Hospital Facilities

Submitted to Submited by

Anuprita Pawar. Suraj Negi

Vivekananda Global

University, Jaipur

S.No. Content

1 Introduction

General
cleanliness
2 requirements

3 Human resourses

4 Condition of
public health care

5 Role Government

6 Facilities in
Hospital

7 Documentation

8 Medical
codification

9 Increases cases of
wrong diagnosis

10 Fundamental
 Right of Health

11 Conclusion
Introduction

Health systems and policies play an important role in determining how health care is delivered,
used, and affects health outcomes. Because 'health care' is a public matter, the ultimate authority
for the implementation of initiatives for caring for newborns remains with the state, even though
the central government has issued guidelines.1

The public healthcare system in India evolved due to a number of influences since 1947,
including British influence from the colonial period. The need for an efficient and effective
public health system in India is large. Public health system across nations is a conglomeration of
all organized activities that prevent disease, prolong life and promote health and efficiency of its
people. Indian healthcare system has been historically dominated by provisioning of medical
care and neglected public health. 11.9% of all maternal deaths and 18% of all infant mortality in
the world occurs in India, ranking it the highest in the world. 36.6 out of 1000 children are dead
by the time they reach the age of 5. 62% of children are immunized. Communicable disease is
the cause of death for 53% of all deaths in India.

“Data on the prevalence of vacancies in the Indian healthcare system is generally sparse.
Government statistics for 2008, based on sanctioned vacancies, show that 18% of medical
centers did not initially have a doctor, about 38% did not have a test technician, and 16% did not.
pharmacist,” an article titled 'anticipating future needs and gaps in requirements for public health
1 Health systems in India - PMC (nih.gov)
professionals in India through 2026' was published in the journal of Public well - being. WHO
Southeast Asia Community. The medical workforce in India consists of about 8 categories,
namely: doctor (allergy medicine, alternative medicine); nursing and midwifery specialists;
public health professionals (medical, non-medical); pharmacist; dentist; paramedics (medical
professionals); core workers (frontline workers); and support staff.

Public health initiatives that affect people in all states, such as the National Health Mission,
Ayushman Bharat, National Mental Health Program, are instilled by the Union Ministry of
Health and Family Welfare. There are multiple systems set up in rural and urban areas of India
including Primary Health Centers, Community Health Centers, Sub Centers, and Government
Hospitals. These programs must follow the standards set by Indian Public Health Standards
documents that are revised when needed.

Modern hospitals, an institution that is established, staffed and equipped for the diagnosis
of diseases; medical and surgical treatment of the sick and wounded; And in this process for
their dwelling. Modern hospitals often serve as centers of research and education. People of
developed countries are taking the benefits of this services but it’s not in the case of most of the
developing countries. 2

Currently, the situation in hospitals of most of the developing countries are very poor. The
populations of developing countries are very large and there is a shortage
of hospitals, equipment and trained staff to treat patients in need. Therefore, the inhabitants of
developing countries suffer from poor hospitals, lack of equipment and untrained personnel.
Lack of facilities in hospitals is even worse than insufficient access to healthcare. Only access to
health care is not enough, we need a good health care system to make our health system more
effective. Millions of people are dying every year by a treatable disease to just because of this
poor health care than insufficient access of healthcare. Around 122 Indian out of 100,000 die due
to poor health care. Around 2 million people die just because of poor facilities, this number is of
India only, All over the it’s even more than this. India death rate due to poor health care is even
worse than many under-developing countries.3

Good hygiene play a very important role in hospitals for preventing patients from infection by
bacteria and virus and also ensure that it does catch visitors and go out in general community.
Hygiene is very important in health care center, not only on the wards and operating rooms
themselves, but also in all public places including waiting rooms, public restrooms, canteen, and
floor.

2 hospital | Definition, History, Types, Services, & Facts | Britannica

3 More Indians die of treatable diseases than lack of access to healthcare | Business Standard News
(business-standard.com)
“Providing health services without guaranteeing a minimum level of quality is ineffective,
wasteful and unethical,”

By: Muhammad Pate

General cleanliness requirements

For maintaining good hygiene in hospitals, following step should be taken:

 Keep the hospital roof, wall, floor and equipment neat clean for prevention form
infection

 Hand hygiene is mandatory, hand should be clean before doing any medical
process.

 There should be no leakage from the roofs and walls of the hospital

 There should be no bad smell in health care center

 When wet cleaning is used, hospitals must take appropriate safety measures, such
as the use of signs (wet floors).

 There should be availability of appropriate cleaning and disinfection materials and

equipment needed for different areas.

 The hospital should use standard methods for cleaning in different areas of
hospitals
  The hospital ensures that monitoring of cleanliness activities should be done at
predefined intervals and corrective actions are taken when needed

 The drainage and sewage should be well maintained to avoid any leakage,
blockage and easy flow through the drain.

Human Resources45

Number of sanitary staff :

An inhouse Housekeeping in charge should be appointed with a direct reporting to the Facility in
charge or the Nursing In charge. In case of the sanitary staff’s number is more than 30, an extra
sanitary supervisor (01) can be appointed for every extra 15 sanitary workers. The housekeeping
responsibility should be delegated through the inhouse supervisor to the contractor’s supervisor
to maintain single line of control thus making sure of better supervision and accountability.
However it must be point up that the responsibility of keeping an area / department clean lies
with the in charge of that area / department. He / she should correlate with the housekeeping
supervisor for assign the staff for their respective departments. Common areas must be under the
direct supervision of a cleaning supervisor.

Responsibility and accountability:

An inhouse Housekeeping in charge should be appointed with a direct reporting to the Facility in
charge or the Nursing in charge. In case of the sanitary staff’s number is more than 30, an
additional sanitary supervisor (01) can be scheduled for every extra 15 sanitary workers. The
housekeeping control should be assigned through the inhouse supervisor to the contractor’s
supervisor to maintain single line of authorities thus making sure better supervision and
responsibility. However it must be emphasized that the responsibility of keeping an area /
department clean lies with the in charge of that area / department. He / she should coordinate
with the housekeeping supervisor for deputing the staff for their respective departments.
Common areas are to be directly supervised by a housekeeping supervisor.

Skills and Competencies:

4 The Role of Human Resources in Healthcare | Eddy

5 HUMAN RESOURCE MANAGEMENT IN HOSPITALS | AIHMS Blog
Safai staff/employees residing in medical facilities must be aware of the importance of
cleanliness inside and around hospitals and the requirements of those facilities. They should also
be aware of their vulnerability to hospital-acquired infections (OHI) and occupational hazards
and should receive appropriate training in prevention and punch in.

Rational Deployment :

Proper deployment of cleaners during a shift must be planned in advance and executed correctly
so that cleanliness is maintained at all times. Areas with no or very little patient-to-guest
interaction such as offices and shops can be cleaned once a day and can be grouped with such
areas, while important areas should be cleaned more often.

Condition of public heath care

today problems of India's health system include poor quality of service, corruption,
dissatisfaction with the system, lack of accountability, unethical care, overcrowded clinics, poor
cooperation between public and private sectors, barriers to access to services and medicines, lack
of public health etc. Knowledge and low-cost factors. These shortcomings lead wealthy Indians
to use a private health care system, a system that is difficult for low-income families to access,
resulting in unequal access to health care between classes.

Public health practices in India have been dynamic and have faced many obstacles in their
attempts to affect the lives of people in this country. Since independence, major public health
problems such as malaria, tuberculosis, leprosy, high maternal and child mortality and, more
recently, human immunodeficiency virus (HIV) have been addressed through joint government
action. Social advances, combined with scientific advances and health care, have reduced
mortality and birth rates.

Poor quality care

There are lack of basic medical facilities (such as ambulance, stretcher and wheel chair) and
sanitation. Sanitation worker does not change bed sheet, patients have to sleep on
dirty sheet. They clean rooms once in 3-4 days but they charge patients for cleaning
their room. Due to a shortage of doctor, people have to wait hours in line for a doctor. People
have to sit on chair or on the floor due to a shortage of beds or broken beds.
Corruption

India health care is one of the most corrupt system in the world. According to the survey, India
health care system rank under top 30 corrupted health care system. This corruption effect
the quality, equity, efficiency, and efficacy of health services and is an obstacle to the long-
term goal of achieving universal health coverage 6. Paying staff for entrance in medical
college for studies is the most common corrupt practice in the healthcare sector. Such
payments are expensive in southern India.

Across domains, the main actors driving corruption in this sector are believed to be doctors
(77%) and hospital staff (67%). Also, the fact that money is being demanded directly and
openly by the corrupt is a clear indication that the corrupt persons are confident that no
worthwhile action will be taken against them7.

Wrong treatment/Misdiagnosis

Around 93% people are suffering from some kind of disease and out this most of the people die
every year just because of wrong diagnosis or misdiagnosis. According to the study by BMJ
Quality & Safety, the rate of wrong diagnosis in the hospital is 5% i.e., 1 out of 20 people. This
missed diagnosis is due to unskilled or unproper treatment by nurse, physician, surgeon,
pharmacist, or any other medical practitioner and also because of lack of medical instrument
hospital

It is even true that doctors are mostly drunk and sometimes even stoned while performing
operations in some cases though it's rare but yes it does happen at times so is it anywhere legal
and rightful for patients who visit them with hopes for their well treatment may it be any hospital
that is government or private. There are also some public doctors who spend most of their time in
their own clinic or doing work in some other private hospital. They are not present in hospital for
patient.

Lack of infrastructure

6 Health care is among the most corrupt services in India - PMC (nih.gov)
7 Health care is among the most corrupt services in India - PMC (nih.gov)
India has long suffered from a lack of infrastructure, including a shortage of well-
equipped medical schools. To solve this problem, Indian government bring an official order in
which private medical should be built on at least 5 arcs land in rural areas. Its is difficult to find
professional trained doctor and medical stuff in there that why but only few private collages
build there. Further they proposed to maintain the number of bed available in proportion to the
sheet present in college. In addition, the new regulations also define requirements for lecture
halls, libraries, laboratories, minimum number of beds for affiliated faculty, location of faculty
offices, and student accommodation.8

Lack of trained staff

One of India's most pressing problems is the severe shortage of qualified medical personnel,
including doctors, nurses, paramedics and primary care workers. The situation in rural areas,
where nearly 66% of India's population lives, remains worrisome. The doctor-to-patient ratio is
very low at 0.7 doctors per 1,000 population. For comparison, according to the World Health
Organization (WHO), there are on average 2.5 doctors per 1,000 people. Improving this situation
is still a long process. This problem can be addressed in the long run by increasing the capacity
of existing institutions and creating new ones.9

Unbearable Patient Burden

Serving 1.4 billion people, nearly 20% of the world's population, is a staggering feat in itself.
Sustainable management of health care and human resources to meet the needs of the next
generation must be a top priority in the hearts of today's people. To ensure the proper flow of
patients, healthcare facilities should utilize technology to optimize their operations and clinical
operations to the extent possible. In addition, it can greatly reduce the burden on patients because
it is difficult to facilitate virtual care protocols and telemedicine services beyond the obvious.

Role of Government1011

Health in India remains one of the most important sectors in terms of employment and income
generation. It has recorded a compound annual growth rate of 16.5% and is expected to reach a
value of $280 billion by 2020. However, the healthcare system in India has some problems.

8 5 reasons why India’s healthcare system is struggling - The Hindu BusinessLine

9 5 reasons why India’s healthcare system is struggling - The Hindu BusinessLine
10 Role of government in public health: Current scenario in India and future scope - PMC (nih.gov)
11
subject and is not affordable for everyone. The reality is that healthcare in India pushes families
into deep debt even after illness, especially crushing low-income groups.

Public health is one of the biggest investments governments can make. Relatively inexpensive
early prevention can prevent serious and costly health problems later on. Public health
contributes to the well-being of the entire population, helps keep the population safe from the
spread of infectious diseases and environmental risks, and helps ensure access to safe and quality
health care for the benefit of the community.

Governmental responsibilities for public health extend beyond voluntary activities and services
to include additional authorities such as quarantine, mandatory immunization laws, and
regulatory authorities. The state's partnership functions by encouraging residents to do things that
benefit their health (e.g., physical activity) or create conditions to promote good health, and
requiring certain actions (e.g., food, well-being). In India, around 60 percent of people go to
private health care sector instead of public health care. This private hospital charge more money
but people are still going there, it’s because of good health care in there in compare to public
health care. There is nothing that government is not doing anything, they taken various step for
improving quality of health care in public hospital such as

 The National Health Mission: The National Health Mission (NHM) consists of two of its
submissions, the National Rural Health Mission (NRHM) and the National Urban Health
Mission (NUHM). Key components of the program include strengthening rural and urban
health systems, reproductive, maternal, newborn, child and adolescent health
(RMNCH+A), and communicable diseases infectious and non-infectious.

 Jan Aushadhi: Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana Kendra was established
to provide generic drugs, available at lower prices but with comparable quality and
effectiveness to expensive brand name drugs. This will help reduce personal expenses.

 National Health Commission Bill: Replacing India's Health Commission with National
Health Commission as the primary regulator of medical education. AYUSH students are
licensed to practice allergy after completing a bridging course.

 Support to States: Support is provided to States under the NRHM, to strengthen health
systems, including the creation and rehabilitation of health infrastructure, the
participation of nurses, doctors and specialists on a contract basis.

 Financial Assistance: Financial assistance is provided to Countries/UTs to select and train

Accredited Social Health Activists (ASHAs) who act as a link between the community
and the community. communities and medical facilities.

 implementing National Quality Assurance (for improving quality of health care),

  ‘kayakalp’ award scheme (for maintaining hygiene),

 Pradhan Mantri Jan Arogya Yojana (to provide health cover to poor people)

 providing free drugs to poor people,

 providing free dialysis to poor people,

 building more AIIMS intuitions

Public Health Foundation on India12

The Public Health Foundation of India (PHFI) is a non-profit public-private initiative working
for a healthier India. A national consultation, convened by the United Ministry of Health and
Family Welfare in September 2004, recommended a platform that could rapidly promote
education, training, research and advocacy. community wellbeing. The Government of India
authorized the establishment of PHFI in 2006 to meet the limited public health institutional
capacity and established foundation to strengthen training, research and policy through inter-
educational education. sector and health system related and related research on policy agenda,
evidence for policy making based on promoting equity, affordable health technology,
empowering people, promoting health and advocating for priority health goals in public health.

Ayushman Bharat Health and Wellness Centers13

Under Ayushman Bharat Health and Wellness Centers (ABHWC) initiative, launched by
Government of India in the year 2018, 1.5 lakh Subhealth Centers (SHCs) / Primary Health
Centers, both in rural/urban areas, are being upgraded into HWCs for the betterment of local
public health care. Accordingly, more than 77,406 HWCs start working (73,391 in rural areas &
4,015 in urban areas) and are bringing comprehensive primary health care closer to the homes of
the people. Details of packages provided under ABHWCs in rural/urban HWCs is at Annexure.
Also, the Fifteenth Finance Commission has allowed grants aggregating to Rs.70,051 Crores,
over the time of five years (20212026) through local governments, for building up healthcare
system at the primary health care level.

Packages are offered under the ABHWC in rural/urban HWCs.

12 About - Public Health Foundation of India (phfi.org)
13 Official Website Ayushman Bharat | HWC (nhp.gov.in)
  Care during pregnancy and childbirth.

 Neonatal and neonatal health care services.

 Child and adolescent health care services.

 Family planning, contraceptive services and other reproductive health services.

 Management of infectious diseases: national health programs.

 General outpatient care for simple acute illnesses and minor illnesses.

 Screening, prevention, control and management of noncommunicable and chronic

communicable diseases such as tuberculosis and leprosy.

 Basic oral care. Basic screening and management of mental illnesses.

 Care for common ophthalmological and ENT problems.

 Elderly and palliative health care services.

 Emergency medical services, including burns and trauma.

Facilities in Hospital

The health care system consists of primary, secondary and tertiary levels. At the primary level,
there are the Support Center and the Primary Medical Center (PMC). At the middle level is a
Community Health Center (CHC) and a small community hospital. Finally, the highest level of
public assistance provided by the state is at the tertiary level, which consists of medical schools
and regional/general hospitals. Although the number of PHCs, CMPs, sub-centers and regional
hospitals has increased over the past six years, not all hospitals meet the criteria set by Indian
public health standards.

Sub - Center14

The sub-centers are designed to serve extremely rural areas and are fully borne by the national
government. The mandate requires that medical staff consist of at least two workers (male and
female) to treat a population of 5,000 (or 3,000 in remote or hilly areas). The sub-center is also
working to educate villagers on healthy habits for long-term impact.

Primary Care Center15

Primary care centers are located in more developed rural areas with a population of more than
30,000 (20,000 in remote areas) and serve as large clinics with resident doctors and paramedics.
In more complex cases, patients can be sent to PHC from a regional subcenter. The main
difference from sub-centers is that the state funds the PHC rather than the central government.
The PHC is also working to improve health education with a greater focus on preventive
measures.

Community Health Center16

Community health centers are also state-funded and receive referrals from primary health care
centers. It serves 120,000 people in urban areas and 80,000 people in remote areas. Patients at
these institutions may be transferred to general hospitals for further treatment. A CHC is
therefore also a primary care institution or FRU that must have facilities for obstetric care,
neonatal/parental care, and blood storage at any time of the day of the week.

District Health Center17

Regional hospitals are the final referral centers for primary and secondary levels of the public
health system. It is expected that there will be at least one hospital in every region of India, but in

14 Sub-centre level healthcare in India « PG Blazer

15 Primary Health Centre (India) - Wikipedia
16 Community health centres - Better Health Channel
17 District Mental Health Program - Need to look into strategies in the era of Mental Health Care Act, 2017 and
moving beyond Bellary Model - PMC (nih.gov)
2010 only 605 out of 640 regions were reported. Typically there are 75 to 500 beds depending
on the needs of the population. These local hospitals often lack modern equipment and local
blood bank connections.

Medical Colleges

All of India's medical science institutes are owned and controlled by the central government.
These are reference hospitals with specialized facilities. All Indian institutes currently active are
AIMS New Delhi, Bhopal, [14] AIIMS Bhubaneshwar, AIIMS Jodhpur, AIIMS Raipur, AIIMS
Patna and AIIMS Rishikesh. A regional cancer center is a cancer care hospital and research
institute jointly controlled by the central government and the respective state governments.
Government medical colleges are owned and controlled by their respective state governments
and also function as referral hospitals.

Documentation18

It is very important for the attending physician to properly document patient care under their
supervision. Maintaining medical records has become an independent science. Only in this way
can the doctor prove that the treatment was carried out correctly. It will also be of great help in
scientific evaluation and consideration of patient care issues. Medical records are an important
part of patient care. It is important for physicians and healthcare organizations to maintain
adequate patient records for two important reasons. First, it aids in the scientific evaluation of
patient profiles, analysis of treatment outcomes, and planning of treatment protocols. It also
helps plan government strategies for the future of health care. But what is important in the
current environment is the issue of allegations of medical malpractice. The legal system relies
primarily on documentary evidence in situations where the patient or his or her relatives allege
malpractice. When charged with negligence, this is often the most important piece of evidence
for a doctor's verdict or innocence. As the use of health insurance for treatment increases,
insurance companies are also requiring adequate record keeping to prove patients' medical
expenses needs.

Poor record keeping can lead to denial of medical claims. The good news is that despite knowing
the importance of good record keeping, it is still a stub in India. It is wise to remember that "Bad
record means bad defense, no record means no defense". Medical records include extensive
documentation of patient history, clinical findings, diagnostic test results, preoperative care,
activity notes, postoperative care, daily progress, and records a patient's medication. Obtaining
appropriate consent goes a long way in demonstrating that the procedures were performed with
the patient's consent. A properly written surgical note can protect the surgeon in the event of
18 Getting Started With Medical Coding In INDIA – Annova Solutions
alleged negligence due to surgical complications. It is important that the prescription be legible
with the patient's name, date, and physician's signature. An overdue prescription can get a doctor
in trouble if a patient uses it wrong. There are also many documents that are indirectly related to
patient management, such as accounting records, human service records, and administrative
records, which are also useful as evidence for litigation purposes. Medical registration requires
the concerted effort of several people involved in the patient's care.

The primary care physician is responsible for overseeing this process and is primarily
responsible for the medical history, physical examination, treatment plan, surgical records,
consent forms, medications used, referrals, medical statements. hospital and medical certificate.
Appropriate documentation of nursing care, laboratory data, diagnostic evaluation reports,
pharmacy records, and billing procedures is required. This means that medical staff and nurses
must also be trained in how to properly keep patient records. The medical scene in India ranges
from small clinics to large hospitals. Medical record keeping is a specialized area in large
corporate and teaching hospitals with separate medical records officers handling these matters.
However, it has yet to develop into a proper procedure in the large number of small clinics and
hospitals serving a large portion of the population in India.

Some common error in documentation:

Misplaced documents:

Misplaced patient data is another major problem in medical records. An example is a procedural
note ending with a progress notes section. Physicians not satisfied with the customization of
electronic health records may start using their own templates, which may result in documents
being placed in the wrong place in the medical record. Inappropriate information can be
frustrating and you waste a lot of time looking for it. Sometimes institutions may use hybrid
record models that include both paper and electronic records. This can result in doctors and
nurses working with incomplete information as many records such as examination reports, x-ray
reports, etc. may be missed when the patient is sitting in front of the doctor.

Incomplete/Missing Documentation:

This is also a common problem with medical records. Many providers may use misleading terms
such as "not otherwise specified" or "not specified", and some important information may be
missing from medical records. Lack of health information not only harms patients, but can also
negatively affect physician reimbursement. If your documents are incomplete or vague, you may
receive calls from Medicare auditors and insurance companies looking for documents that
support your need for health care.
Copy-and-paste issue:

Electronic health records allow users to reuse all or part of a descriptive portion of a medical
record. This can later be viewed by other providers with access to the records. Misuse of copy
paste is a serious problem. This can harm the patient. This makes it difficult to understand
disease progression or resolution. As a result, he can flag the auditor looking for fraud. Bad
copying practices can add more pages to a patient's medical record and slow down various
processes, including viewing medical records.

Medical codification19

 Medical coding is a professional's job and is part of the financial and administrative
functions of the healthcare industry. Medical coding and medical billing are two
important aspects of the healthcare industry, but are different terms. Here's the gist of
why coding is so important:

 All patients' medical history, treatment, medications, and diagnoses must be documented
and documented. Medical Coding ensures that doctors are properly and fully paid.

 Medical Coding data aids in the development and planning of projects and initiatives
related to the healthcare industry.

 Medical Coding is also an important factor in claiming insurance benefits and

maintaining a medical history.

 Insurance companies use medical coding data and pay accordingly.

 medical coded data is also used in the medical claim resolution process. This is the
process insurers use to decide whether a claim will be reimbursed, denied, or reduced.

 Medical coding is a complex task, so quality and accuracy are paramount throughout the
healthcare industry.

19 What is Medical Coding? - AAPC

Presently the medical coders in India are mainly receiving jobs from the USA and this has been
possible because India offers cheap labor and high standard medical Coding and Billing
Solutions. Secondly, India is also the hub for data Processing and data solution services.
However, in near future, it is possible that there will be outsourcing from UK, Australia, Canada,
and other western countries too. In the USA alone, less than half of the employers in the
healthcare Industry have well trained and certified staff to work as medical coders and this is the
biggest reasons why the US employers outsource the medical coding business to India. Globally,
the offshore healthcare services industry is growing at a breakneck rate every year. It is also the
fastest-growing outsourced business process in India and therefore trained and certified coders
are in demand these days. The recent advancement of computer assisted coding (CAC) has eased
the job of medical coders’ globally. This tool has been designed to improve productivity and
increase the accuracy of the highly critical coding process. Coding is the first step in the revenue
cycle management process, while automated coding is a step towards faster processing of the
claims, which will save costs and ease the coding operations.

The healthcare industry only accounts for a small portion of the total market, but the growth
potential of medical coding in India is very high due to the rising demand. You also want the
quality offered by Indian medical coders. There are many healthcare companies and
multinational corporations operating in India and globally and providing specialized healthcare
services such as medical coding. They hire trained and certified programmers from other
medical, pharmaceutical, and life science backgrounds for medical coding. The medical coding
industry is known for providing excellent remuneration as companies offer good product
packages and career growth in the industry.

Increases cases of wrong diagnosis20

Despite employing 5 million workers, India's health care sector continues to have a low density
of health care workers and the number of countries is lower than that of Sri Lanka, China,
Thailand, the United Kingdom and Brazil, according to the World Health Organization (WHO)
database. This labor force statistic puts the country into the category of "severe shortage of
health care providers." Delhi, Kerala, Punjab and Gujarat compare favorably while Bihar,
Jharkhand, Uttar Pradesh and Rajasthan have been hit hardest.

“Southeast Asia needs to increase the number of healthcare workers by 50% to achieve universal
health coverage by 2030. India, like many other low- and middle-income countries, faces a

20 Smt Kamalabai Vishnu Khodse & Anr. vs Dr. Yeshwant B. Khaosle & Anr. on 17 January, 2020 (indiankanoon.org)
severe shortage and unequal distribution of skilled healthcare workers,” said K. Srinath Reddy.
President of the Public Health Foundation of India.21

The medical profession is considered a noble profession because it helps to save lives. We
believe that life is God-given. Thus, the physician understands God's plan when he is ready to
carry out God's commands. Usually, a patient goes to a doctor/hospital based on his reputation.
Patient expectations are twofold. Doctors and hospitals must provide treatment with all
knowledge and skills, and secondly, do not cause any harm to patients through negligence,
negligence or recklessness. attitude. their staff. Physicians cannot always save a patient’s life, but
they should use their special knowledge and skills most appropriately, keeping in mind the
interests of the patient who entrusted them with their lives.

Therefore, it is expected that the physician will perform the necessary tests or ask the patient to
report. In addition, unless it is an emergency, informed consent is obtained from the patient
before proceeding with any major treatment, surgery, or invasive study. The failure of doctors
and hospitals to fulfill this duty is inherently tortious liability. A tort is a tort (property)
compared to a contractual obligation (personal rights). This is a violation that entails judicial
intervention in the form of damages. Therefore, the right of patients to receive care from doctors
and hospitals is essentially a civil right. The relationship takes the form of a contract to some
extent due to prior consent, remuneration, operation/treatment, etc., while maintaining significant
elements of tort.

In case of Smt Kamalabai Vishnu Khodse & Anr. vs Dr. Yeshwant B. Khaosle & Anr. on 17
January, 2020

On 17 January 2020, a patient named Smt. Kamalabai Vishnu Khodse filed the allegation against
Dr. Yeshwant B. Khaosle of wrong diagnosis and wrong treatment. In this, doctor diagnosed that
50% of the patient's liver was damaged and was suffering from "liver Cirrhosis", but the doctor
did not examine the necessary test of oesophagus, stomach and small intestine at proper time. All
the treatment was given on the base of wrong diagnosis which led to patient death. In the end,
when found guilty, the doctor was punished to pay 2,00,000 rupees compensation as the account
of death of patient.

This is the just simple case of misdiagnosis there are also some cases when doctor left scissor or
any other equipment in body of patient while operating. Some doctors don’t throw their surgical
gloves after use but reuse their surgical glove and it is very harmful for patient health as it will
21 India facing critical shortage of healthcare providers: WHO - The Hindu
transmit communicable disease from one to other. Some private health center doctor just for the
shake of money recommend expensive treatment and medicine which a common man can’t
afford. Treatment in public hospital is cheap but doctor don’t come on time, people have to wait
hours in the line, there is a shortage of basis medical facility and un hygiene environment.

Fundamental Right of Health22

The Indian constitution does not explicitly guarantee the basic right to health. However, there are
many provisions in the Constitution on public health and the role of the state in health care for
the people.

The guiding principles of state policy in Part IV of the Constitution of India are the basis of the
right to health. Article 39(E) orders the State to ensure the health of workers, Article 42 orders
the State to provide fair and humane working conditions and maternity support, Article 47
imposes water's obligation to raise the nutritional level and standard of living of the people and
to improve public health. Furthermore, the Constitution not only obliges the state to improve
public health, but also allows Panchayats and centrally run cities to promote public health under
Article 243G (read with Appendix 11, section 23).

In the absence of an express recognition of the right to health or medical care under the
Constitution, the Supreme Court of India in Bandhua Mukti Morcha v. Union of India & Ors has
explained the right to health care under Article 21 which guarantees the right to life. In the State
of Punjab & Ors v Mohinder Singh Chawla, the High Court reaffirmed that the right to health
care is fundamental to the right to life and it should be noted that the government has a
constitutional obligation to provide such services. medical. In the State of Punjab & Ors v Ram
Lubhaya Bagga, the court further upheld the state's responsibility to maintain health services.

In September 2019, a high-level health group formed within the framework of the 15th finance
committee recommended that the right to health care be considered a fundamental right. He also
recommends moving the health discipline from the national list to the competition list. The
recommendation declares the right to health care as a fundamental right that, if exercised, will
enhance people's access. However, the latest recommendation to move healthcare to the
concurrent list will lead to a constitutional conundrum about whether centralizing public health is
helpful in the context of cooperative federalism. of India or not. Currently, the topic is “public
health and environmental sanitation; hospitals and clinics” are on the list of states on Roadmap 7
of the Indian Constitution – that is, state governments are entitled to constitutional guidelines for
the adoption, enactment and enforcement of medical regulations. public economy.

22 The fundamentality of Fundamental rights in India: Right to health in the pandemic (indiatimes.com)
A 2019 NITI Aayog report has shown that Indian states have unequal public health systems. This
imbalance is mainly due to limited technical expertise and budgetary constraints. While the
states' financial dependence on the hub continues to be a major challenge, moving the topic of
health to the list will also lead to excessive bureaucracy, stress, and financial stress. Institutions.
Although the political decisions of the states will continue to be subjective regarding the political
direction of the federal executive, this centralization will strip the states of constitutional rights.
Furthermore, a one-size-fits-all strategy will not provide the specialized attention that Indian
states need.

On a topic as important as health, there must be coordination between the center and the states
without hindering the cooperative federalism, an essential element of the Constitution of India.
The overall response to COVID19 demonstrates the need for strong capacity at the district and
local levels to contain the spread of the pandemic. Lessons learned from the response also show
that while good coordination between states and centers is required, health must continue to be
on the state's list. It is therefore imperative that states decentralize powers and funds to
strengthen their public health systems. For example, Uttar Pradesh and Bihar, although they
struggled at first, were able to bring the Japanese encephalitis outbreak under control in 2019.
Even during the ongoing pandemic, Maharashtra and Delhi invoked the Pandemic Act 1897
before the central government invoked the National Disaster Management Act 2005 on 23
March.

Through the Guiding Principles of State Policy, the Constitution strongly urges the State to
provide a good standard of living. Several legal precedents stipulate that the state is responsible
for the health care of its citizens. India's commitment to international legal treaties and
conventions also obliges it as a member state to improve and provide adequate public services
and minimum standards of care. health care for the entire population. Existing constitutional
guarantees, legal precedent and global commitments provide a strong foundation for the
fundamental right to health in India. The right to be guaranteed by law makes access to health
legally binding and ensures accountability. A constitutional amendment based on the 93rd
Amendment to the Constitution, where the constitution punishes the right to education, will be
passed to provide adequate healthcare in India.
Conclusion

The best thing about life in the 21st century is the rapid change in each field of society. In
particular, the medical sector in India has made significant progress. From advanced biomedical
tools to unimaginable robotic surgery, India's healthcare industry is at its historical peak. But
with rapid development comes the burden of the world's second largest population. A growing
global population is straining India's health care resources, and increasing life expectancy is
putting a heavy strain on India's health care system. India's healthcare sector is faced with an
enormous amount of infrastructure challenges, so there is an urgent need for healthcare
professionals to keep up to date with the latest knowledge and resources.

As the world's second most populous country and one of the fastest growing economies, India
faces unique challenges and unprecedented public health opportunities. Over the past decade,
India has experienced a significant reduction in poverty along with record economic growth.
According to the World Bank, the infant mortality rate in India fell from 66 to 38 per 1,000
between 2000 and 2015. Life expectancy at birth increased from 63 to 68, and the maternal
mortality rate fell from 374 to 174 per 100,000. birth in the same period.

India also has active pharmaceutical and biotechnology industries; world-class scientists,
including a burgeoning clinical test industry; and leading hospitals that attract foreign patients
and treat its better off citizens. Yet Indian government and public health officials agree that the
country also faces constant and intimidating public health challenges, particularly for the poor.
These include child undernutrition and low birth weights that often lead to too death or lifelong
health problems; high rates of neonatal and maternal dying; growth in noncommunicable
diseases such as obesity, diabetes, and tobacco use, leading to cancer and other diseases; and
high rates of road traffic accidents that result in injuries and deaths23

India's rapidly developing health care system continues to be a concern as the Government of
India strives to provide comprehensive health care for all. There is a difference in health care and
health care systems between the poorer and wealthier states and underfunded health systems that
are in many cases poorly managed and poorly adjusted. New government-funded health
insurance programs are expanding coverage, but coverage is still limited.

23 Pharma industry in India: Invest in Indian Pharma Sector (investindia.gov.in)

Public and private health care systems place tremendous demands on the nation's ability to
produce outstanding health care leaders and professionals. By preparing to meet these
challenges, the people of India have the opportunity to have a significant impact on the future of
public health and healthcare around the world, as well as the future of wellbeing.

For strengthen health care center government should2425

 Adoption of Public Health Standards of India: they not only define the package of
services that each facility must provide, but also prescribe the minimum inputs required
to ensure quality of care, in terms of infrastructure, equipment, qualified human resources
and materials. States are covered when funding the gap between the available levels of
these inputs and the levels needed to meet IPHS standards. These dramatic increases in
inputs have been driven by facilities surveys to identify gaps, then planning and funding
to fill those gaps.

 Quality standards have been defined for clinical processes, administrative and regulatory
processes, and support services. The Maternal and Newborn Care Activity Guidelines
issued by the Ministry of Health and Family Welfare comprehensively define these
quality standards for RCH care.

 The Standard Treatment and Skills Gap: The skill sets and standard treatment procedures
needed to deliver quality RCH services, and training modules that will deliver skill sets.
This has been planned. These involve the Skilled Birth Specialist (SBA) training module
for ANM, Navjat Shishu Suraksha Karyakram (NSSK) and the IMNCI for ANM, Home
Newborn Care (HBNC) module for ASHA and Care. emergency obstetric care (EmOC)
to your doctor. These training modules also introduce standard treatment procedures in
each of these areas.

 Hospital Management Company (RKS) and Untethered Fund: Mandatory establishment

of a Hospital Management Company (Rogi Kalyan Samiti) and empower this agency
with non-binding capital allowing public participation and also contribute to improving
the quality of care. Members of RKS have been trained and aware of the quality-of-care
issues. Prior to the start of the NRHM, many states created user fees, but non-binding
grants for all public health facilities were provided under the NRHM, reducing financial
barriers to access to health care services. This is evident in the increased use of indoor
and outdoor services in medical facilities.

24 Declaring the right to health a fundamental right | ORF (orfonline.org)

25 UPSC CSE Prelims Exam 2022 MCQs Set 7 - PDF Download (studyiq.com)
  Quality Improvement Programs: NRHM also supports initiatives to establish a quality
management system. These areas range from the establishment of quality assurance
committees that use checklists and periodic monitoring visits to assess quality gaps, to
more structured quality management systems. leads to third party audits and quality
certification using ISO 9001:2008 or NABH. To date, 82 facilities have been ISO
certified, nine have been certified by NABH, and 446 are in the process of being
certified.

Covid 1926

Health systems and policies are key to defining how health services are delivered, used, and
impact health outcomes. Healthcare in India is struggling, but there is a vast sea of hope and
improvement with the direction of health education in the country.

Aside from resolving the obvious infrastructural deficiencies, the training of professionals should
be given the topmost priority. The utilization of online healthcare workshops and courses
provided by trusted platforms allows for more advanced and specific training. The role of good
quality medical training is truly invaluable and investing in this sphere will be beneficial for us in
the long run.

India's health care system has also been thrown into chaos as the COVID-19 pandemic puts the
world's most advanced health care systems to the test. Health care in India was generally
adequate, but in April 2021 it was brought to its knees by a ferocious second wave of COVID-
19. The collapsed Indian health system infrastructure is severely vulnerable due to the lack of
oxygen and medicines needed to treat COVID-19 in India. Also, the lack of awareness about
health insurance makes it very difficult for the general public to get full hospital treatment for
COVID-19. But not all news was depressing.

The bright side in the whole situation was that private Indian healthcare companies took the
initiative and have been delivering the government with all of the resources it requires, including
testing, isolation beds for treatment, medical personnel, and equipment at government COVID19
hospitals, as well as home healthcare. Furthermore, the utter determination with which the
health care system in India implemented innovative treatment methods for COVID19 shows how
far the healthcare industry in India has progressed since its inception in the 1900s.

26 Impact on health and provision of healthcare services during the COVID-19 lockdown in India: a multicentre
cross-sectional study - PubMed (nih.gov)
Various medical personnel in the Indian healthcare sector, from nurses to doctors, have taken an
active step in updating their knowledge to meet their unique needs. COVID19. Managing change
in the healthcare sector in India is the task best assigned to academic reform aimed at providing
healthcare education, although healthcare workers can certainly have a say. their say. The way
the healthcare industry in India controlled the second wave of COVID19 is mainly due to the
advanced healthcare training offered at the university level to all students.

No one can predict what can really happen in the next decade or so. However, it is not hard to
hypothesize the presence of a few elements that we will see in the health care system in India
sooner or later:

Medical tourism: In comparison to countries in Western Europe or the United States, India’s
healthcare sector appeals to overseas patients because of the availability of high-quality
treatments at lower pricing. We can quickly expect a massive boost in the medical tourism front
owing to the excellent vaccine supplying relations with stable economies like Russia and Brazil
too.

Use of technology: In today’s world, online consultations and technological platforms are in
high demand. Given that the pandemic has extended the need to socially distance,
teleconsultations have become a need rather than a want for a majority of the population. In
August 2019, the Ministry of Health and Welfare launched the 'eSanjeevani' application, an
integrated telemedicine web service. It hopes to close the gap between India's urban and rural
areas, making health care more equitable.

Health Insurance Awareness: The good news for India is that health insurance, one of
India's most pressing health problems, has improved significantly. Awareness of health insurance
products has increased in recent years, attracting more and more people to purchase each year.

Need to avoid another collapse of health care system27

A deadly secondary coronavirus infection has emerged in India over the past few weeks,
resulting in a surge in deaths and overwhelming health care systems. The ever-increasing

27 Strengthening health systems during a pandemic: The role of development finance (oecd.org)
demand for healthcare outpaces available beds, oxygen, ambulances, pharmaceuticals and
healthcare workers.

Several experts have pointed out that India's private sector-dominated health care system is not
adequately prepared for this critical crisis. The government of India should prioritize reforms to
address these shortcomings to avoid similar crises in the future. This includes increasing
spending on the health sector, ensuring a stable supply of a skilled workforce and essential
medicines, and collecting reliable data on key health indicators.

Among countries with similar income levels and levels of economic growth, India spends very
little on health care. India pays out only 3.5% of GDP on health care, despite being the sixth
largest economy in the world (as of 2018). By comparison, Brazil spends 9.5% of GDP on
healthcare, China and Mexico 5.4% and the UK 10%. Most of the money spent on healthcare in
India comes directly from the pockets of individuals. Public spending on health care is the lowest
in the world, averaging around US$38 per capita per year over the past 20 years.

Hospitals in India are mostly concentrated in cities, and primary care is vulnerable in both urban
and rural areas. The lack of critical health infrastructure in public health facilities in most parts of
the United States means they are not prepared to meet the daily needs, let alone the crisis. The
long-standing demands of experts and research scientists and even the temporary promises from
the Ministry of Finance and National Health Policy to increase public health pay out to 2.53% of
GDP have yet to yield concrete results.28

To prepare for the future, we need to look back at what has worked in the past. India has seen
significant advances in healthcare infrastructure over the past few decades. Programs like the
National Health Mission, Indra Dhanush Mission, and Integrated Child Development Services
have helped revolutionize access to health systems. Recently, the government launched the
Ayushmann Bharat program to build up the strength in health system. While significant progress
has been made through these programs, India needs to accelerate reforms over the next few years
to revolutionize the healthcare sector. This reform must begin with increased investment, where
India has historically lagged. Although public spending on health has tended to increase in recent
years, it is still below the country's target of 2.5% of GDP. Increased investment in health must
be accompanied by accelerating key policy efforts around reform of the public sector, human
capital for health, and health infrastructure.

Additional investment is also needed to enhance scientific research capacity in various medical
schools across the country. Stable public funding and incubating a strong team of research
professionals will help improve preparedness and ensure a swift response to any crisis. India's

28 What India's government needs to do to avoid another healthcare meltdown (theconversation.com)

healthcare system is suffering from a severe shortage of qualified medical staff: doctors as well
as medical staff, such as nurses and laboratory technicians. In addition to poor wages and
working conditions in public hospitals and clinics, the limited availability of medical and
medical education and training institutions across the country is a major restriction. The recent
expansion of medical schools, mainly in the private sector, has failed to meet the growing
demand. Significant developments in medical and medical training are needed to fill the gap.
And expansion should be prioritized in underserved areas, such as rural areas where shortages
are most pronounced and small towns in poor states.