Maharashtra: Valiant Covid fight, but need future-proofing

MUMBAI: Faced with Covid-19, the worst healthcare crisis in modern history, the MVA government in the state introduced a number of measures from March that had never been implemented in the country before.
CM Uddhav Thackeray’s government extended the benefits of the government insurance scheme Mahatma Jyotiba Phule Yojana to all Covid-19 patients admitted in its empanelled hospitals, announced the taking over of 80% of beds in the private sector for Covid-19 management, capped the prices of essentials right from plasma therapy to CT scans to face masks, among other measures.
“These may be good measures, but they are, at best, a firefighting response,” public health economist Ravi Duggal said.
Few long-term measure to handle any future Covid-like pandemic have been announced. “Efforts to improve and strengthen the public health system are missing,” he said.
Among the many shortterm measures were the setting up of jumbo field hospitals, mobile sample collection buses and mobile ICUs.
The MVA government was barely four months into office when the pandemic struck, forcing all attention and resources towards checking its spread. Among chief minister Thackeray’s first tasks was to gather some of the best-known doctors to work out Covid-control plans and draw up standard operating procedures for drugs.
Dr Abhijit More, a member of the NGO Jan Swasthya Abhiyan and a member of the Aam Aadmi Party, said he would rate the new government’s healthcare role at 6/10. “It came up with good measures and implemented them well enough, but measures such as regulating private hospital charges should be a permanent measure and not be allowed to lapse in December,” he said.
He said price regulation is a feature of the Clinical Establishment Act that the state government has not yet implemented. The health portfolio was held by the Shiv Sena in the previous government.
“One of the first promises of the MVA health ministry was to fill up vacancies in the health sector — in some sections vacancy is almost 70%,” Dr Anant Phadke, a public health expert from Pune, said.
During the Covid-19 peak in May in the city, the government had to call upon healthcare personnel, including doctors and nurses, from other parts of the state as well as other states like Kerala.
“Every year, 20,000 medical students graduate across various medical practices — allopathy, ayurveda and homeopathy, among others — and we have 1,800 primary healthcare centres in the state. Why can’t these graduates be rotated across these centres,” asked Duggal.
Throughout the Covid-19 crisis, there have been instances in various parts of the state where private doctors roped into the government’s Covid-19 care system were not paid for months. “Maharashtra is perhaps the only state where medical staff in different categories get different pay scales. While some are on the Seventh Pay Commission, some are still paid Sixth Pay [Commission] scales,” More said.
There also is the long battle between the public health and medical education departments. Almost 80% of the Covid-19 patients have been treated in civil hospitals and dispensaries run by the public health department, while the 3%-5% serious patients have been sent to staterun medical colleges and hospitals handled by the medical education department. “Yet DMER walks away with all the bouquets and adulation,” a doctor said.