rankings join government institutions,
6.
Availability of reasonably good buildings and other infrastructures.
7.
Decentralisation of administrative powers and adequate financial power' •
in case of autonomous institutions. jKIMS, HUBLt; ■ 'IMS, BELLARYj.
8.
Work turned out by the staff is really >n excess of the infrastructure
facilities provider! with.
9.
Availability of full lime teachers impai linti imn.ilai
programmes.
"hing and training
11. WEAKNESSES
! . Inherent problems' of woi'kiirg in a Goverrtmenf system s relation to the' •*••••
' availability of man power.' eqtiipn'ients.’suppfi’es and bikMTaiyallocatioiis’
2„ Quality of teaching and tra.ining and reseated procjrains'are not'
satisfactory due io lack of equipments’ and inadequate manpower.
3.
Lack of motivation and commitment on the part OT teachers and
clinicians due to various reasons like inadequate working conditions and
poor pay scales.
4.
Quality, of service delivery is not satisfactory due to factors like
inadequate budgetary allocations and difficulty, in. utilising budgeted
money due to procedural delay and inadequate financial powers.
b. The brightest of the students are learning in a poor-infrastructure
manpower equipments. library, hospitals and hostel.facilities..
.
6. Old buildings of hospitals and hostels are in a. very bad shape.
The rooms, bathrooms, lavatories,, sewerage system, water supply and
electricity are the-biggest problems fcr the patients and students.
7.
Substantial and sufficient budgetary allocation is not available
for the maintenance and renovation of existing buildings.
8.
Public works department section is net under the control of Medical
education department and her.ee riot directly accountable.
9.
inadequate and improper administraiive structure to plan, develop
implement, monitor and evaluate Hie fi.inclioning at all levels.
10.
Mon-teacliiug staff
under the control of Diteclor of Health
and Family Welfare Services. leauirigto lack of direct accountability
tolheDirector of Medical Education.
i I. Large number of specialists are working, a-s 0-O-t>.'lecturers for
a long period. leading to frustration
lack of motivation.
12.
Improper placement and developn>ent of trained manpower due to
various reasons.
13.
Concentration of Administrative and financial powers will) the
office of the Director, making tile posts of. Principals and...
Superintendents less important and redundant',.in autonomous.
institutions(KIMS&VIMS).
14.
Chief Administrative officer and Financial Advisor seem to be
above the rank of Principal and Medical Superintendent, leading
to administrative difficulties (KIMS & VtM3>.
15.
There is no Vice Principal's, post in Bangalore Meo- .;i College
and Mysore Metrical College leading, to heavy- a.dniinistrati'zedoad.
on the Principal.
IS. Tire financial powers of the Principals and Medical-Superintendents'
are a.meagre.Fls. 2LLQ0.0/- which is'absolute.ly inadequate to purchase.
maintain and repair the equipments and the purchase of drugs.
17. Absolute absence of manpower & management training (Training of
Trainers) and opportunity, for attending scientific conferences in India
and abroad.
18. The Director of Medical Education being the technical and administrative
head of the department, has inadequate administrative and financial
oowers leading to procedural delay
RECOMMENDATIONS:-
Tte Medical Education department of Government of Karnataka has
constituted a committed of'Experts-in June >998 to perform the Situation
Analysis and needs assessment of feu Government Medical.Colleges, ,one
Dental College, one Nursing College and one Pharmacy College and to formulate
s Developmental proscammeta satisfy MS.L, D.C.l^LbT.C...an<iP.C.'L.
guidelines -sithregard to. infrastructure, manpower, equipments, teaching
training end research programmes- Services delivery, and speciality services.
The Committee also analysed the administrative stricture, Pay and
emoluments of the teaching staff, management information system and monitoring
and evaluation component.
01. As an essential first step the Committee has done the situation analysis aid
needs assessment of ail the identified institutions in great detail. A
great emphasis was given to the availability of inirastructure, manpower
="-d equipments to satisfy various Council's guidelines end service delivery.
02. Quality of teaching-anty training of undergraduate and postgraduate students
to be upgraded.
...
03. Quality of patient care and service delivery to be improved.
04. Under utilised capacities of infrastructure, msnp'oyver and equipments
are identified end suggested remedial measures.
05 To strengthen the capacity in the existing d.epu’traents md to create new
departments especially insuperspeciaiities.
06. The necessity of Academic, scientific and research programmes, to keep
pace with the advances made in the fiektof the medical science World over
is highlighted.
07 Manpower and management training programmes are essential to enhance
the quality of teaching, training and service delivery. Training programmes to be.
initiated and implemented.
08. Appropriate and adequate pay andemo.lunientsrU.G.C.psy.scales] are needed
to (lie teaching faculty to motivate them to give their best.
09. P.e-crgantssiion of administrative- structures at ail levels is necessary
with a reasonable financial-burden on.the.Govemmnent to make the establishment
optimally functional; to achieve its short term and ieng term goals and
objectives.
10. Astrcng monitoring and evaluation system has to be developed with a
strong backup of management information system. It keeps track of al!
relevant components of ongoing activities, personnel matters, supplies,
equipments money spent in relation to buaget allocated, operations! research
user changes, quality of teaching, training.and service delivery Student’s
and patient's (consumer) satisfaction, financial viability, and longterm
sustainability.
DEPARTMENT OF MEDICAL EDUCATION
DJRECTORATE OF MEDICAL EDUCATION
• PRESENTADMINTSTRAT IVr. STRUCTURE
DJRECTOR
t c.
_j_OME
PRINCIPAL
8MC
■,
PRINCIPAL
M.MC
1
1
PRINCIPALGO C
DIRECTOR' ■
R 1.0
1
• •
PROFESSORS
MEDICAL COLLEGES
ASS I. PRO! ESSORS
_ _______ lecturers________
(T)
o 5
i DOME
C O
i j
1
1
■ SENIORPROFESSOR
PROFESSORS
DENTAL COLLEGE
ASST. PROFESSORS
LECTURERS
P ROPOS ED A DM INi.STR ATI VE S I RU.CT VR£
WIU'li: OR A/W/( 7!/. i-.Dl 'CATION
'IJIR/R TOR'OT' A/ED/( .!/. R!)l /( '.I i KJN'
j
DIRECTOR/
1
!
PRINCIPAL
B.M.C(I)
DIRECTOR/
PRINCIPAL
M M.C (1)
ADDL DME
i i»
!•'7
l
JDME(I)
JDME(l)
viceprincipal
!
DDMEH)
DIRECTOR
RIO (I)
G.D.C (1)
MED SUPID.,
liOSPlIALS
BMC(i) MMC(I)
LECi URERS
j
REGIS! RARS / IU I'ORS
J DDE
(1)
(3)
DDDE I!) PR OF. & HOD'S
fJ 1 LC
___ DOMEiDPR or: & i iod's
B M.C, M.M.C
PROFESSORS
ASS'S l .’TT i ’.ROFE.SSOR.S
DIRECTOR/
PRINCIPAL'
.
PROFE SSORS
ASSISTANT PROFESSORS
LECTl JRERS
REGIS TRARS / I L! TORS
i
One post of JDME to be upgraded as Additional DME
One post of JDME to be re-designated as JDDE '
There arc 12 sanctioned posts of Senior Professors
Two posts of Senior Professors to be re-design-ated as JDME
Two posts of Senior Professors to be re-designated as Vice-Principal
(I3.M.C - r. M.M'.C - 1J
Eight
posts
oi
Senior
Professors To
be'' fe-dcsignated'
as
Med'
Superintendents.
(B.M'.C- 5. VTM.C - 3J
13.M.C :- Victoria Hospital - I, 13 & L.C Hospital - f, Vanivilas Hospital Minto Ophthalmic Hospital - 1,-SDS.and 1 11 &. CD Hospital•- I
M.M.C
Kd< Hospital - J, Cliehivamba Hospital - I, PK Saniloriunr - 1
The above mentioned posts arc equivalent to Joint Director of Medical
Education
PLEASE NOTE
•
Present Adnunislfalivd Slriieture' of"Directorate of Medical Education was creak'd (o'
administer four Govt. Medicai Colleges and-attached- hospitals- and one Govt. Denial
College
°
At- present in Karnataka Stale there are about 21 Medical Colleges and attached
■hospitals.-. about 41 Denial Colleges, 7 Aulon-c-mons l-nsl-ilulions, one Nursing
College, one Pharmacy College anti a number of Pj.-j.valc Nursing-ami Pharmacy
Colleges
»
There is ah increase in work-load m terms of UG and PG Admissions
’
There is an increase in work-load in terms of activities of Para Medical Board and'
constitution of Inspection Committees and conducting regular inspections for starting
new medical and para medical institutions and upholding minimum standards of
Medical and Para Medical education as prescribed by MCI, DC1, INC, PCI etc.,
1 l-e above mentioned facts amply justify restructuring of administrative set up at
various levels, especially Directorate of Medical- Education.
I he Committee appreciates the acaiion oi a separate post of ScciClarv lo Govt. lor
Medical education. The Committee sincerely feels that the Secretary, Medical Education
should be supported by a medically qualified Additional Secretary (Technical) and a
Deputy Secretary (Technical) io assist on technical mailers, 'rhe Committee-observes that
lhe post of medically qualified Additional Secretary was existent on earlier cccassions.
1 he details of die posts lo ue upgraded, created, financial implications and
administrative responsibilities have to be woiked out separately.
The present System oi'Appointing any one of the Professors ns Medical
Superintendent, has the following flaws
:ic Appoiniee is not necessaiily the senior most professor in the-respective hospital
.eadirrg io dissenlment.among the seniors leading ;o Migations.- Also
»
. he Superintendent being one of the professors (no! a- promotional' post)- cannot offer
Mfective-administration, as-being one amongst-equals
®
There aie possibilities of frequent change of Medical Superintendents-due to various
reasons
«
Medical Superintendent's post is devoid of promotional benefits
The cadre of Professor and HOD io be created in Medical and Dental Colleges will be
equ;--men! to Deputy Director.
’Ihc above mentioned cadic is necessary for effective adminislialien of (lie
departments at college and hospital levels find to remove stagnation at the level ofprofessors.
Such a cache was existent prior io 1976 and was functioning cffectivclv
Present practice of designating MDBS / BDS qualified doctors as Lecturers is not
acvofding; to MCi/DCi- Rcguialions. lienee; -doctors witlr-PG--tpralilicafions lo be’
appointed as Lecturers in fuluie.
Doctors with MDBS I BDS Degm.: Io be appointed as Registrar / Tutor in future;
Doctors with MDBS / BDS qualification 'working as Lecturers Io be i e-designnlcd-as.
Reuisfrar/ Tutor. Their pay has to be prutcclcd.
There are 4 i Denial Colleges as against one Gon. Dental College, earlier
io become a Qualiiicu Medic a i I cacher, one has :o si u civ Eight, ami a. 1 lalf years
To become a Qualified Denial teacher, one Jias .o study for Seven years
1 here are no Super-speciality Degrees like DM / MC>4 in Den-tar Derailment
A Medical Icacher has to pul in 1'ive years oi leachimi as Asst. Professor to become a
Professor
A Dental 1 eacher has to put in ; hree years o> 'eacmms as Asst. Professor to become a
The Kmnaiaka Civil Services and Kccruitmcnt Pules are different lor Medical and.'
Denial Departments
....
....
Director ot Medical Education •‘ .Medical Person; cannot become a Member of Denial
Council of India, and Dental person cannel become Member of Medical Council of
India
Enhanced work-load over the ycais for tm: Directorate'of Medical Education needs
bifurcation into Directorate of Medical Education and Dental Education, which is in
vpugc in states like Kerala and Tamilnadu
The committee recommends separation, and creation of both teachinu. ■mmieachim’
tlmical) and ail other categories of suppotlmg slaii' f;r the semirated Diicemmm.
PROPOSED DIRECTORATE OF DENTAL EDUCATION
DIRECTOR
l>IR£ CTO R /' PR i M Ci?‘AL (•G ifC)
JDDE VICE-ERiiNX'i V,\ i, i (; DC)
DDDE & PROFESSOR & HOD’S (GDC)
PROFESSORS
ASSISTANT ’’ROF ESSQ];s
LECTURERS
. REGISTRARS/TUTORS
As there is only one Govt. Dental College,, creation of one.post of Additional Director
(Dental Education) is not suggested by. the Committee
.
One. post of JDDE can be created by le-dcsignaling one post of prescnrJDME
One post of Vice-Principal has to be created for GDC
One post of DDDE to be created
The Committee is of the opinion that one post of Director of Dental Education and
e post of Deputy Director (Denl-ii Education) has to be sanctioned v/itii corresponding
and Allowances of Department o<r Medical Education.
The details of the posts to be created mid the lio-mcial burden on the Gu - l. has to be
rrked out separately.
GOVT. NOMINATE ON. TO MCI AND -DC1
I he established practice over the years lias been to nominate a person working in
Directorate’.of Medical' Education / Colleges to represent ilie Stale Govt, al MCi mid
DC!/'iliis practice was-, discontinued dining the year' 19S7 as the their Director "of
Medical Education- was a Dental-person being not eligible lo be-nominated as member
of MCI. At present, the Govt, nominees forMCCC and DC- are persons-working-in
private Medical and Dental Colleges. Hence the commit-tec strongly recommends that
Govt, nominations-lor.MCI and MCI should be from- the-following-categories'to
safeguard the interest of Stale.
■VDM .IN ATKIN '!'<) MCI should be from the following
» Director of Medical Education (MEDlC/'XL)
Additional Director
’ Director / Principals (Bangalore Medical College, Mysore .Medical
College)
» Director (RIO, MOH)
NOMINATION TO DCi should be Horn the following
» Director of Medical Education (DENTAL)
■> Director/Principal (GDC)
Tiie term of Office shall be lor a period of two '. ears
I he person ceases lo hold -the ollice on al-laiiimg Superantwaiimi or Kesignatioii'
Government of Karnataka
TASK FORCE ON HEALTH AND FAMILY WELFARE
January 3,2000
SUB COMMITTEES
MEMBERS
TOPICS
__
Sri. P. Padmanabha.
A.
Health Systems and Services in Rural Areas
Dr.
M. Maiya.
Health Systems and Services in Urban Areas
Dr.
C. M. Francis."^
Emergency Health Care
Swami
Japananda.
____
Panchayat Raj and Health Care
Dr.
Latha
Jagannathan.
B.
Communicable Diseases
Dr. Jacob John, v'
Dr S. Nagalotimnth.
Swami Japananda.
Sri. P Padmanabha. /
Population Stabilisation (RCH)
C
Dr. Latha Jagannathan.
Dr Suresh. B. Kulkarni.
Dr. Chandrashekar Shetty
D.
Human Resource Development
|LC5OIaS
Dr. C. M Francis.
Medical Education
Dr. Jacob John.
Health Education
Dr. S. Nagalotimath.
Sri P. Padmanabha.
E. ■ Health Financing
Dr. S. Subramanya.
Dr. Jayaprakash Narayan. ✓
Indigenous / Alternate Systems of Medicine
F
Dr Chandrashekar Shetty.
Dr.
S. Nagalotimath. v-'
G. Non Communicable cable Dieseases, Dental Health,
Dr. C. M. Francis.
Mental Health and Epilepsy
Dr. C. M. Francis. </
H. Nutrition
Dr. P Padmanabha.
Dr. Jacob John.
I
Health of Special Groups
Dr. Latha Jagannathan. •/
Swamy Japananda. x/
Voluntary
Sector
in
Health
Care
J.
.Dr. Chandrashekar Shetty.
Dr. M. Maiya.
K.
Private / Corporate Sector in Health Care
Dr. Suresh. B. Kulkarni.
Dr M. Maiya. x/
Dr. Latha Jagannathan.
L.
Law and Ethics
M.
Health Policy
Inter Sectoral Co-ordination
External aided Projects
Health Management Information Systems.
N.
- 2'
Dr. C. M. Francis. v
Dr. Latha Jagannathan.
Dr. C. M. Francis. ■</
Sri. P. Padmanabha.'
Dr. Latha Jagannathan.
(Dr. H. Sudarshan)
-2-
Chairman
TASK FORCE OF HEALTH AND FAMILY WELFARE SERVICES REGARDING
GOVERNMENT MEDICAL STORES
The Government Medical Stores purchases and distributes
drugs and chemicals to ^11 the Government Allopathic Health
Institutions in the State including those coming under the
administrative control of Zilla Panchayaths and Institutions
attached to Medical Colleges.
The Government Medical Stores distributes drugs to the
tune of ?s.25 Crores per annum.
This covers only 40% of the
total budget allotted to them.
The remaining 60% of the
budget willtdirectly utilized by them for purchase of drugs
and chemicals.
Tile drugs and chemicals will be purchased by Government
Medical Stores by way of rate contrct every year after vide
publicity about the tender in all leading news papers of the
Country.
Teaching hospitals and the Health Institutions under
Zilla Panchayth will follow the Government Medical Stores
Rate Contract for procuring the drugs aut of their 60% budget.
The rate contract for supply of drugs and chemicals are done
on the recommendations of the Theraupetic Committee consisting
of experts in each specialisation of medicines and the High
Power Committee at Government level.
The Government Medical Stores will supply 100% of' their
budger^or the. Health Institutions will come with their
indent (requirement) to Government Medical Stores with their
2
During 1996-97 the Government Medical Stores could not
any purchase of drugs as there was no rate contract
existing during the above period.
The Government Medical Stores for the first time in
Karnataka made compulsory good manufacturing practice
certificate according to W.H.O. specifications, and for the
first time, the Government Medical Stores insisted on strips/
blister packing instead of bulk/loose packing of 500 tablets/
Caps., with logogram printed in Kannada on each strip/blister,
stoppers of bottles, and AmjjJ^s., and vials etc.
It was even
brought into force printing of two letters* *-e, ^''meaning
Health Department on Tabs./Caps., t^is~'has prvented to a large
extent pril£erage.
This type of packing has impressed greatly
the patients that even Government supply of medicines will be
of good quality.
The drugs are given to patients in hospitals
phi free of costs.
DIFFICULTIES ENCOUNTERED IN IMPLEMENTING DRUGS SUPPLY SYSTEM
IN KARNATAKA
.
(1)
The whole Government Medical Stores should be
computerised completely.
There are mainly four different
stores in Government Medical Stores.
Computer Operator.
There is only one
For speedy and efficient management of
drug supply four computers with well trained operators are
required.
(2)
Arrangements are being made to procure a FAX machine
to Government Medical Stores.
(3)
The doctors from peripheral hospitals feel great
difficulty in lifting the drugs from the Government Medical Stores
c
to far off places. Hence 3 to 4 truks with drivers are required
-
2
-
During 1996-97 the Government Medical Stores could not
^amke^any purchase of drugs as there was no rate contract
existing during the above period.
The Government Medical Stores for the first time in
Karnataka made compulsory good manufacturing practice
certificate according to W.H.O. specifications, and for the
first time, the Government Medical Stores insisted on strips/
blister packing instead of bulk/loose packing of 500 tablets/
Caps., with logogram printed in Kannada on each strip/blister.
stoppers of bottles, and AmjajAs., and vials etc.
It was even
brought into force printing of two letters'«-©, u " meaning
has prvented to a large
Health Department on Tabs./Caps.
extent prilferage.
This type of packing has impressed greatly
the patients that even Government supply of medicines will be
of good quality.
The drugs are given to patients in hospitals
oh free of costs.
DIFFICULTIES ENCOUNTERED IN IMPLEMENTING DRUGS SUPPLY SYSTEM
IN KARNATAKA
*
— -
(1)
The whole Government Medical Stores should be
computerised completely.
There are mainly four different
stores in Government Medical Stores.
Computer Operator.
There is only one
For speedy and efficient management of
drug supply four computers with well trained operators are
required.
(2)
Arrangements are being made to procure a FAX machine
to Government Medical Stores.
(3)
The doctors from peripheral hospitals feel great
difficulty in lifting the drugs from the Government Medical Stores
to far off places.
c
Hence 3 to 4 truks with drivers are required
3
for safe and speedy distribution of the drugs.
(4)
At present that there is no English and Kannada
Stenographer in the Government Medical Stores, hence
English and Kannada Stenographers are required to be posted
to Government Medical Stores.
(5)
At present^Government Medical Stores, the availability
of space for storing the drugs is not sufficient.
therefore
2 to 3 stores rooms are required to be built.
(6)
The present budget allotment to Health Institutions
for each P.H.C., is to. 50,000/-., Rss 30,000/- for each Primary
Health Unit, was made about 10 - 15 years ago.
With increase
in population, the budget allocation is not increased proportionate!
Therefore an increase in
the increased
(7)
budget of 25% is necessary to meet
demand of the drugs by the peripheral institutions.
There is no cold storage facility at present.
Therefore
two - three waIk-in-coolerj are necessary to store certain
essential drugs such as Insulin.
(8)
No residential quarters at present.
Residential
quarters for Joint Director, Government Medical Stores and
other staff are required.
(9)
The Joint Director and Officers of Govt. Medical
Stores require^ two vehicle with driver.
(10)
There is necessity of establishment of substores
at District level for storing of drugs for easy and quick
distribution .
4
(11)
The latest terms as per the rate contract are to
supply to the F.O.R. destinations, instead of Govt. Medical
Stores.
All the suppliers are required to supply to the Dist.
Surgeons/Dist. Health & F.W. Officers of all districts
directly.
There is necessity of modernising the Government
Medical Stores in view of the above requirements.
JOINT DIRECTOR,
GOVERNMENT MEDICAL STORES,
BANGALORE - 560 079.
Karnataka Health Systems -Development Project (KHSDP)
Status as on October 31, 1999
Basic Data:
Title
Second State Health Systems Development Project (K)
under IDA (WB)
Credit No.
Or. 2833-IN
Date of
effectiveness
Date of closing
(original)
06-27-1996
03-31-2002
Loan Amount
Rs. 54,58.01 Million for Karnataka Component
Project Objectives
1. Improve efficiency in the allocation and care of health resources
through policy and institutional development
2. Improve programme of the health care system through
improvements in the quality, effectiveness and course of health
services at the first referral card and selective course at the poverty
level to better serve the neediest section of the society.
The Second health systems Development Project is being implemented in three
states namely Karnataka, Punjab and West Bengal. This project is assisted by International
Development Association (The World Bank). The total project cost is to the tune of Rs.
16,691.4 million, of which the share of Karnataka is Rs. 5,458.0 Million spread over a
period of 6 years from 1996 to 2002.
The Project components aim at improving service and clinical effectiveness at
district, .sub-division and community level hospitals under the project. 74 Community
hospitals, 104 sub-divisiorial hospitals and 21 district hospitals are renovated “and'
extended. With the result 3832 new beds will be added to the existing bed strength of 5822
at first referral level. The project aims at providing better access to health care to the
Schedule Caste and Schedule Tribe population of the state and also for women.
General overview: The KHSDP became effective on June 27, 1996. The
project could not make considerable financial progress during the year 1996-97 as there
was not much of preparation. However, during the year 1997-98, as all the preparatory
activities were completed and the project has been making a steady progress. The project
activities have been reviewed by the World Bank Supervision Missions during
March 1997, November 1997, May 1998, November 1998 and June 1999.
1.
Civil works: As per the original programme, renovation and expansion of 201 KHSDP
Hospitals should have been taken up in four phases during the years 1997-2000. Ln
order to avoid cost escalation on civil works, a decision was taken by Project
Governing Board with the approval of the World Bank to initiate civil works in all the
t
hospitals simultaneously. On account of this decision, it is expected that the ci'.il
works for ail the 200 KHSDP hospitals (excluding the hospital at Tibetian Colony in
Mundgod) could be assigned by December 1999 after observing all the formalities
relating to Bidding process and World Bank procedures.
In order to prepare plans for all the 200 hospital building works, 46 Architects have
been empanelled. Preliminary Drawings have been cleared by World Bank Architect
for 192 hospital works. 169 hospital works have been awarded after evaluation of bids
under NCB. 6 works are taken up under Force Account. Totally, estimates and detailed
drawings have been prepared and approved for 186 hospital works. In order to
facilitate speedy completion of Work, an Engineering Wing with Chief Engineer, two
Superintending Engineers and 6 divisions is already functioning.
Equipment (Medical & Others): The Procurement Plan for the year 99-2000 has been
approved by the World Bank. The Procurement Plan covers various medical and other
equipment to be procured for the hospitals included in third and fourth phases. The
.. procurement of some medical equipment like X-rays and Dental Equipment has been
-postponed to the next year as the installation of these equipment need additional space.
As approved by the World Bank, the IFB under ICB is issued on 16-3-1999 for
procurement of Ultrasound Scanners with two probes, Portable Ultrasound Scanners,
Dental X-ray and Blood Gas Analysers. The bids were opened on 3-5-1999 and the
. -evaluation reports are placed before the Project Governing Board for approval. In
‘respect of 27 packages, the specifications were revised and sent to the World Bank for
their No Objection and the No Objection is received.
2.
3.
Vehicles: As contemplated in the project, during the year 1997-98, under International
Competitive Bidding process, 180 TATA Sumo Vehicles were procured and given to
Taluk Medical Officers, District Surgeons and District Surveillance Units. Similarly,
21 Equipment Maintenance- Vehicles were procured and given to all the District
Equipment Maintenance Centres. 116 Ambulances are procured and supplied to the
hospitals. For the procurement of 62 additional Jeeps to be given to the Taluk Medical
Officers and the District Surgeons of the newly formed Districts,-IFB under ICB was
issued on 16-3-1999 and the bids were opened on 4-5-1999. -With the approval of the.
"Project Governing Board'and the World Bank, the Supply Order is given to the bidder’
for giving 62 Jeeps.
- Medicines: The Procurement Plan for Medicines during the year 1999-2000 was
4.
approved by the Review Mission during the Mid-term Review. The drugs are being
procured under National Competitive Bidding process. The IFB will be issued towards
the end of December 1999 for procurement of drugs during the year 1999-2000
depending on the actual requirement taking into consideration the procurement made
by Government Medical Stores. During the year 1998-99, 54 drugs have been procured
and supplied to all the project hospitals.
5.
Local Training: So far 1237 Doctors have been trained in different specialities as part
of this programme. Further to develop resource persons, trainers training programme
was organised with the support of JIPMER from Pondicherry and so far 40 Master
Trainers (Doctors) have been trained. At District Level, 464 Doctors have been given
training. The number of Nurses trained under General Nursing so far is 2161. Under
the specialists Nurses Training in the field of Paediatrics, ICCU, Opthalmic Nursing.
Neuro Nursing and Psychiatric nursing, so far 482 nurses have been trained at
NIMHANS. Indira Gandhi Institute of Child Health and Jayadeva Institute or
Cardiology. Bangalore. Similarly 15 Laboratory Technicians have been trained. As par.
of the Equipment Maintenance, 38 technicians have been trained in two batches at
ATI-EPI, Hyderabad. In addition to that a four week training programme was
organised for these technicians to give training on equipment which have been
- procured under the project. The training was imparted by the technical officers ot the
suppliers who have supplied equipment. Further the specialists in the field or
■ ■ Paediatrics, Orthopaedics, ICCU, Laproscopy and Feotal Monitor, Neurology,
Neurosurgery, Psychiatry and Mental Health and Dental have been trained at Indira
Gandhi Institute of Child Health, Sanjay Gandhi Hospital, Bangalore and Jayadeva
Institute of Cardiology. So far 549 Doctors have been trained in these specialities. The
Doctors working in Community Health Centres and Taluk Level Hospitals are being
given training in Administrative Procedures. So far 170 Doctors are trained in
Administrative Procedures. Similarly an induction training programme is being
.. conducted for newly recruited Doctors to give them basic exposure in various aspects
'of administration and also to sensitise them to Karnataka Health Systems Development
Project activities. So far 272 Doctors have been trained in Induction Training. 28 Chief
Pharmacists / Graduate Pharmacists have been trained in Pharmacy Key Trainer’s
Training. 38 Technicians are trained in Equipment Maintenance and Repairs at
. ^Hyderabad and Bangalore.
6.
M/s. STEM Consultants were assisting the project for the Project Management upto
30th June, 1999 and M/s. V.R. Murali & Co. are assisting the project for Financial
Management and accounting system. The contract of M/s. STEM Consultants has
' come to an end on June 30, 1999. For the appointment of project consultants for two
more years, Terms of Reference have been cleared by the World Bank and Notification
for Expression of Interest was published on 21-5-1999. The applications are evaluated
and the short listed firms was sent to World Bank for their clearance. The World Bank
have approved the short list of consultancy firms and the Bid Document. The Bid
Document is forwarded to the short listed consultancy firms. The last date for receiving
the proposals from the short listed consultants is November 25, 1999. Similarly for the
appointment of financial consultants, the Terms of Reference has been approved by'the' -' •
World Bank. A Notification is being published on 8th November, 1999 for Expression
of Interest by the consultancy firms for short listing.
7.
Reimbursement of Claims : Karnataka Government has claimed 111.8 million as
retroactive finance admissible as per project and credit agreement, for the period
covering 1-5-1995 to 27-6-1996. Expenditure incurred during 1997-98 was Rs. 622
Million against the budget provision of Rs. 700 Million. During the year 1998-99, an
amount of Rs. 965.57 Million was spent as against the revised budget provision of
Rs. 1345.50 Million. The details of component wise provision made as in the S.A.R.,
the Budgetary allocation as per the State Government and the expenditure incurred
during 1999-2000 upto September 1999 is indicated in Annexure II-A. The estimate
for the year 1999-2000 is Rs. 1320.00 Million and the quarterwise breakup of this
amount is indicated in Annexure II-B. As against this, upto the end of September 30,
1999 (2 quarters), an amount of Rs. 575.54 Million is spent. Upto the end of
September 1999, the reimbursement claims have been submitted and CAAA has
3
admitted the claims upto the end of August, 1999. The details of reimbursement claims
are presented in Annexure II-C.
Karnataka Health Systems Development Project (KHSDP)
Status as on October 31,1999
Basic Data:
Title
Second State Health Systems Development Project (K)
under IDA (WB)
Credit No.
Cr. 2833-IN
Date of
effectiveness
Date of closing
(original)
06-27-1996
03-31-2002
Loan Amount
Rs. 54,58.01 Million for Karnataka Component
Project Objectives
1. Improve efficiency in the allocation and care of health resources
through policy and institutional development
2. Improve programme of the health care system through
improvements in the quality, effectiveness and course of health
services at the first referral card and selective course at the poverty
level to better serve, the neediest section of the society.
The Second health systems Development Project is being implemented in three
states namely Karnataka, Punjab and West Bengal. This project is assisted by International
Development Association (The World Bank). The total project cost is to the tune of Rs.
16,691.4 million, of which the share of Karnataka is Rs. 5,458.0 Million spread over a
period of 6 years from 1996 to 2002.
The Project components aim at improving service and clinical effectiveness at
district, sub-division and community level hospitals under the project. 74 Community
hospitals, 104 sub-divisiorial hospitals..and 21 district hospitals are renovated—and-"
extended. With the result 3832 new beds.will be added to the existing bed strength of 5822 ”
at first referral level. The project aims at providing better access to health care to the'W Schedule Caste and Schedule Tribe population of the state and also for women.
—I
General overview: The KHSDP became effective on June 27, 1996. The
project could not make considerable financial progress during the year 1996-97 as there
was not much of preparation. However, during the year j_997-98, as all the preparatory
activities were completed and the project has been making a steady progress. The project
activities have been reviewed by the World Bank Supervision Missions during
March 1997, November 1997, May 1998, November 1998 and June 1999.
1.
Civil works: As per the original programme, renovation and expansion of 201 KHSDP
Hospitals should have been taken up in four phases during the years 1997-2000. In
order to avoid cost escalation on civil works, a decision was taken by Project
Governing Board with the approval of the World Bank to initiate civil works in all the
the specialists Nurses Training in the field of Paediatrics, ICCU, Opthalmic Nursing.
Neuro Nursing and Psychiatric nursing, so far 482 nurses have been trained at
NIMHANS. Indira Gandhi Institute of Child Health and Jayadeva Institute of
Cardiology, Bangalore. Similarly 15 Laboratory Technicians have been trained. As part
ot the Equipment Maintenance, 38 technicians have been trained in two batches at
ATI-EPI, Hyderabad. In addition to that a four week training programme was
organised for these technicians to give training on equipment which have been .
■ procured under tire project. The training was imparted by the technical officers of the
suppliers who have supplied equipment. Further the specialists in the field of
■ ■ Paediatrics. Orthopaedics, ICCU, Laproscopy and Feotal Monitor, Neurology.
Neurosurgery. Psychiatry and Mental Health and Dental have been trained at Indira
Gandhi Institute of Child Health, Sanjay Gandhi Hospital, Bangalore and Jayadeva
Institute of Cardiology. So far 549 Doctors have been trained in these specialities. The
Doctors working in Community Health Centres and Taluk Level Hospitals are being
given training in Administrative Procedures. So far 170 Doctors are trained in
Administrative Procedures. Similarly an induction training programme is being
.. conducted for newly recruited Doctors to give them basic exposure in various aspects
'of administration and also to sensitise them to Karnataka Health Systems Development
Project activities. So far 272 Doctors have been trained in Induction Training. 28 Chief
Pharmacists I Graduate Pharmacists have been trained in Pharmacy Key Trainer’s
Training. 38 Technicians are trained in Equipment Maintenance and Repairs at
. -Hyderabad and Bangalore.
6. M/s. STEM Consultants were assisting the project for the Project Management upto
30th June, 1999 and M/s. V.R. Murali & Co. are assisting the project for Financial
Management and accounting system. The contract of M/s. STEM Consultants has
come to an end on June 30, 1999. For the appointment of project consultants for two
more years, Terms of Reference have been cleared by the World Bank and Notification
for Expression of Interest was published on 21-5-1999. The applications are evaluated
and the short listed firms was sent to World Bank for their clearance. The World Bank
have approved the short list of consultancy firms and the Bid Document. The Bid
Document is forwarded to the short listed consultancy firms. The last date for receiving
the proposals from the short listed consultants is November 25, 1999. Similarly for the
appointment of financial consultants, the Terms of Reference has been approved by'the - '
World Bank. A Notification is being published on 8th November, 1999 for Expression '*
of Interest by the consultancy firms for short listing.
7. Reimbursement of Claims : Karnataka Government has claimed 111.8 million as
retroactive finance admissible as per project and credit agreement, for the period
covering 1-5-1995 to 27-6-1996. Expenditure incurred during 1997-98 was Rs. 622
Million against the budget provision of Rs. 700 Million. During the year 1998-99, an
amount of Rs. 965.57 Million was spent as against the revised budget provision of
Rs. 1345.50 Million. The details of component wise provision made as in the S.A.R.,
the Budgetary allocation as per the State Government and the expenditure incurred
during 1999-2000 upto September 1999 is indicated in Annexure II-A. The estimate
for the year 1999-2000 is Rs. 1320.00 Million and the quarterwise breakup of this
amount is indicated in Annexure II-B. As, against this, upto the end of September 30.
1999 (2 quarters), an amount of Rs. 575.54 Million is spent. Upto the end of
September 1999, the reimbursement claims have been submitted and CAAA has
3
admitted the claims upto the end of August, 1999. The details of reimbursement claims
are presented in Anne.xure II-C.
INDIAN MEDICAL ASSOCIATION
KARNATAKA
STATE
BRANCH
IMA House, Alur Venkata Rao Road, Bangalore - 560 018 TeleFax : 080-6703255
Dr. S. B. Kulkarni
President
Akshaya Eye Hospital.
3935/51, Club Road,
Belgaum - 590 001
Tel 0831 - 425333 (O) 480292 (R)
Dr. H, R. Maheswarappa
Sr. Vice - President 1
Bangalore
Tel: 080 - 5452059
Dr. S. Sheela Bhanumathi
Vice-President
Bangalore
Tel 080-5721158
Dr. KJVIadusudhana Rao
Vice-President
Bellary
Tel 08392 - 55819, 56645 (R)
72724 (C)
Or*
Shanmuganandan,
Hony State Secretary
No 3. Kempanna Road.
Maruthi Sevanagar. Bangalore - 560 033
Tel 080 - 5464021 (R). 5539277 (O)
Dr. Anil Kumar
Hon. Jt Secretary
Tel 080-6525846 (R).
6616869 (R)
Dr. V. M. Puttaraiu
Hon Treasurer
Bangalore
Tel 080 - 3342700 (R)
Dr. V. B. Yelburgi
Asst. Secretary
Belgaum
Tel 0831 - 466062 (R)
Dr. B. S. Ramesh
President Elect
Tel 080 - 2222267. 2293862 (H)
2261435 (R)
Ref : IMA - KS13 /
/ 99
January 8, 2000
Dr. B. Ramc Gowda
Director of Studies. IMA CGP
Tel 0821 - 511552 (R)
Dr. II. P. Harshan,
Hon Secretary. IMA CGP
Mysore.
Tel 0821 - 544124 (R)
Dr. A. K. Handigol,
Chairman. IMA AMS
Dharwar.
Tel 0836 - 42686 (R)
Dr. S. M. S u res Invara in b,
Hon Secretary. IMA - AMS
& Editor IMA Focus
Bangalore
Tel : 080 - 3363180 (R)
Dr. M. K. Vasudev
Editor, KMJ
Dr. K. C. Raju Reddy,
Convenor, Building Committee
Bangalore.
Tel ’ 080 - 5461264 (R)
Dr. P. N. Govindarajulu
Public Relations Officer.
Tel 080 - 3363038 (R).
Internal Auditor
Dr. S. Ramakrishna
Tel . 080 - 6695646 (R).
State Working Committee
Dr. C. Rajan
Dr. Mallesh P. Hullamani
Dr. Shankar Goud B. Amarkhed
Dr. B. Ramegowda
Dr. S. Ramakrishna
Dr. D. G. Hallikeri
Central Working Committee (Reg.)
Dr. Suresh Halasangimath
Dr. K. C. Raju Reddy
Dr. Nanjundaiah
Dr. J. V. Narayan
Dr. S. M. Sureshwaraiah
Dr. D. Prabhamandal
Central Working Committee (Alt.)
Dr. I. S. Patil
Dr. A. S. Mantganikar
Dr. B. V. Rajagopa!
Dr. N. Vecranna
Dr. II. R. Maheswarappa
Dr. A. K. Handigol
Dale :
The Indian Medical Association views submitted to
Task Force of Karnataka State on 10th January 2000 on
the subject of development and implementation of
health care system in Karnataka.
NGOs(IMA) and Health Care
The complexities of die merging Health Care delivery system, in
terms of investment, maintenance and patient expectations has
resulted in a situation where in the Government alone can not take
up the total Healdi Care responsibility of its citizens.
Hence the necessity to recognize the presence of NonGovemmental organizations and effectively co-ordinate with them
in appropriate areas keeping in mind to health needs of the people
and the specialized expertise available with the NGOs for this
purpose.
The Government should preferably concentrate itself in matters
pertaining to the larger interest of the community such as prevention
of communicable diseases, implementation of the various National
Health Programme and simultaneously utilize the services of
available NGOs for successful implementation and effective
coverage.
Providing basic amenities such as safe water supply, public sanitation
etc should be the prime concern of die governmental sector.
Accordingly specialized Training requirements to be assessed based
on ground realities. While investing on specialized Manpower
training die government should be aware of the requirements and
ensure effective usage of such trained personnel.
Ex-Officio Members :
Dr. D. Prabhamandal,
'mm. Past President
Dr. H. R. Maheswarappa,
^m. past Hon. Secretary.
Your Membership is our Strength "
'bp
INDIAN MEDICAL ASSOCIATION
KARNATAKA
STATE
IMA House, Alur Venkata Rao Road, Bangalore - 560 018 TeleFax
BRANCH
080-6703255
Dr. S. B. Kulkarni
President
Akshaya Eye Hospital
3935/51, Club Road.
Belgaum - 590 001
Tel 0831 - 425333 (O) 450292 (R)
Dr. H. R. Maheswarappa
Sr. Vice - President
Bangalore
Tel. 080 - 5452059
Dr. S. Sheela Bhanumathi
Vice-President
Bangalore
Tel 080-5721158
Dr. K. Madusudhana Rao
Vice -President
Bellary
Tel. 08392 - 55819, 56645 (R)
72724 (C)
Dr. V. C. Shanmuganandan,
Hony State Secretary
No.3. Kempanna Road.
Maruthi Sevanagar. Bangalore - 560 033
Tel . 080 - 5464021 (R). 5539277 (O)
Dr. Anil Kumar
Hon Jt. Secretary
Tel. 080 • 6525846 (R).
6616869 (R)
Dr. V. M. Puttaraju
Hon. Treasurer
Bangalore
Tel 080 - 3342700 (R)
Dr.V. B. Yelburgi
Asst. Secretary
Belgaum
Tel : 0831 - 466062 (R)
Dr. B. S. Ramesh
President Elect
Tel : 080 - 2222267. 2293862 (H)
2261435 (R)
Ref: IMA - KSB /
Dr. B. Rame Gowda
Director of Studies. IMA CGP
Tel . 0821 - 511552 (R)
Dr. 11. P. Harshan,
Hon Secretary. IMA CGP
Mysore.
Tel 0821 - 544124 (R)
Dr. A. K. Handigol,
Chairman. IMA AMS
Dharwar
Tel . 0836 - 42686 (R)
Dr. S. M. Sureshwaraiah.
Hon Secretary. IMA - AMS
& Editor IMA Focus
Bangalore
Tel : 080 - 3363180 (R)
Dr. M. K. Vasudev
Editor, KMJ
Dr. K. C. Raju Reddy,
Convenor, Building Committee
Bangalore
Tel : 080 - 5461264 (R)
Dr. P. N. Govindarajulu
Public Relations Officer.
Tel 080 - 3363038 (R),
Internal Auditor
Dr. S. Ramakrishna
Tel ’ 080 - 6695646 (R).
State Working Committee
Dr. C. Rajan
Dr. Mallesh P. Hullamani
Dr. Shankar Goud B. Amarkhed
Dr. B. Ramegowda
Dr. S. Ramakrishna
Dr. D. G. Hallikeri
Central Working Committee (Reg.)
Dr. Suresh Halasangimath
Dr. K. C. Raju Reddy
Dr. Nanjundaiah
Dr. J. V. Narayan
Dr. S. M. Sureshwaraiah
Dr. D. Prabhamandal
Central Working Committee (Alt.)
Dr. I. S. Patil
Dr. A. S. Mantganikar
Dr. B. V. Rajagopal
Dr. N. Vccranna
Dr. IL R. Maheswarappa
Dr. A. K. Handigol
/ 9)
Date :
Flow Chart ofhealth care facilities at different levels
Sub Centre level
5,000 Population
Health Worker
P.H.C
MBBS Graduate
Taluk
District
Speciality Centre with Post
graduate Doctors
Regional Centre
Speciality Centre
State head Quarter
Centre of excellence with
super specialty set up
Health Insurance Scheme
The role of private organizations in evolving a workable health
insurance scheme should be explored for the benefit of all sections
of the community.
Care of the elderly
With the rise in life expectancy a significant sections of the
population belongs to the elderly group, requiring specialized care
and efforts must be made to gear up to meet their health
requirements not only to term of medical care but also in terms of
social and community support to make them feel that then not being
neglected.
Ex-Officio Members :
Dr. D. Prabhamandal,
Imm. Past President
Dr. H. R. Maheswarappa,
'dim. past Hon. Secretary.
Your Membership is our Strength "
INDIAN MEDICAL ASSOCIATION
KARNATAKA
STATE
IMA House, Alur Venkata Rao Road, Bangalore - 560’018 TeleFax
BRANCH
080-6703255
Dr. S. B. Kulkarni
President
Akshaya Eye Hospital
3935/51, Club Road.
Belgaum - 590 001
Tel 0831 - 425333 (O) 480292 (R)
Dr. 11. R. Maheswarappa
Sr. Vice - President
Bangalore
Tel : 080 - 5452059
Dr. S. Shcela Bhanumathi
Vice-President
Bangalore
Tel . 080-5721158
Dr. K. Madusudhana Rao
Vice-President
Bellary
Tel : 08392 - 55819, 566*5 (R)
72724 (C)
Dr. V. C. Shanmuganandan,
Hony State Secretary
No 3. Kempanna Road,
Maruthi Sevanagar, Bangalore - 560 033
Tel 080 - 5464021 (R). 5539277 (O)
Dr. Anil Kumar
Hon Jt Secretary
Tel 080 - 6525846 (R).
6616869 (R)
Dr. V. M. Puttaraju
Hon. Treasurer
Bangalore
Tel 080 - 3342700 (R)
Dr.V. B. Yelburgi
Asst. Secretary
Belgaum
Tel 0831 - 466062 (R)
Dr. B. S. Ramesh
President Elect
Tel 080 - 2222267. 2293862 (H)
2261435 (R)
Ref : IMA - KSB /
Dr. B. Rame Gowda
Director of Studies. IMA CGP
Tel : 0821 - 511552 (R)
Dr. H. P. Harshan,
Hon Secretary. IMA CGP
Mysore
Tel 0821 - 544124 (R)
Dr. A. K. Handigol,
Chairman. IMA AMS
Dharwar
Tel : 0836 - 42686 (R)
Dr. S. M. Surcsliwaraiah,
Hon. Secretary. IMA - AMS
& Editor IMA Focus
Bangalore
Tel . 080 - 3363180 (R)
Dr. M. K. Vasudev
Editor. KMJ
Dr. K. C. Raju Reddy,
Convenor, Building Committee
Bangalore
Tel : 080 - 5461264 (R)
Dr. P. N. Govindarajulu
Public Relations Officer.
Tel : 080 - 3363038 (R).
Internal Auditor
Dr. S. Ramakrishna
Tel 080 - 6695646 (R),
/ 99
Dale :
“Family Welfare Programme”
The Non Governmental organizations have always played a pivotal
role in popularizing the small family norm and efforts to enhance
die fruitful co-operation with other community based NGOs should
be explored.
Alternate systems ofMedicine
While efforts should be made to popularise the alternate systems of
medicine, which are cost effective, caution should be laid to prevent
practitioners of such system of medicine organising into the others
system, which would amount to quackery.
Accountability and quality care
Accountability at all levels of health care delivery’ should be an
incorporated factor, which would thereby ensure availability of
quality health care services.
State Working Committee
Dr. C. Rajan
Dr. Mallesh P. Hullamani
Dr. Shankar Goud B. Amarkhed
Dr. B. Ramegowda
Dr. S. Ramakrishna
Dr. D. G. Hallikeri
Provisions should also be made to periodically review, reassess and
effect necessary corrective changes at all levels to ensure delivery of
quality health care services, be it government or non-govemment.
Central Working Committee (Reg.)
Dr. Suresh Halasangimath
Dr. K. C. Raju Reddy
Dr. Nanjundaiah
Dr. J. V. Narayan
Dr. S. M. Sureshwaraiah
Dr. D. Prabhamandal
Role ofMedical colleges”
Central Working Committee (Alt.)
Dr. I. S. Patil
Dr. A. S. Mantganikar
Dr. B. V. Rajagopal
Dr. N. Vceranna
Dr. Ii. R. Maheswarappa
Dr. A. K. Handigol
The curriculum of at the Medical College should be re -oriented to
suit the requirements of the community and the concept of holistic
medicine, where is the individual is treated as one complete unit
rather titan treating the disease per se should be incorporated to give
medical educational humanistic approach.
Ex-Officio Members :
Dr. D. Prabhamandal,
Imm. Past President
Dr. H. R. Maheswarappa,
Imm. past Hon. Secretary.
Your Membership is our Strength "
INDIAN MEDICAL ASSOCIATION
KARNATAKA
STATE
BRANCH
IMA House, Alur Venkata Rao Road, Bangalore - 560 018 TeleFax : 080-6703255
Dr. S. B. Kulkarni
President
Akshaya Eye Hospital,
3935/51. Club Road.
Belgaum - 590 001
Tel 0831 - 425333 (O) 480292 (R)
Dr. H. R. Maheswarappa
Sr. Vice - President
Bangalore
Tel. 080 - 5452059
Dr. S. Shcela Bhanumathi
Vice-President
Bangalore
Tel. 080-5721158
Dr. K. Madusudhana Rao
Vice-President
Bellary
Tel : 08392 - 55819, 56645 (R)
72724 (C)
Dr. V. C. Shanmuganandan,
Hony State Secretary
No.3. Kempanna Road.
Maruthi Sevanagar. Bangalore - 560 033
Tel 080 - 5464021 (R). 5539277 (O)
Dr. Anil Kumar
Hon. Jt Secretary
Tel: 080 - 6525846 (R),
6616869 (R)
Dr. V. M. Puttaraju
Hon. Treasurer
Bangalore
Tel. 080 - 3342700 (R)
Dr. V. B. Yelburgi
Asst Secretary
Belgaum
Tel. 0831 -466062 (R)
Dr. B. S. Ramesh
President Elect
Tel : 080 - 2222267, 2293862 (H)
2261435 (R)
Ref: IMA - KSB /
Dr. B. Rame Gowda
Director of Studies. IMA CGP
Tel . 0821 - 511552 (R)
Dr. H. P. Harshan,
Hon Secretary. IMA CGP
Mysore.
Tel 0821 - 544124 (R)
Dr. A. K. Handigol,
Chairman. IMA AMS
Dharwar.
Tel : 0836 - 42686 (R)
Dr. S. M. Sureshwaraiah,
Hon. Secretary, IMA - AMS
& Editor IMA Focus
Bangalore
Tel • 080 - 3363180 (R)
Dr. M. K. Vasudev
Editor, KMJ
Dr. K. C. Raju Reddy,
Convenor, Building Committee
Bangalore.
Tel : 080 - 5461264 (R)
Dr. P. N. Govindarajulu
Public Relations Officer.
Te' 080 - 3363038 (R).
internal Auditor
Dr. S. Ramakrishna
Tel : 080 - 6695646 (R).
State Working Committee
Dr. C. Rajan
Dr. Mallcsh P. Hullamani
Dr. Shankar Good B. Amarkhed
Dr. B. Rarnegowda
Dr. S. Ramakrishna
Dr. D. G. Hallikeri
Central Working Committee (Reg.)
Dr. Suresh Halasangimath
Dr. K. C. Raju Reddy
Dr. Nanjundaiah
Dr. J. V. Narayan
Dr. S. M. Sureshwaraiah
Dr. D. Prabhamandal
/ 99
Date :
Health education
‘For effectively combating the health problem of the individual and
the community, an effective information, education and
communication system involving the non governmental
organisations would go a long way in the community accepting the
Health programmes and in bringing about the desired life style
changes which would form the basis of a health community.
Community participation
In order to inculcate the concept of feeling involved and thereby
active participation on in all the health programme the community
should be involved at all levels starting from an assessing the health
requirement. Planning, executing and manning the system.
The participating NGOs in all health endeavours should be
encouraged by the government by way of:1. Providing infrastructure such as land, building, men and material
where possible
2.Financial assistance in terms of meeting the basic expenses of
those involved in actually carrying at the health activity
3.Providing inter departmental co-ordination and assistance for all
Health activities.
Central Working Committee (Alt.)
Dr. I. S. Patil
Dr. A. S. Mantganikar
Dr. B. V. Rajagopal
>r. N. Vecranna
Dr. II. R. Maheswarappa
>r. A. K. Handigol
:x-Officio Members :
Dr. D. Prabhamandal,
mm. Past President
Dr. H. R. Maheswarappa,
nm. past Hon Secretary
Your Membership is our Strength "
29
5.2
Consultants:-
Appointed by Govt, of India are also
evaluating the programme and guide in implementation of
the programme.
Prompt feed back is given to the Director
and District Leprosy Officers.
5.
Patches: -
cases are more.
Among newlydetected cases, single patch
This shows early detection,
nearly,
505o oases are single natch cases.
Plan of Action for 1999-2000
1. Consolidation of LPT services.
— • Ini sn sialo s/c ion oi
3. T~~2n'
nn
io Hu.02.ii0n -“-oiiviiiss.
ior 2II iis Hsslih Psr* sound p^i Public
— A a ' ~T ~-P O
F.eplacement of wcrnout vehicles under I1LZP.
5. Establishment of Regional Leprosy Try^r-ing &
Research Institute (RLTFIE) from Govt, of India.
IOO<2_- Cf
NATIONAL TUBERCULOSIS CONTROL P RO GR A-GTE
National Tuberculosis Control Programme is a
Centrally sponsored scheme which is integrated with General
Eealth Services at the peripheral level.
Thls programme is
being run by State and Central assistance of 50:S0 share.
The state
Tuberculosis Centre located in
Bangalore is responsible for Planning, Implementation, Super
vision, Monitoring and Evaluation of Tuberculosis Pro gramme
in the State.
The State Tuberculosis -Centre has got the
. —
folio-wing 7 wings;
1) Epidemiology and Survellance
’
' '
fl.
2) Bacteriology
3) Research Wing
O Administrative Wing
5) Monitoring of Nations 1 IB Programme in the State
6) Training to Medical and Para Medical Personnel &■
7) Clinical section to cater the needs of TB
patients who are
referred to State Centre.
AU the Districts in Karnataka State are provided
with District Tuberculosis Centres for implementing National
Tuberculosis Control Programme.
Revised National Tuberculosis Control P.fh gramma
under Phase III with World Bank assistance has been imnlemented
in Bangalore Urban
District since November'98.
The remaining
four Districts will be implemented frsra next year for which
preparatory activities are going on.
The affected villages and towns were taken up for control
of* fly nuisance and all drinking water sources have been
Chic—inated with bleaching powder.
FINANCIAL PROGRESS
For the control of Diarrhoeal diseases the .State Governmen
have allocated (under State Sector PLAN Scheme) a sum of
Rs. 25 lakhs for the purchase of medicine, disinfectant and ■
to supply the same to the affected district through the
Government Medical Stores, Bangalore.
(Rs.in lakhs)
BUDGET ALLOCATED
YEAR
1998-99
EXPENDITURE
25.00 (upto
end of Dec 98)
25.00
KYASNUR FOREST DISEASE
This disease is prevalent in the districts of shimoga,
Uttara Kannada, Bakshina Kannada and Chikmagalur.
The disease is prevalent in the laluk of Thirthahally,
Hosanagar and Saraba in Shimoga District, Honnavara, Bhatkal,
Kumta, Supa and Yellapura Taluks in Uttara Kannada District,
Koppa taluk in Chikmagalur District and B'elthangadi Taluk
in Dakshinna Kannada District.
In addition, the surveillance activities are carried out
by the staff of both field stations and field staff of
district Health and FW Officer, for diagnosis, . treatment
and prevention.
PHYSICAL PROGRESS
The incidence of Kyasanur Forest Disease during 1998
are as follows:'-
NUMBER OF SUSPECTED CASES
•-
ATTACKS
298
•
DEATHS
1
NUMBER CONFIRMED
ATTACKS
47
DEATHS
1
FINANCIAL PROGRESS
(Rs. in Lakhs)
YEAR
1998-99
10C2. - j
BUDGET
5.00
EXPENDITURE
1.5 (upto end
of Dea. 1998)
' : 42
f
HANDIGODU SYNDROME
This is a peculiar disease of genetic origin found
in few villages of Shimoga and Chikmagalur Districts and
found mostly in Harijan Families.
c
This disease will easss
:se the disability mainly because of its affliction of
joints and bones.
The rehabilitation and symptamatic treatment are given
ohese patients.
PHYSICAL PROGRESS
The incidence of Handigodu Syndrome are as follows:
DISTRICT
Shimoga
Chikmag al ur
TOTAL
NO. OF VILLAGES
49
30
79
NO. OF CASES
438
338
776
—
. >IV• .NUTRITION EDUCATION ACTIVITIES INCLUDING TRAINING;
Eive Nutrition Education & demonstration units are functioning
in 5 districts of Bangalore Division via., Bar<;aLore(Rural), Solar,
Chitrsdurga, Shimoga and Tumkur.
Cooking demonstrations, Jila shows,
exhibitions ard Group nestings on Nutrition are organised in rural
are aS.
A joint training programme on MCHN activities was organised
for LHVs and Mukhya SevikaS of Bellary District from 24-6-98 io
25.5.98 at Bellary. 41 members attended the training programs.’’inilaT training programmes were organised for LHVs and Mukhya.
’ikas of Bijapur district from 17-11-08 to 19-11-98 and for
Jalkot District from 18-11-98 to 20-1 1-98 at Bijapur.
48 members
..on Bijapur and 55 from Bagalkot attended the training programme.
V. CONTINUOUS MONITORING OF DIET AND NUTRITION SURVEYS 'BY NNMI UNIT;
NNMB unit, a branch of ICMR attached to Bureau of Mitrition is
conducting Diet and Nutrition surveys on the protocol of National
Institute of Nutrition, Hyderabad.
During this year the unit has
conducted tribal surveys in Chicknagalur and Dakshina Kannada
district.
52
HOSPITAL PHARMACY PROGRAMME
INTRODUCTION
'Hospital Pharmacy' is a programme being implemented by
the Government of Karnataka under State sector.•
OBuDCTIVBS;
1)
Go organise a technically sound dispensing section-,
Quality Control System, Central Sterile Supply Division
and store Practice in the Hospitals.
2)
To develop a reliable 'Drug Information Service'
for the benefit of staff and the patients/their attendants
3)
To manufacture life saving intravenous fluids for
use in the hospitals»
€>5
III.
fu;ancial
DExAILS
Budget allotment and expenditure for the year 1998-99
Head of Account: Plan: "2211 Family Welfare - 108 Selected
Area Programme - 071 IPP-IX (Karnataka)
102 - Special grants.
Non-Plan: "2211 Family welfare - 108
Selected area Programme - Including
IPP-01-India Population Project population Centre" .
Budget
proposed
for
1998-99
Item
Rs.
Expenditure
incurred upto
Dec. 98
Rs.
Plan
Usefulness of the training
acted to tha tribal girls
25,000/-
25,000/-
1, pay of Officers
7,39,000/-
2,59,826/-
2. Pay of Staff
11,47,000/-
7,26,519/-
3. Dearness Allowance
28,15,000/-
15,19,442/-
4. Other Allowance (including
medical exj.enses)
4,49,000/-
2,64,407/-
5. Office Expenditure
4,00,000/-
50,044/-
6. footer vehicles
2,00,000/—
8,665/-
7. Travel Expenses
1,00,000/-
8,947/-
58,51,000/-
27,92,810/-
Non- Plan
Total
OF P0?:JL.:.TZ0!I CCi
1998-9?
1.
Perception of People about Quality of ,‘ledical
Services in Secondary Level Hospitals in Kolar
District.
2.
Status of Primary Health Care in Hassan District.
3.
A District Profile of Karnataka on Socio-Economic
Denegraphic ane Family welfare Indicators.
4.
Concurrent Evaluation of Family
Printed on KSTRC Tickets.
ielfare Slogans
STUDIES IN PROGRESS
1- Evaluation of AHM Training for Tribal Girls under
the Innovation scheme of IPP-IX.
2.
ilulti-indicator Cluster Survey.
3.
A study on benefit accrued from IPP-I and IPP-IH
in
at aka .
4.
Role of ,’iahila Swasthya Sangha - A study.
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udjae.0^ aaoJOoOJCodjc; 3joj_, 3jJ>/) alarua el.e.3^ etdoatjli fie.sdOOrl 30de.fi
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Psxdoxi2anoe paper t oi Sireou oi' Hoolti; Lduca^on and HmiidLni; Eeotion z- the niroctoreto of Ileal
and Saciiy woliura Servlcscp pan^ploro ioc the year 129-6-07fl 1597-93 and 1993-99.
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couroea to PoKoWo
Para Medical Staff like BeaHSi Assistants (Junior and Senior) Holes and. pcaal.es
thick uer© organiaed by this Hrectoxate are now organised. ty ScJoJ^LZ and XJI^oD^o
IV-, 75.old SbiTtiy and pgranstsotlpn centre;
She rdSGfi Study and Zxrxnstraticn in also being camicdout as a .'-USd trial axh pre-tenting'
of Health Education natcriols produced. ly 1^oCa Uns,
the field
study elc^ insludec o-o
a deejonstsatfon to the beissficLories,
Th© Aotlvities iicludcd. ore tmining cd.’ School rOu£lux=a svi lirr- ycdloal Stuff ud Primary'
Health Centro ard. Supervision,
Z^LcacnQEt dqrl^i th?_x^._l£'£_&r)7, ^997-91 andl9-jc>99t
-2io World Health isy on 7th April isis dhcoirjed thraigbout tho state on a particular Glogpn
duuirg
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a najor
Health unu ihaily wclfana sthLl uta arraagod. cn tha occasion of Mysore zacaia mhihLtian -at
Mysore during these years and also ascietod to organtsc the Health aui ya^rtTy lOlExxc Dthitilions at
Hacuir^ itinnur and other places.
5
Ide Health Liu cation natcriais line xoldcio0 doctors, leailGtn ware
iredaul printed
in local lanjuaee on dli2ercnt i;no£zmnico in cxHLaion. to j<urcaasc of Audio—Visuai jxiaipc.snt;is illu
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(L~ie and rerale)
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(&iio and rocnl.0)
5° Senias’ and Junior Health
■'^Lstanis Giole and I'cmio
trained ttf no bile teac,
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It io colcly nordtcrcl
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lip Seiioci health Itjdns d been inpl evented in ell the Priixny ,arn "ijior prim-p
fchoolc in loti mrGl nd Urban nraaD od ’lie Stctco
m tiio Hctrict Hcoith end rordr ',SE.ic.no
Cxdioora tnre Lnplonuntlnc tie preonaono di effectively sc per the instructions of tils pirocnorc
Che xo.’ilaui.iif; arc vazirjo netivit’ec,,
• . Hoi-lcsl mxxijrrtion of the rr^jeSentB
2o Irzsxs&Sat inn of Children dth yr- £
>0 PiCridlnG troueesni xcr ninon aUjoc-nnG
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2aalth -iiuoapioo. to ietxnezx; sswH ao
otudemE rorsdirc peTocrSl hyd-hO*
environnoixdl o-'initn.i.ian3 drirUnc uatrr, uce of istcrinoc on-o beini' tayj-.t rojilaily,.
IHoPtutencn't shewing the n-yroao report or. r.ohoGl Gael th Sarvicoc Sixtii 1996=97 to 1?9p-99n
19’96—>97
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MCI-211/98-Regn ./19956
20/10/1998
To:
1. The President of aH State Medical Councils,
2. The Directors of Health Servlces/Directors of Medical Education
All State Govt and Union Territory Administrations.
Subject Action to be taken against un-quatlfled medical practitioners/quacks.
Sir,
Section 15 of the Indian Medical Council Act, 1956 provides that no person other than
a Medical Practitioner enrolled on a State Medical Register or given provisional
registration under Section 25 shall practice Medicine In any State and any person
contravening this provision shall be punished with Imprisonment for a term which
may extend to one thousand rupees, or with both.
In the tetter addressed by the Central Govt (Ministry of Health & F.W.) to all State
GovtAJT Govt on 01.06.1982 they were informed that despite lapse of so many years
no tangible action has been taken against the entry of fresh unquaSfied persons into
the rank of the registrable stock. At that time the annual addition of medical graduates
from 106 merfical colleges were 13,000. With the significant increase in the number
of qualified doctors there was no dearth of trained and qualified medical personnel in
the country. Also, a number of cases of gross negligence on the part of unqualified
medical practitioners came to notice of the Govt To put an end to the problem of
unqualified medical practitioners as wen as to ensure that there is no fresh adcfltion
whatsoever of unqualified persons to the stream of practitioners, the State/UT Govts.
were asked to invoke the penal provisions of I.M.CAct, 1956, as per the above stated
communication of the Central Government.
In connection with a writ petition filed by the Indian Medical Association, Delhi Branch
in the High Court of Delhi., the High Court of Delhi had directed the Government of
National Capital Territory of Delhi to file HRs on individual basis and In persuance of
the decision, the Delhi Govt, have formed an anti quackery raid party who on day to day
basis have been filing FIRs against unqualified medical practitioners. In this context a
copy of the Govt, of India, Ministry of Health & Family Welfare letter
No.C.18018/9/96ME( UG) dated that 9th August 1996 is enclosed for ready reference.
Contd........2.........
:2:
It is therefore, requested that all State Govts./State Medical Councils may please take
necessary action against quacks practising In the State/UT concerned. Action taken
may please be Intimated to this Council.
Yours faithfully,
(DR.M.SACHDEVA)
SECRETARY.
Endst. No. MCI-211 (2)Z98-RegnJ19998
Dated: 20.10.1998
Copy to Ministry of Health & F.W., Deptt. of Health, attention Shri S.K.Mishra, Desk
Officer ME (UG) with the request that necessary action may please be taken to follow
up with the StateAJT Govts, for taking necessary penal action against quacks.
(DR. M.SACHDEVA)
SECRETARY .
Letter No.KMC/UNQ/84_SS detod 31-S-1984 from tho President,
Karnataka Medical Council, Bangalore to the Secretary to tho
Government of Karnataka, Health and Family Welfare Department,
Multi Storeyed Building, III Stage, Dr.B.R.Ambedkar Veedhi, K.R.
Circle, Bangalore-560001.
*****
Subject: Problem of Quackery - Containment of by the Government of Karnataka.
* ■*•'*■
Recommendations of the Committee and recommended by the
Karnataka Medical Council.
★ ★ ★
1. All Doctors practising allopathic system of medicine in
Karnataka State should be registered.
The registration shoulc
be made mandatory as per provisions' of the Medical Council of
India Act and KarnatakaMedical Council Act.
In addition, the
Medical Practitioners should, invariably quote their KMC .
Registration number and its validity on their prescriptions issued to the patients, on the sign Boards and on their letter
heads, etc.,
2. Any doctor t-ho intends to practice in the State of Karnate..
jneul
i?: respective of his registration in other : '. ate Medica1
• ou,. .-’Is of India must register in the Karnataka Medical Coun_i.
3.
Prescriptions not mentioning the KMC. registration nut -.r and
its validity shall not be honoured by the Pharmacists/Chemists
and Druggists.
No person who is not registered in the Karnataka Medical
Goul !1 is empowered to prescribe or use Allop.a- ■. <. drugs.
5.
■' aer persons practise .ag as Registered Medical Practitioners
(RMP) in other systems of Medicine, Like Ayurv.da, Unani,
Siddha etc., should also be regulated through their respective
In-rd/Council and the,' should not encroach upon prescribing
allopathic Medicines.
6.
Stringent punishment should be stipulated for violation of
the above by making suitable legislation on the lir.'-s o'Kacnataka Medical Council Act.
7.
Public are requested to co-operate and to be cautious.
XmlcULevix Medical Association
Karnataka State
President
Dr. S. 8. Kulkarni
> Population Control -- A National Emergency
r Potable Water- A Civil Right
x Nutrition As a Child's Right
r Primary & Preventive Health Care- A Citizen's Right
Increase in Budget for Health
> Compulsory Secondary Education for the Adolescent Girl
Child
x Environment and Sanitation- A National Commitment
z- Medical Education and Research Policy
> Abolition of Quackery
r Health Education for All
> Involvement of Private Sector in National Health Programmes
Uniform Wages and Service Conditions Policy for Different
Medical Professionals
Con^umer Protection Aptito be Amendecl
!'
z- Extended Universal Immunisation For Children
z- Creation of National Health Commission
s tri
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BRIEF NOTE ON THE DEPARTMENT OF
INDIAN SYSTEMS OF MEDICINE AND
HOMOEOPATHY
BRIEFNOTE ON HIE PROGRAMMES OF THE DEPARTMENT OP'
INDIAN SYSTEMS OF MEDICINE AND HOMOEOPATHY.
Indian Systems of Medicine and Homoeopathy is rendering medical relief to the
public in Ayurveda, Unani, Yoga, Nature Cure and Homoeopathy System of Medicines
and regulates Medical Education, Drugs Manufacture and practice of medicine in these
systems.
There arc 93 hospitals, 582 dispensaries and 63 colleges functioning in the state.
All the dispensaries and 55 hospitals (40 Taluk Level, 15 Rural ) are under the
administrative control of Zilla Panchayatlis. The remaining hospitals are under the state
sector. Out of 63 colleges 58 are private colleges of which 5 are under grant-in-aid. The
remaining 5 colleges are Government Colleges.
The budgetary provisions and expenditure of the last llu ee years are as follows:-
97:1996-
Particulars
State Sector
District Sector
Total
Non-Plan
B.E.
Expr.
1034.15 865.49
580.85 580.85
1615.00 1446.34
(Rupees in lakhs)
Plait
B.E.
Expr.
140.00
110.95
343.00
307.62
483.00
418.57
B.E.
6.00
6.00
C.S.S.
Expr.
6.00
6.00
Non-Plan
B.E.
Expr.
1196.35 1037.07
982.27
982.27
2178.62 2019.34
(Rupees in laklrs)
Plan
Expr.
B.E.
150.00 99.05
311.49 89.89
461.49 188.94
B.E.
6.00
6.00
C.S.S.
Expr.
2.17
2.17
Non-Plan
B.E.
Expr.
1266.12 1052.69
1121.93 1121.93
2388.05 2174.62
(Rupees in laklrs)
Plan
Expr.
B.E.
200.00
128.69
247.41
150.36
447.41
279.05
B.E.
6.00
6.00
C.S.S.
Expr.
4.23
4.23.
1997-98:-
Particulars
State Sector
District Sector
Total
1998-99
Particulars
State Sector
District Sector
Total
1999-2000:(Rupces iii laklis)
Particulars
State Sector
District Sector
Total
Non-Plan
Expr.(Oct)
B.E.
1513.43
805.81
1318.97 Not available
2832.40 805.81
Plan
Expr(Nov).
B.E.
270.00 143.70
238.07 118.03
B.E.
8.00
C.S.S.
Expr.fNov)
3.51
508.07
8.00
3.51
261.73
The achievements of the last three years are as follows:-
1996-97:1.
A Divisional Office of Indian Systesm of Medicine and Homoeopathy has been
sanctioned and functioning at Mysore.
2.
A 10 beded Homoeopathy wing has been sanctioned and started functioning at
Mysore.
3.
Three Govt. Ayurvedic Dispensaries have been started.
98:19971.
A Divisional Office of Indian Systems of Medicine and Homoeopathy has been
sanctioned and functioning at Belgaum.
2.
A 15 beded Govt. Ayurvedic Hospital has been sanctioned and functioning at
Raichur.
3.
The bed strength of Taranath Hospital,Bellary has been increased from 85 to 100.
4.
A 10 beded Homoeopathy wing has been sanctioned and functioning at Govt.District
Ayurvedic Hospital,Shimoga.
5.
21 Teacliing Posts( Professor:14, Asst.Professor:02, Lccturer:05)have been
sanctioned to I.S.M& HColleges.
6.
5 Taluk Level Hospitals, 43 Dispensaries have been sanctioned and functioning
under District Sector Scheme (Z.P)
7.
P.G. Course under 100% CSS has been sanctioned and started at Bellary.
8.
Administrative approval has been accorded for the constiuction of Govt.Unani
Medical College with an estimated cost of Rs. 75.00 laklis.
99:19981.
126 posts of Physicians have been selected by KPSC and appointed bj'
Government..
2.
1 Post of Drugs Inspector(Homoeopathy) has been sanctioned to Directorate of
Indian Systems of Medicine and Homoeopathy.
3.
A Divisional Office of Indian Systesm of Medicine and Homoeopathy sanctioned and
functioning at Bangalore and essential staff to Divisional Office,Belgaum have been
created.
4.
'Hie bed strength of Sri.Jayachamarajendra Institute of Indian Medicine (Unani Wing)
has been increased from 75 to 100 and a 10 beded Homoeopathy wing has been
sanctioned to Govt. Ayurvedic Hospital,Bijapur.
5.
Two Ladies Hostels have been sanctioned one each at Mysore and
Bellary and constructed.
6.
Essential teaching posts (7 posts) have been sanctioned to ISM&H Colleges
DIFFICULTIES FACED BY THE DEPARTMENT;The Department of Indian Systems of Medicine and Homoeopathy was bifurcated
from the Health Department during 1972.
Consequent on the bifurcation of the
department, the developmental activities are on increasing trend. However the budgetary
allocation are not sufficient to improve further. At present there are 18 District Level
Hospitals of ISM&H
functioning. But there are many places including District Level
in the State where ISM&H hospitals and dispensaries donot exist. The department is not
in a position to start such hospitals and dispensaries due to paucity of funds.
In this
connection the kind attention is drawn towards the Estimate Committee Report for the
year 1998-99 wherein the Committee has suggested to start District Level Hospitals in
the remaining districts within tlu'ee years and Taluk Level Hospitals in all the Taluk
places within a period of live years. With a view to implement the suggestions sufficient
budget allocation under State and District Sectors is required,
hi many hospitals bed
strength could not be increased due to shortage of funds though demands for such
increase is being received.
The department is planing towards establishment of Sanjeevini Vanas at District and
Taluk Levels in co-ordination with the forest department. To implement this scheme,
sufficient budget provision is required.
Director
Indian Systems of Medicine
and Homoeopathy.
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ANNUAL TARGET
-IM C N 7 H L Y
- - r.
„-TA.Rp-I
.ACHIEVEMENT _
“on t h
:3ctocer-199
CT
U M U L A T I
ACHJEVEfEST
-C
•?
V £
.
.bangalore
7 70
64
75
117.19!;
448
596
1 3 3. 0 4!;
BANGALORE RURAL
310
26
21
8 0.7 75;
182
315
1 7 3.0 8!;
BEL GAUM
300
25
81
32 4.0 05;
175
602
34 4 . 0 05; *
BELLARY
850
71
171
24 0.8 55:
497
1522
3 0 6.2 4!;
BIOAR
600
50
54
10 8.0 0 5;
350
441
1 2 6.0 05;
BIJAPUR
620
52
58
111.5 4!;
364
603
1 6 5.6 6*4
90
6
5
8 3.3 35;
60
41
68. 33*4
23
16 4.2.9*4
98
179
1 8 2.6 5*4
17
8 5.00*4
140
184
1 31.4 3*4
CHIKMAGALUR
CHITRADURGA
170
14
DAKSHIN KANNAO
.240
20
dharwad
. 270
-23.
44
19 1.3 05;
161
346
214.9 1*4
GULBARGA
1350
.— —
. 30
113
142
12 5.6 6*4
791
1677
2 1 2 . 0 1 *4
2
3
15 0.0 05;
20
37
1 8 5.0 0*4
HASSAN
_ .
.
. _______ .. _
. .
KODAGU
. 30
2
5
25 0.00*4
20
35
1 7 5.0 0*4
KOLAR
530
44
39
20 2.2 75;
308
580
18 8.31*4
MANDYA
170
14
31
22 1.4 35:
98
25G
2 5 5 . 1 0*4
MYSORE
210
17
39
22 9.4 15;
125
360
2 8 8.0 0!.
RAICHUR
530
44
125
28 4.0 9*4
308
836
2 71.4 3*4
1 2 8.5 7*4
-0
REMARK5
.
-
,
r-
-m'
.4
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r
...................... -
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k
SHIMOGA
160
13
15
11-5.3 85;
91
117
TUMKUR
270
23
46
20 o.oc?;
161
306
1 9 0.0 65;
UTTAR KANNAD
290
24
23
9 5.8 3*4
: 16 8
270
160.71:;
5AGALKOTE
510
43
70
16 2.-7 9*4
301
738
2 4 5 . 1 85;
CHAMARAJNAGAR
230
19
45
236.84*4
133
368
2 76.69-4
■f
DAVANGERE
310
26
50
19 2.31*4
182
338
18 5.71-4
GADAG
250
21
32
15 2.385;
147
306
2 08.1 6!:
HAVER I
380
32
59
184.385:
2 24
442
1 9 7.3 25;
KQPPALA
410
34
118
34 7.065;
238
754
3 1 6.8 1 *4
12. J2 0.0 0*4
.70
.98 . 1 4 0, 0 0:;.. .
17 4.6 45;
5S6G
UDjRI
Total
,
_ _ ,
- A?0-
1 0000
r
r _ 10v
832
1453
_
12 3 4 1
10.6 0*4
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■<_
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.
1
QUALITY ASSURANCE SYSTEM OVER DRUGS IN THE STATE OF KARNATAKA
Quality Control over Drugs in the State is exercised through the
implementation of Drugs & Cosmetics Act & Rules there under.
Drugs & Cosmetics Act and Rules there under is a Central legislation and
the responsibility of implementation wrests with the respective State
Governments. The mechanism of control is in the form of:
1.
2.
3.
Licensing of manufacturing and sales establishments.
Pre conditions for the grant of license and conditions of license .
Periodic inspection of all licensed establishments and sampling of drugs
by Drugs Inspectors.
LICENSING OF MANUFACTURING AND SALES ESTABLISHMENTS.
Manufactures of Drugs and Dealers in drugs have to obtain license by
fulfilling the pre conditions stipulated.
PRE CONDITIONS FOR THE GRANT OF LICENSE:
The Rules have been framed to ensure that quality is built in from the
initial stage of manufacturing activity. The salient requirements to be eligible for
grant of license for manufacture is construction of manufacturing facility as per
Good Manufacturing Practices requirements,
employment of competent
technical staff possessing technical qualification and experience to supervise
production and quality control activity and necessary infra-structure in the form of
segregation of different activity, equipment and other facilities required during
manufacture and laboratory for test and analysis.
CONDITIONS OF LICENSE:
The conditions in the form of mandatory Rules have been framed so that
the manufacturer assumes responsibility for the quality.
Thus, every raw
material, whether active or inactive ingredient, must be subjected to analysis,
various in-process control tests are applied during different stages of
manufacture and the finished products are subjected to specified tests and
analysis. Every stage of activity has to be documented and these documents
have to be preserved and are open for inspection by the Officers of the Drugs
Control Department.
2
PERIODIC INSPECTION AND SAMPLING BY DRUGS INSPECTORS
Under the Drugs & Cosmetics
Act and Rules there under, four
functionaries have been identified.
They are 1) Drugs Inspectors, 2)
Government Analysts, 3) Licensing authority and 4) Controlling Authority.
Specific qualifications and experience have been stipulated for appointment to
these posts so that only persons with technical background and experience hold
these posts.
The drugs inspectors are expected to inspect all licensed premises in
their jurisdiction not less than twice a year and draw samples of Drugs and
Cosmetics for Test and Analysis.
The Government analysts have been vested with the responsibility of
analysing the samples sent by the Drugs Inspectors and issue reports thereof on
the quality of drugs.
The licensing authorities discharge the duties of licensing, of
manufacturing establishments and sales establishments upon ascertaining that
the conditions for the grant of licenses have been fulfilled. They are also vested
with the power of cancellation of licenses or suspension of licenses for a period
as deemed fit for violations of conditions of other provisions of Act and Rules.
The controlling authority is the authority to whom all inspectors appointed
are subordinate and inspectors have to carry over the instructions of controlling
authority in the discharge of their day today work.
DRUGS CONTROL ADMINISTRATION IN THE STATE OF KARNATAKA
Drugs Control Department in Karnataka is functioning as an independent
department since 1962 under Health and Family Welfare Department. To
enforce the provisions of Drugs and Cosmetics Act and rules there under,
Enforcement Wing consisting of inspectors and supervisory officers namely
Assistant Drugs Controllers , Deputy Drugs Controllers and Additional Drugs
Controller are functioning. Drugs Controller is the head of the Department. The
inspectors undertake inspections and draw samples from manufacturing and
sales establishments and hospitals.
Licensing of manufacturing establishments is looked after by the head
office located at Bangalore and the Drugs Controller is the licensing authority
For licensing of sales establishments, fifteen circles have been identified in the
state and the Assistant Drugs Controllers functioning in these circles have been
notified as licensing authorities.
In every District an inspector has been
posted.
3
For the purpose of test and analysis of samples drawn by the Drugs
Inspectors, an independent Laboratory namely Drugs Testing Laboratory located
to the department has been established and seven Government analysts have
been appointed and they are engaged in test and analysis assisted by other
technical staff of the Laboratory.
Drugs Controller is the controlling authority for all the inspectors.
BLOOD BANK AND INTELLIGENCE WING
Recently, a separate wing called Blood Bank and Intelligence Wing has
been established in the department, located at four places namely Bangalore,
Mysore, Hubli and Gulbarga to undertake auditing of Blood Banks and to keep
surveillance over spurious, adulterated and substandard quality drugs.
SUCCESS AND DIFFICULTIES
ASSURANCE OVER DRUGS.
IN
IMPLEMENTATION
OF
QUALITY
Karnataka State has been regarded as a model state for Drugs Control
Administration in the Country, Counterfeit and substandard drugs is not a
problem in the State.
The major constraint encountered by the department is inadequate
inspectorate staff and laboratory staff.
As per the Statutory requirement, an
inspector is expected to inspect all the licensed establishments in his jurisdiction
at least twice a year and also draw samples. It has not been possible to adhere
to this requirement due to inadequate inspectorate staff. The Task Force
constituted by Government of India to suggest measures for satisfactory
enforcement of Drugs & Cosmetics Act and Rules there under
has
recommended that there shall be one inspector for every 100 sales
establishments and one inspector for every 25 manufacturing units. In the State
of Karnataka there are about 12,800 sales establishments and 732
manufacturing units (including loan licenses and Blood Banks). As such, at least
158 inspectors are necessary, but the sanctioned strength is only 56, of which
8 posts are vacant. Therefore, there is an urgent need to increase the
inspectorate staff.
Due to the revolution in information technology, enforcement officers are
required to act very swiftly so that delay in their movement will result in removing
the spurious or counterfeit drugs and they will go unpunished. It is very important
to provide vehicles for the movement of the officers. In this regard it is suggested
to consider giving standing permission to hire vehicles in case of need by the
drugs inspectorate staff.
The capacity of Drugs Testing Laboratory in terms of number of samples
that can be analysed in a year is around 1800 When compared to the turn over
of drugs in the state, this capacity is not adequate and the capacity has to be
increased to analyse at least 5000 samples in a year. The Drugs Testing
Laboratory is totally inadequate in terms of the infrastructure facilities like
equipments and consumables (glasswares, chemicals and reference standards).
The Drugs Testing Laboratory also lacks in qualified technical staff to analyse
the samples, as new drugs are introduced. With the introduction of new dosage
forms and on the signing of the W.T.O. importing drugs will be the order of the
day, to keep pace with these challenges, highly qualified technical staff has to be
attracted with higher pay scales to meet the challenges of counterfeiting in the
drugs. A time bound programme has to be implemented for removing obsolete,
unserviceable equipments in the Drugs Testing Laboratory. It is also pertinent to
note that ail the electronic equipments and other smaller equipments required for
day to day work are maintained by annual maintenance contracts. As otherwise
very precious manpower will be lost in the case of brake down of equipments.
For this purpose, the facilities at the laboratory in terms of infra structure
and technical staff has to be augmented
The budget allocation towards sampling and traveling allowances and
office expenses is inadequate and needs to be augmented.
Statistics pertaining to enforcement wing and Drugs Testing Laboratory is
furnished in the Annexure.
GOVERNMENT COLLEGE OF PHARMACY
The only Government College which is imparting Pharmacy Education in
the State is under the administrative control of Drugs Control Department. The
Government College of Pharmacy was established in 1963 and the facilities are
totally inadequate and the college is facing de-recognition from the various
bodies. Pharmacy Council of India/AICTE has been insisting implementation of
pay scales for the teaching staff. Due to the delay in implementation of the
AICTE pay scales Pharmacy Council of India has asked to stop the admission of
students for the D.Pharma course for the academic course.
Government College of Pharmacy is receiving 100% central assistance
for conducting the post-graduate course from AICTE. The college is required to
obtain acredition certificate from AICTE for the year 1999-2000. Due to the
improper infrastructure facilities in terms of building, equipments and teaching
staff, it is likely that the AICTE may not give acredition certificate to Government
College of Pharmacy. The vacant posts of teaching staff could not be filled, as
the C & R rules has not been finalized since 1992. In the event of failure to get
the acredition certificate from AICTE the assistance for post-graduate education
from AICTE will get automatically cancelled.
It is requested that atmost
5
importance should be given for augmenting the facilities of Government College
of Pharmacy on war footing.
The construction of the fourth floor of Government college of Pharmacy is
not under progress.
For want of proper budgetary allocation the work is
delayed. An additional allocation of Rs.75.0Q lakhs is required for completion of
the building with necessary infrastructure facilities for the year 2000-2001.
Brief note on the National Human Rights Commission recommendation
National Human Rights Commission in its order dated 31st March 1999
has recommended that the steps to be taken for the effective implementation of
quality assurance programme.
It is requested that unless the necessary
infrastructure facilities are made available to the department it may be very
difficult to fulfill the recommendations of NHRC (as per annexure).
Data Task Force
6
BRIEF NOTE ON THE PERFORMANCE OF THE ENFORCEMENT WING
Particulars
Number of manufacturers in the State
(a) Allopathic Drugs(including Blood Banks)
(b) Cosmetics
Total number of sales premises in the State
NUMBER OF INSPECTIONS CARRIED OUT
Sales premises
Manufacturing premises
Hospital Stores attached to Govt.Hospital
Cancellation
Suspensions
Prosecutions launched under both Drugs and
Cosmetics Act and Drugs (Prices Control)
Order.
Convictions
1996-97
1997-98
1998-99
567
69
11622
570
70
11611
657
75
12747
11709
348
102
777
138
12226
390
104
736
150
14053
290
57
406
67
26
20
39
06
04
01
1997-98
1603
1414
171
37
134
1998-99
DETAILS OF SAMPLES ANALYSED
SI.No.
1.
2.
. 3.
Particulars
Samples Analysed
Samples found to be standard quality
Samples found to be not of std.quality
1. Karnataka State
2. Other States
1996-97
1764
1538
209
28
181
1800
1529
175
14
161
NATIONAL HUMAN RIGHTS COMMISSION
SARDAR PATEL BHAVAN
NEW DELHI
Case NO.778/96-97/NHRC
Name of the Complainant:
Indus Hospital Shimla
Referred by the Himachal
Pradesh State Human Rights
Commission, Shimla
Case NO.158/6/96-97/NHRC
Name of the Complainant :
Suo Motu cognizance of the Press
Clipping in the 'Indian Express'
dated 9.9.1997
CORAM:
JUSTICE SRI M.N VENKATACHALIAH, CHAIRPERSON
JUSTICE SRI V.S. MALIMATH, MEMBER
SRI VIRENDRA DAYAL, MEMBER
101
8.0
BROAD FINDINGS AND RECOMMENDATIONS
8.1
General
(1)
Fungal contamination in FV fluids is a serious health risk. Glucose/nutrients
in the fluid provide an excellent medium for microbial growth. Fungal
contamination can occur through contaminated ingredients during
manufacture, or cracks/leakage of faulty containers during transportation
and/or storage. Gross fungal contamination can be detected by visual
observation as suspended, white to blackish, cotton-like matter. A
Cautionary' labelling regulation provides for the hospital staff to visually
inspect and examine the FV fluids before administration to patients. It goes
to the credit of the hospital staff at the Indus Hospital in Sliimla and the
Ram Manohar Lohia (RML) Hospital in Delhi to have spotted the fungal
contamination before administering the defective FV fluids to patients.
. (2)
The purpose of the present investigation has been to examine: (a) critical
steps during manufacture, transportation or storage of LVPs upto the stage
of administration to patients vulnerable to fungal contamination; (b) to
identify the possible cause(s) or failures which lead to the observed
contamination; (c) suggest checks/counter-checks/measures to minimize.
if not to completely eliminate, occurrence of such lapses, and (d) in case it
still happens and complaint is received, suggest reporting system which
must be in place to minimize consequences and to prevent recurrence of
such happenings.
(3)
Unfortunately there is no reliable mechanism for obtaining a feed back on
the magnitude of the fungus problem in TV fluids in India. Though fungal
contamination in FV fluids is a serious health risk, neither the manufacturer.
or the regulatory authorities or hospitals have adequate record-keeping
which could indicate the extent of the problems. Rather a certain percentage
of defectives due to fungal contaminated bottles is taken as an acceptable
norm. This mindset needs a change. We must aim for zero-defective batches.
Fungus infested LVP is not common any were in the developed countries.
As per the Gold Sheets, in the USA no recall of LVPs took place after
early 70s. Similarly. Australia has not recorded such recall after the earlv
90s.
Core Healthcare Limited
8.2
(1)
Core Healthcares manufacturing operations are located at two separate
spacious sites, Sachana and Rajpur near A^medabad.
(2)
Core Healthcare manufactures FV products by the world-class Rommelag
technique of Blow-Fill-Seal technolog}'. As per the Company, manufacturing
processes are validated for aseptic filtration prior to filling, sterilization of
the Blow-Fill-Sealed containers and leak testing of filled containers
102
However, fungal contamination as reported has occurred very likely during
storage, transportation, due to defective containers and/or damage incurred"
The manufacturer does not have a proper system of monitoring the qualin
of the product particularly from the angle of contamination after the product
leaves the manufacturing plant. The Batch Production Records of the
manufacturer invariably show no evidence of damaged stocks. Further, the
informal free replacement of defective stocks by the Company’s field staff
has under-played the problem as no records of such transactions are made
available. In fact, in the absence of data on defectives, it seems that the
extent of this problem is under-reported.
A.
(a) Sachana and Rajpur plants have different levels of practices: while
Sachana plant is state-of-the art. Rajpur plant is older and has inherent
drawbacks of design
(b) Containers with weak neck could have cracked during transportation
and storage creating leakage
(c) Weak secondary' packing of corrugated shippers could have further
aggravated the problem especially when stacking was higher than
desirable height which could have damaged the containers due to hea\y
weight
(d) Manufacturer’s warehousing facilities in Delhi, are shoddy and not
rodent-free; rodent can damage shippers which can damage containers
B
(e) The batch records contain .information related to manufacturing. Bui
the records on market complaints, distribution, quarantined or recalled
batches al company's warehouses is not easily accessible
(g) Lack of system in attending to complaints from hospitals and lack of
ownership for removal of rejected goods from the hospital stores
(h) Important processes like sterile aseptic filling with broth fill and
container suitability are not validated regularly
(4)
There is an immediate need for the manufacturers to take up improvement
of system involved in the management of quality' of LVPs as a major project
and bring about improvement results in the shortest possible time-frame so
as to make LVPs a defect-free product. Blow-Fill-Seal equipment is a
purpose-built machine that contains an extrusion, moulding, filling and
sealing station to produce product under aseptic conditions. As with any
machinery, function is directly' related to training and the validation exercises
required to establish the operating limits of this machinery. In reviewing
this issue there are several areas of manufacturing and validation that should
103
be examined: extrusion process, cycle time, MOPE plastic granules, and
sterilization.
The manufacturer must aim at getting a defect-free product during the
entire supply chain management including manufacture, transportation and
storage on the lines of the Six Sigma programme adopted by the electronics
industry'. Six Sigma is a standard of quality which has only 3.4 defects per
million opportunities for error. The quality improvement within
manufacturing of LVPs can be achieved by using tools and technology' for
high speed repetitive process of Blow-Fill-Seal technology'.
The manufacturer must benchmark to international standards to raise
standards of quality'. It is not just the manufacturing process which is
important. It involves the whole culture and attitude towards every function
in the supply chain. Benchmarking involves finding the best-in-class for
any world-standard. To institutionalize this culture, an extensive training
programme must become the central focus.
Present
mindset of LVP
manufacturers is to measure
defect in terms of
percentage
LVP manufacturers need to
move towards perfection
defects per million
defects per million
1%
=10.000
6 Siama
= 3.4
2%
= 20.000
5 Sigma
= 233
3%
= 30.000
4 Sigma
= 6200
4%
= 40.000
3 Siama
*-
= 66.803
1
5%
= 50.000
2 Sigma
= 308,733
j
6%
= 60.000
1 Siama
= 697.700
-*•
1
j
1
Industry must change mindset of measuring defects from percentages to Sigma levels.
It is well recognised that the fungal contamination in plastic containers
develops due to microleaks. Therefore, select critical materials/processes
which affect the integrity' of the container during manufacture, transportation
and storage and require special attention are:
(a)
Material of construction, weight, size, shape of container
(b)
Sterilization cycle
(c)
Leak test in during production and also during storage
Position: 1766 (3 views)