Recent NMC Order is death knell for private hospitals and catastrophic to society-VHA

Outcry amongst Nagpur citizens on having COVID Treatment units in residential areas

Nagpur: More than 110 private hospitals of Vidarbha with total bed strength of more than 10000 spread across Vidarbha had joined hands to form Vidarbha Hospitals Association.

On 23th April; Tukaram Mundhe- Nagpur Municipal Commissioner using his powers had issued an order asking selected Nagpur based private hospitals to be “State of readiness” with all requisite infrastructure, manpower, equipment, medicine & consumables and staff to handle COVID 19 patients as per all laid down government norms. This order has shaken Nagpur private health care sector and has caused apprehensions and confusions amongst Non COVID 19 patients taking treatment at these hospitals. After discussing with all members; Vidarbha Hospitals Association led by Dr Ashok Arbat –President, Dr Sameer Paltewar- Convener and Dr Alok Umre- Secretary had today reverted back to NMC Municipal Commissioner conveying the technical lacunas in said order. Moreover, VHA has allayed the apprehensions of concerned citizens that Government is bound to initially utilise the existing government facilities, private medical colleges based in government land, hospitals based in government land, charitable trust hospitals, NMC run hospitals/ Isolation hospitals; and then only reach out to private health care sector and will surely consider treatment facility also for Non COVID 19 patients. The Citizens had conveyed their apprehensions that if Nagpur in totality has only quality 4000-4500 beds and they are blocked and reserved for COVID 19 patients where will rest of emergencies go?

Likewise, there is outcry amongst citizens based near the selected private hospitals who are objecting to having a COVID 19 treatment centre in their midst of their residential colonies. The citizens are surprised at the erroneous strategy of spreading positive COVID-19 patients across the city in several Hospitals, thereby compounding the risk of cross- resulting in high mortality and morbidity as seen in Italy. People are even considering filing medical negligence liability on these private hospitals if they shift negative COVID-19 patients requiring urgent medical attention.

VHA had already highlighted the dire straits of private Hospitals across the city of Nagpur which have been forced to operate at shrunken revenues and enhanced costs and are worried about the prospect of having to subsidize the costs of treatment with no financial support towards salary bills, utility charges, infrastructure usage charges and statutory taxation and financial obligations to Financial and Operational Creditors.

As can be witnessed from the effective medical response by China, COVID-19 patients were concentrated in a few Hospitals in order to minimize the risk of cross-infections. Since the only remedy is to convert Hospitals into full-time COVID designated Hospitals, it would be wise to only identify few Hospitals with buffer expanse of government land around and their bed strength to contain the spread of disease and also bonafide obligation of the Hospitals based on government land and trust run Hospitals. Having said that, it is equally important to consider provision of emergency medical services to Non COVID 19 patients and segregating them to prevent mix up amongst them to contain the spread of disease. State is also bound by its commitment to ensure emergency treatment facility to Non-COVID19 Patients as can be seen in their orders to private practioneers to remain open and render treatment, it would be prudent to let Government medical colleges/ Private Medical Colleges/Corporation run Hospitals/ Isolation Hospitals/ Hospitals on Government land/ Trust Hospitals to manage COVID19 Patients considering the buffer expanse of land around them and let private hospitals based in residential areas treat NON COVID 19 patients. Moreover, the shortcomings and limitations within framework of laid down isolation facility guidelines pointed out in the self-assessment check lists of all private hospitals cannot be overruled as it would be catastrophic for society. No private hospital was ever designed as Isolation facility and till date all contagious patients were bound to be notified and referred to Isolation Hospitals since they are based in residential areas.

VHA has highlighted that they are not at all in “State of readiness” because of grossly inadequate High-Risk PPE kits, grossly inadequate infrastructure & manpower to handle COVID 19 patients. The Identified Private Hospitals do not have the requisite infrastructure, manpower & equipment requirements or tools and resources to treat Contagious Covid19 patients in desired isolation facilities as per norms. Overriding and turning a blind eye to the shortcomings & asking them to be ready in 3 days will not only be calamitous to society but will land the decision makers with civil and medico legal suits. Private Hospitals are financially incapable of investing in resources to revamp the facility into a COVID designated isolation facility. The private hospitals are presently working with skeleton staff. The private hospitals never had conceptualized additional staff for rotational duties wherein staff gets quarantined for 14 days, rest room facility, quarantine arrangements etc. Hence, how can they treat COVID 19 patients with such gross manpower limitations? Will it not affect the quality of care? Who will be responsible for said lapse?

Nowhere in the country has any Empowered Officer under the Epidemic Diseases Act, distributed and spread COVID 19 treatment centres all across city in various private hospitals based in residential areas with gross shortcomings and not fitting into the isolation criteria’s laid down by government. Such step had landed highly advanced countries like Italy in a condition that is known to all and will land Nagpur city in a bigger mess, VHA has stated. VHA has emphasized that all private hospitals based in residential areas should only be used as treatment centres for NON COVID 19 emergencies and asymptomatic positive COVID 19 patients should only be quarantined either in home or institutions rather than admitting in hospitals since it eats up the resources. VHA has also demanded testing facilities for screening even Non Covid patients.

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