Tamilnadu - Healthcare, Public Health and Medical Tourism

[TShyam]

Tamilnadu is known for its healthcare since prehistoric times. Siddha medicine system was developed in Tamilnadu thousands of years ago and its literature predates almost all forms of medicine practiced around the world. Allopathy or modern medicine was introduced by the British and one of India's oldest medical colleges, Madras Medical College started functioning 176 years ago in 1835.

Tamilnadu has enjoyed the preeminent position for health care in India and continue to do so. It has produced such stalwarts like Dr. A.L.Mudaliar, Dr. Muthulakshmi Reddy, Dr. Mary Scharlieb, Dr. C.Natesa Mudaliar, Dr. Balasubramaniam Ramamurthi, Dr. S.S.Badrinath, Dr. Govindappa Venkataswamy, Dr. K.M.Cherian, Dr. Lakshmi Sahgal, Dr. Vilayanur S. Ramachandran, Dr. Prathap C. Reddy, Dr. T. Thomas among others.

The public health system is among the best in the country. It is either the best performing or second best performing state (usually behind Kerala) in critical parameters such as infant mortality rate, maternal mortality rate, antenatal coverage, total fertility rate, net reproduction rate, life expectancy and PHC coverage.

Tamilnadu also hosts some of the finest medical centres and research institutes in India and is a hub of medical tourism as can be evident from the following article ranking the best hospitals in India which shows TN dominating in almost all categories.

Originally Posted by Raji7373

The cities of Chennai, Vellore, Coimbatore and Madurai offers exceptional medical care and the state with 6% of Indian population takes care of 50% of inbound foreign medical tourists. Not only foreign medical tourists but the state also acts as a hub of domestic medical activity.
So it is only reasonable that this important part of the economy and education has a separate thread. Please post any news regarding TN's and Pondicherry's healthcare, public health and medical tourism in this thread.

Tamilnadu government ministry of health and family welfare
Official TN medical tourism website with the list of approved hospitals
Tamilnadu government policy note 2010 - 11 including all health related statistics for the state of Tamilnadu
Body donation form (Please spread the word).

[TShyam]

Kamola (centre) from Uzbekistan with Medical Director of Vedanayagam Hospital S.V.Kandasami (left) and consultant urologist Ganesh Gopalakrishnan (right) at the hospital on Tuesday. Standing behind are her parents Manzura and Sharaffudin. Photo: S.Siva Saravanan

Fifteen-year-old Kamola is eager to get back home with fond memories of the friends she and her parents found and the soft idlis they relished at the canteen of Vedanayagam Hospital here.

Kamola will be leaving for Uzbekistan capital Tashkent in a couple of days with an enhanced bladder created by urologists S.V. Kandasami and Ganesh Gopalakrishnan to stop urine reflux to her kidneys, a problem she has battled since birth.

A lot of trauma

She wants to catch up with lost time in academics and learn swimming. She went to school all these years with tubes from both kidneys draining urine into two plastic bottles.

In between classes, she had to go to the restroom to empty the bottles.

“We went through a lot of trauma because of this. Fellow passengers in buses complained of smell. They stayed away from her. Though school mates and teachers were very understanding, at times they too indicated discomfort. But my daughter's determination made her carry on,” said Sharaffudin, Kamola's father. He is a manager in a company that manufactures heating systems.

Ms. Kamola underwent five surgeries on her bladder in Tashkent to correct a congenital problem that caused urine to flow back into the kidneys.

“From birth, she did not have the sub mucosal tunnel in the bladder through which urine flowed,” the urologists said.

Surgeons in Tashkent tried to create the tunnel. But the repeated operations reduced the size of the bladder. The problem worsened as the bladder could hold only 30 ml of urine, against the normal capacity of 350 ml, Dr. Kandasami said.

This led to the tubes being inserted into the kidneys from a little above the waist to drain urine.

Dr. Kandasami, who is the Medical Director of the hospital, said that in a 10-hour surgery, a portion of the big intestine and the small intestine were cut to form a pouch, and this was stitched to the original bladder in order to create more space to hold urine.

“Now, she has normal functioning of the bladder. Fortunately, her kidneys have not been damaged, though the prolonged use of tubes led to stone formation. We removed the stones,” he said.

Kamola's mother Manzura said their biggest problem was solved. “Now, my daughter can lead a normal life.”

Wait for a year

Through a friend in Tashkent, Mr. Sharaffudin came to know last year about the Vedanayagam Hospital and that Dr. Gopalakrishnan (then president of the Urology Society of India) was working there after retiring from the Christian Medical College in Vellore, where he had performed many such surgeries.

“The father and daughter came to us last year [January 2010] and returned to Tashkent after a consultation. The entire family returned in December so that the girl could be operated upon,” Dr. Gopalakrishnan said.

Kamola underwent the first surgery when she was two years old and all the five were done by the time she was four. “Now, when I get back home, I just want to study,” she says.

http://www.thehindu.com/health/article1100261.ece

[satishanu]

Nice thread

[TShyam]

CHENNAI: Cardiologists in Chennai have implanted a drug-coated absorbable stent that would dissolve in the body within two years. The biodegradable stent, which is in the last phase of clinical trials, can make scarred blood vessels appear and function like normal ones. Doctors who did the implant will make a formal announcement in Chennai at 3 pm on Tuesday.

A team headed interventional cardiologist Dr Mathew Samuel Kalarickal and Dr Sai Satish at the Apollo Hospitals, Chennai implanted the stent in two patients a fortnight ago as a part of the last phase of the human trials. The doctors TOI on Tuesday that if the clinical trials show expected results, these stents could soon replace the existing ones which are non-biodegradable.

The drug-coated absorbable stent, manufactured by Abbott Laboratories, is left behind in the arteries after doctors clear the blocks in the blood vessel using balloon angioplasty. Unlike the metal-mesh or drug coated metals, these stents are designed to be absorbed slowly by the coronary arteries. "In two years, these stents will be gone. It seems effective at keeping arteries open and reducing chances of relapse or heart surgeries. Studies so far have also shown that arteries that were once scarred look near normal after two years," said Dr Satish.

The new stent is yet to be available in the commercial market. As a part of the clinical trial, more than 100 institutes all the over the world including five centres in India will implant the stent on patients, free of cost. The Indian hospitals involved in the trial include Apollo Hospitals and Madras Medical Mission in Chennai, Escorts Heart Research Institute in Delhi, Care Hospital in Hyderabad and SAL Hospital in Ahmedabad.

http://timesofindia.indiatimes.com/h...ow/7310863.cms

[TShyam]

The Tamil Nadu Government has drawn up a plan to set up at least one medical college in each district of the state and to establish a State Medical Services Corporation and drug warehouses in all districts that provide quality drugs free of cost, a top official said.
"Tamil Nadu now has the highest number of medical colleges in government sector with 15 medical colleges, contributing to human resource development in medical, nursing and paramedical disciplines," State Health and Family Welfare Principal Secretary V K Subburaj told PTI.
He said the policy of one medical college per district proposed by the State Government is a milestone in the history of medicine in Tamil Nadu.
The State Government would encourage private trusts to start courses such as dental, BSc nursing and diploma in nursing courses in rural areas, he said.
"Government has given permission to start ten nursing schools and ten nursing colleges to conduct BSc nursing courses," he said.
Subburaj said government hospitals with medical colleges would be upgraded on par with international standards.
"Apart from this, all government hospitals will also be accredited by the National Accreditation Board for Hospitals and Healthcare Providers (NABH), a constituent board of Quality Council of India (QCI), set up to establish and operate accreditation programme for healthcare organisations."
"Currently, two government hospitals in the state have been accredited by NABH," he said.
Stating that all Primary Health Centres in the state would also be accredited by NABH, he said at present 48 PHCs have applied for accreditation.
"NABH standards have more than 500 objective elements and about 70 per cent of these elements concern clinical practices and the rest focus on managerial functions," he said.
"The department is also encouraging public-private partnership to improve services of PHCs and government hospitals," he said.
In the last four years, 6,300 medical officers, 7,242 staff nurses, 1,282 village health nurses and more than 9,000 para medical staff had been appointed in various government hospitals, he said.

http://news.in.msn.com/national/arti...mentid=4635852

[TShyam]

The State government will make all-out efforts to contain the rise in prices of essential commodities, Deputy Chief Minister M. K. Stalin told the Assembly on Thursday.

Concluding the debate on Governor's address, Mr. Stalin said the problem of price rise was prevalent not just in the State or in the country but also at the international level.

Giving an exhaustive account of the government's measures, he referred to the provision of rice at Re. 1 a kg besides pulses, edible oil and condiments at concessional rates. Stating that the government had been taking steps to enhance the purchasing capacity of people, he said that wages to the tune of Rs. 1,847 crore were, so far, paid in the State during 2010-2011 under the Mahatma Gandhi National Rural Employment Guarantee Scheme, which was being implemented by Central and State governments.

http://www.thehindu.com/news/states/...cle1090351.ece

[ganie006]

Soon, autopsy in private medical college hospitals

CHENNAI: From the next academic year, the state government would consider allowing private medical college hospitals do post-mortem examinations, senior health department officials said.

Presently, post-mortems are done by the government medical college hospitals and district headquarters hospitals across the state. The only private hospitals authorised to do post-mortem examination is Sri Ramachandra University.

However, the announcement is being withheld as the election commission has enforced the model code of conduct. "When private hospitals can treat victims of road accidents, assault or murder, they should be able to handle post-mortems as well. This will also help the students in the medical colleges as forensic science is part of MBBS syllabus in the second and the third year," the official said. The private colleges willing to do post-mortems have to apply and permission will be granted after inspection, the official said.

The department had so far rejected applications from private colleges. But with shortage of forensic experts in the government sector, it has decided to reconsider the decision. The Karnataka government has already permitted private hospitals to conduct post-mortems.

Presently, for the 17 government medical colleges, there are just 20 qualified forensic surgeons. Eight of them are in the city colleges and hospitals. Madras Medical College has five, Stanley Medical College has two and Royapettah Government Hospital has one. There are two forensic surgeons each in Madurai, Thoothukudi and Theni, and one each in Chengalpet, Coimbatore, Kanyakumari and Vellore. In the government medical colleges in Tiruchi, Thanjavur and Dharmapuri, there are no qualified persons.

In the government hospitals, a MBBS or post-graduate doctor with any specialty is deputed to the forensic department for conducting post-mortems. A forensic expert is given only cases where the cause of death is a mystery or suspected murder. Doctors deputed to the department mostly handle accident cases. They will hand over the case to forensic experts if they think it deserves expert opinion. "Private hospitals can also do this," the official said.

Forensic experts at the government hospitals feel that this will bring down the work load in government hospitals and also offer medical students in private colleges a better learning environment. "Most students in private colleges do get to see a real-time post-mortem," he said.

http://timesofindia.indiatimes.com/c...ow/7783682.cms

[TShyam]

COIMBATORE: He cares for the health and well-being of those around him. He believes that a healthy nation needs healthy people. So, Amith Kumar, a physiotherapist and fitness consultant based at Kovaipudur here, has launched a initiative, offering health tips as mobile alerts on a daily basis. And he does it absolutely free of cost.

Amith Kumar's treatment centre named 23 Physia Clinic is now embarking on a unique mission of mobile alerts on heath tips to Coimbatoreans on a daily basis, free of cost. Once you subscribe, you can get health alerts on a daily basis. The alerts mainly pertain to major diseases like diabetics, cancer, AIDS, hypertension etc.

"Prevention is better than cure. So I am encouraging people to lead a healthy life to reduce the time and money spent on medical treatment. The health sector is largely money oriented and even minor consultations are very expensive," says Amith Kumar, who was born in Mannargudi and has worked in Singapore and Mumbai.

"It is not a business. I set aside about Rs 5,000 from my earnings every month to provide health education to residents through this mobile alert service. I feel it is my responsibility," says Amith, who has decided to settle down in Coimbatore permanently.

Getting enrolled in Amrit's mobile SMS list is easy. All you have to do is send the following message, 'HEALTHYLIVING NAME' to the mobile number 9488545655. "This is free of cost," says Amith, who has availed the free services of half a dozen medical practitioners in his efforts to supply health tips.

Dr M Aarthy, Dr V Lakshmy, Dr Rashmi Desai, Dr M Sarmila and Dr P Sruthi and Dr M V Parthipan are now helping Amith to prepare his tips.

Amith started the project on an experimental basis this January, sending out his tips to his list of patients. Initially, he had 256 members. "Now we have about 1,320 subscribers, only through word of mouth. We have a few from other cities too," says Amith.

"As a physiotherapist, I am dealing with pain on a daily basis. Through this project, I am hoping for a painless world," he says.

http://timesofindia.indiatimes.com/c...ow/7894117.cms

[Arul Murugan]

Salem tops in body parts donation:

உடல் தானம் செய்வதில் சேலம் முதலிடம்:அரசு மருத்துவமனை கண்காணிப்பாளர் தகவல்

சேலம்: ""தமிழக அளவில் உடல் தானம் செய்ய அரசு மருத்துவமனைகளில் பதிவு செய்துள்ளவர்களின் எண்ணிக்கையில் சேலம் மாவட்டம் முதலிடம் பெற்றுள்ளது,'' என, சேலம் அரசு மருத்துவமனை கண்காணிப்பாளர் டாக்டர் மோகன் தெரிவித்தார். சேலம் அரசு மருத்துவக் கல்லூரி மருத்துவமனையில் அகரம் காலனியை சேர்ந்த, 45 பேர், நேற்று தங்களின் உடல்களை தானம் செய்வதாக கூறி, அதற்கான உறுதி மொழி ஒப்பந்த பத்திரத்தை கண்காணிப்பாளர் டாக்டர் மோகனிடம் வழங்கினர். ஆர்.எம்.ஓ., டாக்டர் ஜெகதீஸ்வர், டாக்டர் தண்டபாணி ஆகியோர் உடனிருந்தனர். உடல் தானம் குறித்து கண்காணிப்பாளர் டாக்டர் மோகன் கூறியதாவது:
உடல் தான செய்திகளால், மக்கள் மத்தியில் விழிப்புணர்வு ஏற்பட்டுள்ளது. தங்களின் உடலை மாணவர்களின் படிப்பு, ஆய்வுகளுக்கு தானமாக வழங்க மக்கள் முன் வருகின்றனர். இதில், சேலம் அரசு மருத்துவமனையில் சேலம் மாவட்ட மக்கள் மட்டுமின்றி நாமக்கல், தர்மபுரி மாவட்ட மக்களும் தங்களின் உடலை தானமாக வழங்க பதிவு செய்துள்ளனர். கடந்த 1991ல் துவக்கப்பட்ட சேலம் அரசு மருத்துவக் கல்லூரி மருத்துவமனையில், இதுவரை, 700 பேர் தங்களின் உடலை தானம் செய்ய பதிவு செய்துள்ளனர். அவர்களில், 28 பேரின் உடல் தானமாக பெறப்பட்டு, மாணவர்களின் படிப்புக்கு பயன் படுத்தப்பட்டு வருகிறது. உடல் தானம் செய்வதற்காக பதிவு செய்துள்ளவர்களின் எண்ணிக்கை அடிப்படையில் சேலம் மாவட்டம் தமிழக அளவில் முதலிடத்தை பெற்றுள்ளது. கடந்த 1994ல் முன்னாள் எம்.பி., கிருஷ்ணன், முதன் முதலாக தன் உடலை தானமாக வழங்கி, இந்த சேவையை துவக்கி வைத்தார். இந்த ஆண்டு இதுவரை, 76 பேர் தங்களின் உடலை தானமாக வழங்க முன் வந்துள்ளனர். இவ்வாறு உடல் தான ஒப்பந்தத்தை எங்களிடம் வழங்கியவர்கள், இறந்த நான்கு மணி நேரத்துக்குள், எங்களுக்கு தகவல் கிடைக்கும் பட்சத்தில், எங்களின் கண் மருத்துவக் குழுவினர், உடலை எடுத்து வந்து, முதலில் கண்ணை எடுத்து மருத்துவமனை கண் வங்கியில் பராமரிப்பர். பின், இந்த கண் வேறொருவருக்கு பொருத்தும் பணிகள் துவங்கும். உடல் தானம் செய்துள்ளவரின் மூளை செயல் இழப்பு ஏற்படும் பட்சத்தில், அவரின் உடலில் இருந்து சிறுநீரகம், கல்லீரல், கணையம் ஆகியவற்றை எடுத்து மற்றொருவருக்கு பொருத்தலாம். இதற்கு மருத்துவர்களிடம் முறையான சான்றிதழ் பெற வேண்டும். அவர்களின் இறந்த உடலை பயிற்சி மற்றும் ஆய்வுக்கு பயன் படுத்தலாம். இது போன்ற உடல் தானம் செய்பவரின் உடலுக்கு பதப்படுத்துதல் மற்றும் பக்குவப்படுத்துதலுக்காக அரசு, 25 ஆயிரம் ரூபாய் வரை வழங்குகிறது. உடல், உறுப்புகளை தானம் செய்ய முன்வரும் பொதுமக்கள் மருத்துவமனை நிர்வாகத்தை நேரடியாக தொடர்பு கொண்டு தங்களின் பெயரை பதிவு செய்து கொள்ளலாம். இவ்வாறு அவர் கூறினார்.

Kaalaikathir news appeared in Dinamalar.

[kongutamizhan]

Election time arrived. After all he is also a politician...

Source

US President Barack Obama on Tuesday said his aim was to change the US healthcare system to discourage Americans from seeking medical treatment in India and Mexico. His healthcare reforms - called Obamacare by critics - is being opposed by Republicans on the ground that it will add up to the country's expenses, thereby worsening the debt situation.

"My preference would be that you don't have to travel to Mexico or India for cheap healthcare," he said in response to a question about why US health insurance won't cover medical expenses incurred abroad.

"I'd like you to be able to get it right here in the United States of America that's high quality."

Obama also said that prices of prescription drugs must be brought down "so that you don't feel like you're getting cheated because you're paying 30% more or 20% more than prescription drugs in Canada or Mexico."

In the run up to the elections in November, Obama had repeatedly brought up off-shoring to India and how he intended to change rules to keep US jobs from going to India.

[ganie006]

Meenakshi Mission to tap medical tourism

By R Srividhya Jun 14 2011 , Chennai

Tags: Madurai, Medical tourism, Meenakshi Mission hospital, Thanjavur, Opportunities
In an attempt to redirect medical tourism opportunities from Chennai to smaller cities like Madurai and Thanjavur, which are popular tourist destinations for foreigners, Meenakshi Mission Hospital is planning to set up two hospitals, in Madurai and Thanjavur, with a combined investment of Rs 370 crore. The promoters are also looking at tapping private equity funding for the new projects.

Meenakshi Mission Hospital & Research Centre in Madurai is a 750-bed hospital with multiple specialties. The hospital clocked revenues of Rs 150 crore in 2010-11 with net profit of Rs 15 crore.

“The hospital is run by a non-profit trust, which means that we do not have much liberty on the pricing front and are also not in a position to tap the full potential of the medical tou-rism business. So, instead of expanding the existing hospital, we have planned to set up one corporate hospital each in Madurai and Thanjavur, aimed at the medical tourism sector,” Dr N Sethuraman, founder chairman of the hospital, told Financial Chronicle.

Medical tourism is expected to become a $2 billion business by 2012, according to an IBEF research report. Chennai is at the forefront here with corporate and specialty hospitals like Apollo, Sankara Neth-ralaya, Madras Medical Mission and Christian Medical College of Vellore.

The 350-bed Madurai hospital will be built with an investment of around Rs 300 crore. It would have all major specialties like cardio, orthopedic, gastroenterology and nephrology, among others. “We have already signed a Rs 150-crore loan agreement with HDFC Bank for the project,” Dr Sethuraman said. The hospital in Thanjavur would be smaller with 200 beds and entail an investment of Rs 70 crore, of which Rs 50 crore would be loan component and the promoters would fund the rest through equity investment.

[murlee]

Tamil Nadu’s efficient drug procurement system offers clues to fixing the glitches in the national health system


I t is five in the evening, but patients are still making a beeline to see Dr. N. Vijayalaxmi, the duty doctor at the district headquarters hospital at Thiruvallur, about 50 km from Chennai. The doctor patiently listens to each one of them, chides some for not coming in earlier in spite of fever, and furiously scribbles tests and medicines.

Although the hospital lacks the spiffy look of private institutions, it treats about 1,500-2,000 patients a day. “The number of patients has at least doubled,’’ says Dr. Vijayalaxmi, who joined the hospital four years ago. There are only about three doctors on duty at any given point of time.

Though the hospital staffing has not kept pace with the increase in the number of patients, she does not recall a single instance during those years when the hospital has been short of medicines. Over the years, it has also acquired modern equipment such as a CT scanner, nebulisers and those used in physiotherapy.

“Sometimes we get referrals from even private hospitals here,’’ the amiable doctor says with visible pride.

The Thiruvallur hospital is not an isolated case of a well-functioning public health care system. Tamil Nadu boasts of the best public health care system in the country. State care is so competitive that until some time ago, deliveries in private hospitals in Chennai city often cost less than those in rural Bihar. At about 9 percent of its health budget, Tamil Nadu spends the most on drugs among states. Its per capita drug allocation in 2006-2007 was Rs. 27. In comparison, Rajasthan’s was Rs. 2 in 2005-2006 and Uttar Pradesh’s was Rs. 3. Even Kerala, which boasts of reasonably robust public health care, spent only 1.5 percent of its health budget on drugs.

One of the pillars of this successful system is the Tamil Nadu Medical Services Corporation (TNMSC), a state-owned company set up under the Companies Act in 1994 in the wake of a spurious drugs scam. The corporation streamlined drug procurement in the state and has helped shave costs by about 30 percent.
“TNMSC has a simple goal,’’ says R. Poornalingam, who set the company up. “It has to ensure availability of quality drugs to everyone at an affordable cost.’’ The central government is now using the TNMSC model as a national benchmark in rational use of drugs in the public sector in procuring, logistics and capacity building. The ministry has also proposed a company for the central government to manage the supply chain of centrally administered programmes such as malaria and TB eradication, pulse polio and HIV control. It has roped in Poornalingam as the chief evangelist for the project.

The Model
When TNMSC was set up, drug procurement in the state was scattered, with each public hospital sourcing drugs on its own with no standard procedures. TNMSC, which relied heavily on information technology systems and processes to streamline drug procurement, helped in dramatically bringing down drug prices. For instance, the price of 10 strips of antibiotic ciprofloxacin tablets in 1992-1994 (before TNMSC) was Rs. 525. That fell to Rs. 88 in 2002-2003. Similarly, the cost of 100 Norfloxacin tablets fell from Rs. 290 to Rs. 51.30 during the same period.

These improvements have helped bring down the average cost of drugs for inpatients in Tamil Nadu’s public hospitals to Rs. 102, according to the National Sample Survey Organisation’s (NSSO) sixtieth round survey in 2004. In comparison, the average cost of drugs was Rs. 3,268 in Haryana, Rs. 2,166 in Himachal Pradesh and Rs. 3,187 in Rajasthan. The total average cost of a patient’s hospital stay in Tamil Nadu was the lowest at Rs. 255.





Infographic: Hemal Sheth

The key to TNMSC’s success is its tendering process and a passbook system for distributing drugs. It floats tenders at the beginning of every year to identify suppliers for about 250 drugs, which are the most used and usually cover the treatment spectrum. When the purchases are state funded, it follows a two-tier tendering process where first technical bids are evaluated and then price bids decide
the supplier.

TNMSC follows a stringent testing process — it currently has about 11 laboratories empanelled with it. These labs test the first batches of every drug supplied and subsequently also random samples picked from TNMSC’s 25 warehouses spread across the state. Earlier, drugs used to be supplied in bulk. The corporation put an end to it and insisted on blister packaging and special labelling for it in English and Tamil, which made it difficult to divert them.

In a 2004 paper on access to drugs in public health facilities in Tamil Nadu, Leela Visaria of the Gujarat Institute of Development Research mentions that during a survey in Kanchipuram district, several patients she spoke to could identify the drugs by name instead of colour. One woman said that the strip-packed tablets appeared more genuine and were more effective than the loose tablets given wrapped in a piece of newspaper!





Once the tests approve the drug, TNMSC places regular orders through the year depending on inventory levels in its warehouses. A computerised management information system constantly keeps track of inventories in warehouses and helps place orders and clear payments within 15 days. The system has put an end to excess as well as shortage of drugs.

Girija Vaidyanathan, mission director of National Rural Health Mission (NRHM) in Tamil Nadu says that the concept of passbook introduced by TNMSC was the real innovation. Poornalingam, the architect of TNMSC, says he was inspired by banks to have a similar system to keep track of inventory. Every user of the drug (government run clinics, polyclinics and hospitals) is issued a passbook. Whenever a user requires a drug, it informs the nearest warehouse, which immediately fulfills the order. The name and value of the drug issues is immediately entered in the passbook, which forms the backbone of the information system.

The two key aspects that keep TNMSC going are the transparency in processes and the ruthless dealing with suppliers, says Dr. K. Gopal, managing director of TNMSC. “Any drop in quality and the supplier is immediately blacklisted,’’ says Dr. Gopal. Currently, the blacklist has about 60-70 companies. Once blacklisted, they can’t return for four years. And when they return, they are subject to intense scrutiny. TNMSC currently sources 251 drugs, 90 pieces of surgical equipment and 80 types of sutures from about 125 suppliers.

While the system has worked very well, it still is not foolproof. Last year, a controversy broke out after media reports revealed that several batches of an iodine-based disinfectant solution used widely in surgeries was merely water or soap solution. The supplier and the lab which tested it were eventually blacklisted. Dr. Gopal declined to speak on the issue but said that it had been sorted out.

One of the reasons for such missteps could be the growth of TNMSC, though Dr. Gopal denies it, insisting that quality is never compromised. The corporation has expanded drug procurement to veterinary drugs and medical equipment.

NRHM’s Vaidyanathan says that TNMSC is the best thing to have happened to the public health care system in Tamil Nadu but increasing volumes may be putting pressure on maintaining quality. The diversification into equipment is a different issue altogether which requires a parallel system of bio-medical engineers. “That little bug is yet to be fixed,’’ Vaidyanathan says. Dr. Gopal is already trying to fix it. He admits that manpower is an issue as the company has grown. To tackle the issue of supplier pressure in equipment purchase, he is preparing a standard code of specifications for medical equipment.

Going National
Amarjeet Sinha, joint secretary in the ministry of health and family welfare, says that the government wants to set up similar corporations in at least 10 states in the next five years.

The objectives of the Centre’s rational drug use policy tie in nicely with the results shown by TNMSC. The policy is aimed at breaking the stranglehold of suppliers on the public health system, promoting correct drugs and dosage and curbing unnecessary prescription. However, its success hinges on availability and accessibility of crucial drugs.

A ministry document says that about 300-400 essential drugs are enough to treat most illnesses. Yet 70,000 formulations are available in the market. Often formulations such as cough syrups, tonics, digestives are made of drugs that have no therapeutic value, or have much less value than the generic preparation of the active ingredient.

Corporate consolidation in the drug industry is also worrying the health ministry. TNMSC manages to save costs because it purchases only generic drugs. However, the health ministry says that large companies are manipulating the prices of even generic drugs by buying up smaller generic companies and keeping prices high to discourage their use.

Poornalingam, who is the chairman of the health ministry task force on procurement and is charged with spreading the gospel to the states, says that there is resistance among states to adopt the TNMSC model because of vested interests in the governments, bad suppliers who have a grip on the system and lack of champions. He has suggested a central procurement agency too to source drugs and vaccines for national programmes such as malaria eradication, pulse polio and HIV. He expects such a company to save about Rs. 300 crore every year by setting up 50 warehouses and a chain across states at a cost of just Rs. 50 crore. So far, only Kerala has set up a functioning corporation. West Bengal has set up one and appointed the managing director, but it is yet to start functioning because the employee unions are yet to come around to support it. Chattisgarh and Bihar cabinets have approved setting up a corporation each and Rajasthan is in the process of taking it to the cabinet.

Meanwhile the district health office at Thiruvallur proudly displays a shield won for being one of the best performing under NRHM. It is a shield that TNMSC could wear with pride.

Read more: http://www.business.in.com#ixzz1QyvcIQIm

[arun82]

Frontier Lifeline To Raise Rs 20 Cr For Medicity Project - Frontier Mediville


Frontier Lifeline Private Limited is looking to raise Rs.16-20 Cr through PE to invest in first phase of its Rs.1000 Cr proposed medicity project – Frontier Mediville.

The company has already arranged a term loan of Rs.90 Cr from SBI and Bank of Baroda for the first phase and may also look around Rs.500 Cr PE funding for the second phase.


Promoted by K M Cherian, Frontier Lifeline is a 120-bed specialty heart hospital. Frontier Mediville is being set up on 360 acre in Elavur Village (Tada) in Chennai. Of this, 42 acre has received SEZ status from the central government in 2009.

Frontier Mediville will be developed as a JV with Tamilnadu Industrial Developmental Corporation (TIDCO) under PPP and is expected to be completed in three phases.

The first phase will comprise a medical science park in the SEZ zone in Elavur village and also includes a research and training centre and an animal laboratory to house CROs. It will lease out the research facilities to CROs.

Phase II will include Rs.144 Cr bio hospital with 200 beds in the SEZ and 750-bed multispeciality general hospital would be developed outside the SEZ. Company may also raise Rs.500 Cr through PE for the second phase.

http://www.dealcurry.com/20110712-Fr...-Mediville.htm

[arun82]

North India's Population Growth Rising steeply: NGO

New Delhi, Jul 11 (IANS): India's four largest so-called BIMARU states -- Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh -- have been showing a steep rise in population despite effective methods of birth control in primary health care centres there, a brief by an NGO on World Population Day said Monday.

"Nearly 15 million women, mostly belonging to the 'bottom of the pyramid' in the four large North Indian states of Uttar Pradesh, Rajasthan, Madhya Pradesh and Bihar do not access available methods of family planning," said Devendra Kishore, professor of population programme management at the Management Institute of Population and Development (MIPD), in the brief.

The study depicted a contrast between northern states and southern states that have shown signs of population stabilisation.

"Southern states of Tamil Nadu, Kerala, Andhra Pradesh, Karnataka have been able to achieve the replacement level fertility, meaning a couple having only two children has kept the population growth almost stable," added Kishore.

The replacement rate in the region has been 2.1 children per women, said the brief, primarily based on the census statistics of 2011.

"Northern states have a long way to gap before they achieve the desired target. And that is a cause of concern," Kishore said in the brief.

World Population Day is aimed at increasing people's awareness on population issues such as importance of family planning, gender equality, poverty, maternal health, and human rights.

The brief indicates India's population will grow by 16-17 million annually in coming decades since more than 50 per cent of the population is in the reproductive age of 15-49 years.

http://www.daijiworld.com/news/news_...steeply%3A+NGO

[arun82]

INDIA: India seeks to regain lost ground on medical tourism

One of the pioneers of medical tourism, India has lost ground to many of the new entrants into the medical tourism market. Complex rules and processes have slowed its progress.

For years, India has promoted medical tourism but many agencies, hospitals and local states compete with each other for the same business at prices so low they put off many Americans and European visitors. There has been little concerted marketing, while advertising has all been of the “high quality, very cheap, we do everything’ variety that is being replaced elsewhere with more sophisticated targeted marketing.

As a pioneer, lack of official help has partly been due to the state based nature of government and partly down to guestimates totally lacking any statistical basis, that they were getting one or two million medical tourists year – a figure that generated complacency. These bloated figures may have been due to simple mistranslation with English speaking people translating 1 lakh as 1 million, when it actually means 100,000. India’s tourism authorities have come up with new figures that suggest that in 2011, there will be between 85,000 and 100,000 medical tourists going to India. Putting these figures into perspective, India enjoys 5.6 million worldwide visitors each year.

India has carried out a series of road shows to promote medical tourism for specialized dental treatment, knee transplants, neurosurgery as well cosmetic surgery. So far this year 63,000 medical tourists have traveled to India for treatment says the tourism ministry, and it is expecting somewhere between 85,000 to 100,000 medical tourists by the end of the year; tourism to India is very seasonal and concentrated in certain months.

Despite growth in the medical tourism sector, India has faced tough challenges in last few years with competitive pricing from Malaysia and Singapore. So India arranged a series of road shows to promote medical tourism. In the last few months these shows took place in Cambodia, Thailand, Vietnam, the USA, England, Scotland, South Africa and Caribbean countries. The roadshows had presentations and one-to one business meetings between trade delegations from India and travel trade representatives in the respective countries.

According to the Ministry of Tourism 63,000 medical tourists arrived from Iran, Afghanistan, Turkey, Pakistan, Denmark and the US in the first 6 months of 2011.The destinations of the roadshows and the source countries quoted, suggest that India has failed to convince Europeans to travel there for treatment.

Indian hospital groups have invested heavily in building or buying hospitals, partly with the potential of medical tourism in mind. But so far they have seen little return on their investment in India, often making more money from medical tourists when they have built of bought hospitals in other countries.

Max Healthcare is aggressively expanding nationwide and Dr Pervez Ahmed, of Max Healthcare recently accepted that they are no longer just targeting patients from the US, UK and other Western nations, but also at patients from the SAARC countries as the people of these nations do not have access to good quality healthcare; South Asian Association for Regional Cooperation (SAARC) countries include-Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan and Sri Lanka.

Complex national and local regulations are putting off potential medical tourists. Tamil Nadu gets 150 medical tourists a month but tourism officials say they could get many more if regulations were relaxed. There is an increase in the number of foreigners going to Ahmedabad for medical treatment despite a procedure for police verification that required at least three visits to the police; and although this has been replaced by just one visit to the local police station before going home, medical tourists still have to download registration forms and submit them to the police through the hospital authorities. Any foreign national seeking medical treatment in the city has to register within 14 days after arrival, and report to the police at the special branch of the police commissioner’s office with a number of documents. These include proofs of their stay in the city, ailment for which treatment was sought, and documents from doctors, hospitals and hotels, among others. There seems a lack of understanding in India that Europeans and Americans will not put up with this unnecessarily bureaucratic, cumbersome and time consuming process-however cheap treatment is.


http://www.imtj.com/news/?entryid82=298281

[TShyam]

So true.. It would be great if this is brought to the notice of our bureaucrats or better still CM herself. There is too much unwanted procedures which can be done away with. Healthcare attracts big bucks, employs lots of people, is a huge boost for the local economy and it should be given top priority.

[Vasu]

Action for Rural Rejuvenation (ARR) is a multi-pronged, multi-phased, holistic, outreach program whose primary objective is to improve the overall health and quality of life of the rural poor. ARR is a unique, well-defined philanthropic effort, which enhances existing development schemes by supporting indigenous models of health, disease prevention and community participatory governance, while offering primary health care services and allopathic treatment through its dedicated team of qualified and trained personnel..... see more

[arun82]

TNs health policy impressive

CHENNAI: Stressing on the need for innovation in the areas of disease prevention and the adhering government policies, Thomas R Frieden, Director, US Centers for Disease Control and Prevention, said that he found the health related policies adopted by the government of Tamil Nadu “impressive”.

Delivering a lecture on how public health is integral to economic growth and national progress, Frieden said, “The state government here has made efforts to upgrade labs at a district level. This is a commendable move as it forms a very good data collection model at every level,” he said.

He indicated that such a model followed in most Indian states formed the basis of the Global Disease Detection Centre and the Epidemic Intelligence Service, set up by the National Centre for Disease Control (NCDC) with their assistance in New Delhi. The services would be expected to become a reality by the first quarter of 2012, he added. “The major function of these agencies would be to employ epidemiologists. They will track and stop epidemics by monitoring the data feed of patients at all levels.

Frieden reiterated that the Indian model of handling Tuberculosis was a model that the world could follow. And also added that the Tuberculosis Research Centre, Chennai, had made impressive contributions that have led to the continued control of the once-dreaded disease.

“A sound public health system is the basis of any progressive society. Only collective action and spreading information can make a difference in developing societies,” he said.

Quoting studies conducted, Frieden also pointed out that non-communicable diseases were the largest mortal threat for young Indians going into the next few decades. “It is estimated that by 2020, four times as many young adults will be killed by non-communicable diseases, unless smoking, diabetes and obesity were curbed effectively.”

http://ibnlive.in.com/news/tns-healt...04-60-120.html

[arun82]

State leads the way in organ transplant

MADURAI: Tamil Nadu is a role model for other states in organ donations, according to an expert in cadaver transplantation. Speaking at an awareness programme on organ donation organised on Friday by Meenakshi Mission Hospital and Research Centre in Madurai, convenor Dr J Amalorpavanathan said that more than 200 people have donated their organs between October 2008 and July 2011 in order to save the lives of others.

"As per the current cadaver transplant census report, Tamil Nadu's contribution is about 1.3% per million donations, in 2010. The deceased donors per million population per year are that of USA -20.7 percentage, Europe 15.9 percentage, Asia-1.1 percentage including Tamil Nadu contribution is 0.8 percentages.

Tamil Nadu is the number one state in organ donation in India. However, contributions from the southern districts, have been very poor," Amalorpavanathan said.

He also said that since all major religions are now endorsing organ donations, medical administrative officials should create more awareness programmes in southern districts. "We have created three divisions for organ donation to enable speedy transplantation of organs on the patients. While the north division covers Chennai to Vellore, south division covers Trichy to Nagercoil and the west from Vellore to Coimbatore," he said. He told TOI that medical officers were often confused about the laws related to transplantationand that is why they were conducting awareness programmes in second-tier cites like Madurai

. "Only four persons have donated organs to patients in the past one year," he said. Some one brain goes steam death while four doctors confirmed it and convince the family members of the deceased and taken the organs from the body for save other persons life. The 99 percentage of organs have gotten from accident victims because their brains would be gone to steam death but other organs functions have worked very well", he said.

Dr K Samapathkumar, nephrologist said that according to the Indian Medical Tribune survey there was less than 50% overall positive response in favour of donating solid organs. "In the last 10 years, 1000 cadaver organ transplants including 900 kidney and 100 liver and heart transplants have been performed. Almost 40% of the cadaver transplants in India are done in Tamil Nadu, and its organ sharing network could become the role model for rest of the country," he said.

http://timesofindia.indiatimes.com/c...ow/9753131.cms

[murlee]

Affordable healthcare with revamped insurance scheme

The State Government plans to give a big impetus to healthcare, with accent on modernisation and accessibility of services. The Government had proposed an outlay of Rs 4,761 crore for healthcare this year, during the recent Budget session.

Key among its various initiatives are the revamped health insurance scheme and the proposal to convert the new Secretariat complex into a multi-specialty hospital and medical college.

Super specialty centres

The multi-specialty hospital in Chennai's Anna Salai proposes to provide specialty treatment free of cost to the needy, will house modern equipment; medical experts, nurses and technical staff will also be appointed. The hospital will match the facilities at the All-India Institute of Medical Sciences in New Delhi, said the Chief Minister, Ms J. Jayalalithaa, while addressing the State Assembly a few days ago.

In the recently presented Budget, the State Government had also announced setting up of a super-specialty centre in Annal Gandhi Government Hospital, Tiruchi, at a cost of Rs 100 crore.

Universal healthcare

The Budget proposals also talk about upgrading diagnostic services in district hospitals with supply of additional equipment at a cost of Rs 55 crore under the Tamil Nadu Health System project. Under public-private partnership, computer-aided laboratory facilities will be set up in all districts in a phased manner, the Government announced in its Budget.

Two major schemes, the National Rural Health Mission (NHRM) and Tamil Nadu Health System Project are being implemented to achieve the goal of universal healthcare in the State. During 2011-12, the Government proposes to spend Rs 900 crore under NRHM. The State Government says it will focus on improving primary healthcare facilities in urban areas as they are inadequate at present.

A ‘Hospital on Wheels' scheme will be launched by the Government to provide healthcare services at the doorstep in remote areas. The Government also proposes to distribute sanitary napkins free of cost to rural girls. A sum of Rs 46 crore has been provided in the Revised Budget estimates for this purpose.

New health insurance scheme

Ms Jayalalilthaa has proposed a new health insurance scheme in place of the erstwhile government's scheme. The scheme extends medical cover up to Rs 4 lakh (for four years) from Rs 1 lakh before. It covers 950 types of medical treatment. The new scheme also seeks to give government hospitals priority over those in the private sector. Certain types of treatments will be permitted only in government hospitals and special wards will be set up for this in hospitals approved by the Government.

Bids invited

A tender inviting bids from insurance company to implement the Chief Minister's Comprehensive Health Insurance Scheme in Tamil Nadu has already been announced.

The coverage will be up to Rs 1 lakh per family per year with provision to pay up to Rs 1.5 lakh per year per family for certain specified procedures.

The Project Director, Tamil Nadu Health Systems Society, will pay the insurance premium on behalf of the eligible persons to the successful bidder. The premium will be paid every year in four quarterly instalments.

Private hospitals in the city have welcomed the State Government's health insurance scheme. Says Ms Preetha Reddy, Managing Director, Apollo Hospitals: “People who need healthcare will be able to get it; the scheme is going to be something everyone will be proud of. Government hospitals are upgrading themselves so they should be given priority. The private sector should work alongside the Government.”

http://www.thehindubusinessline.com/...cle2390417.ece