Manpower shortage leaves critical gaps in health sector

Medical interns and student nurses filling critical gaps in manpower; hospitals that face shortage of nursing staff forcing the existing professionals to spread themselves thin; and even lack of adequate personnel on security duty are the problems some of the reputed government hospitals in the city face. While public health activists warn against ignoring these issues, senior officials say efforts are on to fill the vacancies according to the requirement at each hospital.

At Government Stanley Medical College, one of the important hospitals in the city, authorities admit that the nursing staff strength has to be increased by at least one-third. “We have 350 nurses, which is inadequate. We are able to manage because student nurses from the School of Nursing are assisting us at the hospital. We should have at least 150 more nurses,” said Dr Dhanasekaran Krishnan, Deputy Medical Superintendent of the hospital.

This has an effect not just on the patience and the service provided by the hospital, but also puts the staff under tremendous strain, especially at night. “At night, one staff nurse looks after two to three wards, which is too much [for one person to handle],”said Dr Krishnan, adding: “At any given time, 30 per cent of the nurses are on leave like maternity leave. We suggest that there should be a reserve of staff nurses to handle the situation when others are on leave.”

That is not all. The Stanley hospital is also facing shortage in the number of physiotherapists, with only two each at the Physical Medicine and Plastic Surgery departments. “However, as the demand is much more, we get help from the interns from two physiotherapy colleges in the State,” said the Deputy Medical Superintendent.

The shortage of nurses is felt at the Government Multi Super Specialty Hospital, Omandurar Estate, too. “When the hospital started a few years ago, only 150 nurses were allotted. It was way too less compared to the size of the hospital - according to Medical Council of India norms,we should have a minimum of 300 staff nurses,” said a source at the hospital.

However, the administrators at the Rajiv Gandhi Government General Hospital (RGGGH) in Chennai, the biggest government hospital in the State, refused to accept that they are facing any major shortage. “We have 549 nurses and an adequate number of paramedics, both senior and junior, with experience who can ensure that treatment and medical emergencies are taken care of. But we could always work better with an increase in the number of medical caregivers,” said hospital dean Dr R Jayanthi. 

Speaking to DT Next, health secretary J Radhakrishnan said they were working with the Directorate of Medical Education to prepare proposals for additional nurses and other staff based on the requirements of each hospital. “As of now, we have already taken into consideration the need at three government hospitals,” he said.

A good majority of hospitals empanelled under the Chief Minister’s Comprehensive Health Insurance Scheme are from the private sector. This, allege activists, exposes the shortage of personnel and facilities at the government institutions in the State.

Alleging that none of the government hospitals in Tamil Nadu meets the standards of a good public health system, Ameer Khan, national coordination committee member of People’s Health Movement in India, said, “Field visits and observations have brought to light the fact that there are a number of vacancies in the State, even though there is no documented proof of this shortage.”

Recalling what they found during the investigation into the incident from Dharmapuri district where many children died at a government hospital, Khan said their investigations revealed that pregnant mothers had not undergone all the scans as required. However, their names were recorded as it would ensure they received the benefits under the Dr Muthulakshmi Reddy Maternity Benefit Scheme.

“One of the doctors at the centre stated that despite the availability of machines, the shortage of staff made it challenging for them to carry out the scans. Hence, they were referring the women to private hospitals despite registering their names in the government centres. 

But due to the high cost of scans charged bythe private institutions, the women refrained from going there,” Khan added. Stressing on the lack of trained specialists, Khan noted how more than 500 hospitals among the 650-odd hospitals empanelled under the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) are from the 

private sector. 

“We are depending on private hospitals because we do not have enough skilled professionals in public institutions. That is scary,” he said.

Hospitals also have a perennial shortage of lower level staff such as ward boys and sanitary workers. “While lower level staff are usually outsourced from a private agency like in the case of security guards, there is no replacement when the staff hired by the hospital retire,” said Dr Dhanasekaran Krishnan, Deputy Medical Superintendent, Government Stanley Medical College and Hospital. The hospital has already made a request for more staff on security deployment, as they are constructing a new building on the campus.