‘Working of private hospitals needs to be supervised’

Infection control is an issue that has been nagging the healthcare industry since time immemorial. The challenges are discussed time and again among the hospitals and solutions sought. Recently, the Hospital Administration Department of All India Institute of Medical Sciences (AIIMS) organised a national conference on infection control. Nidhi Srivastava caught up with deputy medical superintendent at AIIMS, Dr P C Chaubey to get his views on waste management and other issues in the healthcare industry.

What do you think are the main reasons for hospital acquired infection?
We have around 1100 hospitals in the country with approximately 7 lakh beds. Though the number of hospital beds is increasing continuously, this increase is not sufficient. People are utilising these facilities extensively. We have hospitals where the occupation rate is 120-150 per cent. Along with the attendants and relatives, around 80 lakh to one crore people come in close contact with the hospital everyday.

Apart from this, hospitals generate different types of waste, particularly biomedical waste which comprises about 10-12 per cent of the total solid waste generated. In Delhi itself, besides the liquid waste generated in large quantities, the hospitals are generating about 10 tonnes of infectious solid waste everyday.

What are the changes that have taken place in waste management in the past few years?
Previously the entire waste from the hospitals was collected and taken out by the local authorities and put into a municipal waste dumpsite. Now however, the hospitals have started buying equipment like incinerators, destroyers, shredders, and are also using chemical treatment for waste disposal. So a lot of awareness has developed from biomedical waste point of view.

Now that there is much awareness in the area of hospital waste management, do you think that Indian hospitals will match the management standards of better performing countries?
Hospitals in India have different problems. You can’t compare the Indian hospitals to those in America. Their private sector is different, legislation and rules are different. They have proper punishments for breaking laws. They can close the hospitals. Here, in India, we can’t do that. And with the amount of money the government is spending on health sector, we cannot buy the sophisticated equipment.

Do you think that the present scenario of government aided hospitals can improve if they start charging more?
Government will probably not be able to run hi-tech super-specialty hospitals or if they do so, they will have to charge for services. It should charge money from those who can afford and in fact competitive rates will promote healthy competition between the government and private hospitals.

What is your opinion on the proliferation of private players in the country?
If there are plenty of private hospitals, efficiency and competition will develop, and the cost of care will also go down. Big private hospitals started coming up particularly after the National Health Policy 1983 that encouraged construction of private hospitals. But the plan was to help the private sector build hospitals where the government is unable to. For this they were to be given some economic concessions for importing equipment, etc in return for at least 20-25 per cent services free to the community. However, instead of making these hospitals in the rural areas where they were required, most of these hospitals were constructed in big cities.

Now we see that there is no machinery in the country to supervise or oversee the existence of the private hospitals, unlike the government hospitals that have to send their information and other things to the ministry and other authorities. We have manipulative private hospitals and whatever they charge, there is no competitor. They are not even trying to reduce the costs because there is neither any competition nor are there any regulatory bodies to govern them.