Kerala govt defends round-the-clock specialty plan with redeployment figures

The Kerala government has reaffirmed its decision to introduce round-the-clock specialty services in general and district hospitals, even as the Kerala Government Medical Officers’ Association (KGMOA) has raised concerns over the proposal. The doctors’ body has argued that the plan is impractical without creating additional posts, given the significant number of vacancies in the Health Service.

The KGMOA has cited figures showing 799 vacant posts for doctors in the Health Service, of which around 300 are in the specialist cadre. It has warned that expecting existing staff to cover as many as 24 hours of specialty care could overburden doctors and affect the quality of care.

The government, however, has countered with its own assessment. A senior official said the number of doctors in service and patient load in various institutions had been reviewed. The official said proper redeployment of existing specialists would be sufficient for now to provide round-the-clock specialty services in many districts, and that vacancies would be filled in due course.

The first test of the plan will be at Punalur Taluk Hospital in Kollam district, where the service is slated to begin on September 1. The hospital requires 15 additional specialists. According to government data, Kollam district has 117 specialist doctors, with 74 posted in primary health centres (PHCs), community health centres (CHCs), and family health centres (FHCs). The government believes some of these doctors can be redeployed to Punalur, with their existing posts covered through internal reshuffling.

For round-the-clock service, the government says at least five doctors are needed in each specialty. It is also exploring a working arrangement allowing senior residents at Kollam Medical College Hospital to serve at Punalur on a rotation basis.

The government has also pointed to hospitals where it says specialist resources are underutilised or in excess. Manjeri General Hospital, upgraded to a medical college in 2013, currently has 39 specialists and several assistant surgeons in excess, it said. Officials further mentioned that an analysis of e-health data reveals a mismatch between patient load, services, and human resources in many FHCs and CHCs. With rationalisation, the government is confident that the scheme can be executed.

Officials have called on the KGMOA to cooperate with the initiative rather than raise obstacles. They highlighted the example of two public hospital cath labs — at General Hospital Thiruvananthapuram and Kollam District Hospital — which have been made functional round-the-clock despite similar concerns. Each hospital has two cardiologists and three to five doctors trained in trauma management and patient stabilisation. The cath labs now handle night-time cardiac emergencies, and officials say this was made possible because doctors were willing to cooperate.

The government maintains that the new initiative can succeed through optimal use of existing resources, while recruitment to fill vacancies will proceed as planned. The KGMOA, for its part, has not revised its position, and the matter remains a point of contention between the two sides.