TN launches urgent hospital overhaul after CMO flags gaps in infrastructure, staffing

CHENNAI: The Tamil Nadu government has initiated an extensive exercise to rectify deficiencies in government hospitals after the Chief Minister's Office (CMO) flagged shortcomings in infrastructure, manpower, sanitation and patient amenities across the State. Acting on the CMO's observations, the Directorate of Medical Education and Research (DME&R) has appointed 50 nodal officers to coordinate corrective measures and ensure time-bound compliance in all medical college hospitals. 

The Directorate of Medical Education and Research has already appointed Dr Sudharshini, Professor of Community Medicine, Government Vellore Medical College Hospital, as the nodal officer for quality aspects, including patient experience and satisfaction indicators.

A circular issued by the DME&R on July 9 directed all heads of institutions to nominate nodal officers immediately and submit details the same day. The move follows a note from the CMO that highlighted deficiencies relating to sanitation, drinking water, toilets, patient and attendant amenities, infrastructure, security and equipment in government hospitals besides bribe practices. The Health Department has asked district authorities to review the findings, coordinate with collectors and submit action-taken reports with before-and-after photographs. 

The review covers over 300 government healthcare institutions under the Directorates of Medical Education, Medical and Rural Health Services, and Public Health.

Chennai hospitals under scrutiny

The report paints a worrying picture of several of Chennai's premier government hospitals, identifying manpower shortages, ageing infrastructure and inadequate patient facilities.

Rajiv Gandhi Government General Hospital (RGGGH), one of the State's largest tertiary care centres, has been flagged for inadequate housekeeping, poor sanitation, shortage of MRI facilities, overcrowding in emergency services and insufficient security. The report also points to unregulated parking, malfunctioning CCTV cameras in parts of the campus, damaged infrastructure, lack of purified drinking water and allegations of bribery involving housekeeping and security staff. 

Government Stanley Medical College Hospital has been cited for a shortage of doctors and nurses, delays in treatment, poor internal roads, drainage problems and allegations that staff seek money from patients to expedite movement for tests and admission to wards. 

At Kilpauk Medical College Hospital, the report notes that only a handful of MRI scans can be conducted each day due to equipment shortages. The emergency department is reportedly staffed largely by junior doctors, while security, parking management and CCTV coverage require immediate improvement. Renovation of older buildings has also been recommended. 

Government Royapettah Hospital has been criticised for non-functional X-ray equipment, broken ambulances, staff shortages, overcrowding, inadequate attendant facilities and allegations that some ward staff demand money for shifting patients and facilitating scans. The report also notes that attendants often sleep on hospital floors because of insufficient waiting facilities. 

At Government Omandurar Multi Super Speciality Hospital, the review highlights an acute shortage of cardiologists, forcing patients to seek costly treatment in private hospitals.

The Institute of Obstetrics and Gynaecology (Egmore Maternity Hospital) has been flagged for poor oversight of contract staff, allegations of bribery, unsafe hostel conditions and environmental issues caused by overgrown vegetation and abandoned structures. 

The report also points to fire safety concerns and malfunctioning elevators at Egmore Children's Hospital, while Government Kasturba Gandhi Hospital for Women and Children has been asked to address unsafe hostel conditions and remove construction debris and abandoned vehicles from the campus. 

Beyond individual institutions, the report recommends affordable food outlets inside hospital campuses, improved drinking water and toilet facilities, simplified medicine distribution, dedicated restrooms for attendants, and expansion of cancer treatment services in Chennai hospitals.

Statewide deficiencies

The review identifies similar issues across medical colleges and district hospitals in Tamil Nadu.

Hospitals in Chengalpattu, Cuddalore, Tiruvannamalai, Coimbatore, Salem, Tiruppur, Pudukkottai, Sivaganga, Ramanathapuram, Thanjavur, Thiruvarur, Tirunelveli, Kanyakumari and Thoothukudi have reported varying combinations of doctor and nurse shortages, unhygienic toilets, damaged buildings, poor waste management, lack of drinking water, equipment shortages and inadequate patient amenities.

The report also highlights problems such as stray animals inside hospital campuses, garbage accumulation, sewage stagnation, malfunctioning mortuary facilities, overcrowded wards and delayed diagnostic services in several districts.

In some hospitals, it recommends establishing specialised departments, increasing sanctioned staff strength, improving ambulance availability, upgrading laboratory facilities and strengthening campus security.

Government's response

To ensure prompt implementation, the Health Department has instructed nodal officers to coordinate with district collectors, monitor rectification work, compile action-taken reports and submit consolidated progress reports to the government for periodic review. Heads of institutions have also been directed to nominate senior faculty members to oversee implementation at the hospital level.

The document makes it clear that the government intends to closely monitor corrective measures and expects hospitals to address deficiencies within a defined timeframe. It concludes that improving basic amenities and infrastructure in government hospitals would significantly enhance public confidence in the State's healthcare system.

District-wise observations: 

The report contains specific observations for government medical college hospitals and district headquarters hospitals across Tamil Nadu.

In Villupuram, power fluctuations affecting surgeries, inadequate biomedical waste disposal and the absence of specialised nephrology and cardiology facilities were highlighted.

At Kallakurichi Government Medical College Hospital, inspectors reported dirty toilets, irregular garbage collection, lack of neurologists, inadequate drinking water facilities, poor public transport connectivity and insufficient street lighting.

In Tiruvannamalai, the report called for filling doctor and nurse vacancies, strengthening specialist departments, preventing government doctors from engaging in private practice, improving emergency care to reduce referrals to Vellore, Chennai and Puducherry, and installing CCTV cameras. Complaints of biomedical waste burning, foul-smelling toilets and stray animals inside hospital premises were also recorded.

At Salem Government Mohan Kumaramangalam Medical College Hospital, patients reportedly faced long waiting periods for MRI and CT scans. Bed shortages, poor sanitation, inadequate drinking and hot water facilities, lack of seating for attendants and allegations of security staff demanding bribes from patients' relatives were among the issues noted.

The Dharmapuri Government Hospital report referred to complaints about poor-quality food, shortage of sanitation workers despite large quantities of biomedical waste generated daily, and allegations that some staff demanded between Rs 100 and Rs 300 from patients for facilitating scans and surgeries.

For Coimbatore Medical College Hospital, the note said patient numbers had nearly doubled in recent years while staffing levels remained inadequate. The report recommended demolition of ageing ward buildings and construction of new multi-storey facilities. It also highlighted the presence of anti-social elements and homeless persons inside hospital premises, creating safety concerns. At the ESI Medical College Hospital, the absence of MRI and nephrology facilities was flagged.

The report on Tiruppur Government Medical College Hospital recommended appointing additional cardiologists and neurologists to reduce referrals to Coimbatore. It also suggested expanding ultrasound services to minimise waiting time for patients.

In the Nilgiris, authorities noted severe staff shortages, with only a fraction of sanctioned technical posts filled. The report also recommended providing dedicated ambulances for the medical college hospital and government hospitals in the district.

The observations on Tiruchirappalli included the need to renovate hospital kitchens, establish separate laundry facilities for patient linen, improve visitor waiting halls, install large-capacity drinking water tanks, strengthen oxygen supplies, provide more seating and ensure construction safety inside hospital campuses.

At Mahatma Gandhi Memorial Government Hospital, Tiruchirappalli, the report noted that although bed capacity had increased from 600 to 1,800, the sanctioned strength of doctors had not been revised proportionately.

For Karur Government Medical College Hospital, inspectors observed that two-wheeler parking inside the hospital obstructed patient movement and recommended creating proper parking facilities.

The Ariyalur Government Medical College Hospital report referred to unhygienic toilets, leaking water pipelines, biomedical waste near the mortuary, inadequate lighting and poor cleanliness. It also recommended improving public transport connectivity to the hospital.

At Pudukkottai Government Medical College Hospital, malfunctioning mortuary refrigeration units, prolonged waiting for CT scans and monkey menace were among the issues highlighted.

In Thanjavur, inspectors reported garbage accumulation, rat infestation, stray cattle and dogs within hospital premises and unchecked shrub growth.

The report on Thiruvarur Medical College Hospital described sewage leakage from a damaged septic tank near the maternity block, unhygienic accommodation for attendants, waste dumping behind the mortuary and uncontrolled growth of weeds around the outpatient block.

For Nagapattinam, severe drinking water shortages at Orathur Government Medical College Hospital were highlighted.

At Madurai Government Rajaji Hospital, inspectors observed inadequate drinking water facilities and recommended installation of four additional water tanks across different hospital blocks.

The Dindigul Government Medical College Hospital inspection noted drinking water scarcity, rainwater leakage through buildings and underground drainage overflow.

In Theni, bushes, garbage accumulation, sewage stagnation and unsanitary toilets were among the major observations.

The report on Ramanathapuram Government Medical College Hospital cited severe rat infestation, shortage of ECG machines and ventilators, inadequate drinking water facilities and insufficient mortuary vehicles.

At Sivagangai Government Medical College Hospital, deficiencies included inadequate emergency beds, damaged toilets, unhygienic mortuary facilities, garbage accumulation and heavy infestation of rats and stray dogs.

For Tirunelveli Medical College Hospital, the note highlighted stray cattle and dogs inside the campus and poor toilet maintenance.

In Kanyakumari Government Medical College Hospital, inspectors reported shortages of doctors and nurses despite expansion in bed capacity. The government Ayurveda hospital at Kottar was found to have inadequate toilets and severe rat infestation.

At Thoothukudi Government Medical College Hospital, garbage accumulation near the blood bank and mortuary blocks was observed.