Kerala Health Minister Rules Out In-Patient Care Below Taluk Level, Pozhiyoor May Be Exception

The Kerala government has ruled out extending in-patient care to health institutions below taluk level, stating that such a step is not possible as a matter of policy because of the scale of investment it would require.

Health Minister K. Muraleedharan told the State Assembly on Tuesday that creating in-patient (IP) facilities at smaller institutions would involve heavy investment in human resources, including doctors, nurses and other ancillary workers, as well as a host of basic infrastructural requirements that smaller healthcare institutions are not equipped to meet.

The Minister was replying to a calling attention motion moved by N. Sakthan, who sought the reinstatement of IP facilities at two family health centres (FHCs) in Pozhiyoor and Chenkal. Mr. Sakthan said the facilities had been stopped by the previous LDF government. He also urged the government to speed up the development of the General Hospital at Neyyattinkara.

Responding, Mr. Muraleedharan said both Pozhiyoor and Chenkal were primary health centres (PHCs) that had been converted into FHCs. Such institutions, he said, are meant to provide primary care services and to coordinate public health activities.

Mr. Sakthan, however, insisted that Pozhiyoor had an IP facility for 15 years before it was withdrawn suddenly, and pressed for its restoration.

In his reply, the Minister said the government would consider reinstating the IP facility at the Pozhiyoor FHC alone as a special case, since it serves a coastal area. No similar assurance was given for the Chenkal centre.

In-patient care refers to treatment that requires a patient to be admitted and stay in a hospital, as distinct from outpatient care, where a patient is examined and returns home the same day. In India's public health system, IP facilities are generally provided at taluk-level hospitals and above, where round-the-clock staffing, beds and supporting services can be maintained. PHCs and FHCs are designed as the first point of contact for a community and to handle outpatient care, referrals and public health work.

Administratively, health institutions in the State are organised in a hierarchy. Sub-centres and PHCs, along with FHCs, function closest to the community, while taluk hospitals, general hospitals, district hospitals and medical college hospitals provide higher levels of care, including in-patient treatment. The Minister's statement places the dividing line for IP services at the taluk level.

The exchange in the House highlighted a concern raised by members representing areas served by smaller institutions: that withdrawing IP facilities can mean longer travel for residents. In the case of Pozhiyoor, the Minister acknowledged this by offering to treat the centre as a special case.

A calling attention motion is a procedure that allows a member to draw the attention of the House to a matter of public importance, with the responsible Minister responding on the floor. As reported, the Minister's reply did not set out a timeline for a decision on the Pozhiyoor centre, nor did it indicate a schedule for the development of the Neyyattinkara General Hospital.

The government's stated position means that, as a rule, in-patient services will not be introduced at institutions below taluk level in the State, although exceptions may be considered on the basis of specific local needs, as indicated in the case of Pozhiyoor.