Monday, July 5, 2021

Wanted: A PLI scheme for doctors, nurses? – Express Healthcare



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Unfortunately, doctors and nurses cannot be assembled and rolled off a production line

Last year, 736 doctors lost their lives due to   COVID-19,   says  Dr  Jayesh  Lele,   secretary   general,   IMA. This year’s second wave has already claimed 126 doctors. At one point, 49 of these doctors were from one state alone: Bihar.

Besides COVID-19, doctors and nurses are also perishing in fires breaking out in ICUs. Often caused by malfunctioning or overheated  ventilators,  medical  personnel  are  particularly  vulnerable as their  PPE  catch  fire  while they try to save their  colleagues and patients. We are also hearing of young doctors driven to suicide, anguished by the lives they could not save due to lack of oxygen and medicines. Exhausted doctors,  nurses  are  taking  to  social  media to literally  beg patients with mild COVID-19 symptoms  to  not  insist  on  blocking  a  hospital bed/oxygenator when all they need is home quarantine.

To   fight   any   war,   we   need   soldiers   and   ammunition. Looks like we are running short on both counts in the war against COVID-19.

But while more manufacturing units could be offered the Production Linked Incentive (PLI) scheme to make more medicines, vaccines, ventilators etc, doctors and nurses cannot be assembled and rolled off a production line.

In fact, the government’s PLI scheme for medical devices and medical device parks will hopefully ease the shortage of medical equipment (see cover story in the May 2021 edition: Making med-devices for Bharat and the world)

Worse,  doctors  are  already  warning  us  to  be  prepared for the third surge, projected in June-July this year. This only means more doctors and nurses, at least 20 per cent trained for ICU duty, will be needed.

Which is why Prime Minister Modi’s moves on May 3 to boost the availability of medical personnel to fight COVID-19 are very welcome and in line with most of the suggestions of healthcare associations. But here too more could have been done.  For  example,  Dr  Ravi  Wankhedkar,  Chairman,  IMA Covid Registry terms the decision to postpone the PG NEET exam for at least four more months as “retrograde”  as  it  will  keep  the  more  than  1  lakh MBBS doctors who keep appearing for PG NEET year after year, out of the healthcare delivery system, adding to the burden of “serving junior doctors who are already physically and mentally fatigued.”

It is unfortunate that we still hear of patients’ relatives attacking medical staff, as recently happened at Apollo Hospital’s Sarita Vihar, Delhi facility. No doubt the demise of their family member due to the unavailability of an ICU bed is tragic but taking the lives or injuring doctors and nurses puts more patients at risk.

Unfortunately, it is not just patients and relatives who take medical staff for granted. For instance, the health department of the Government of India and various states should maintain an official record of healthcare   workers   affected   and   died   due   to   COVID-19 with their vaccination status. As per IMA, this is not being done, hence the association has stepped into   collect   this   data. IMA has also created a COVID Martyrs Fund, from which Rs 1.6  crore  has already been disbursed to families of deceased doctors.

Keeping in mind that monetary incentives cannot be the sole motivation for healthcare professionals who are after all risking their lives when they take upCOVID-19 duties, what could be considered a fair incentive?

A notification from the Himachal Pradesh government dated May 3, announced incentives ranging from Rs 3000 per month for fourth and fifth-year MBBS students, contractual doctors, and junior and senior residents; to Rs 1500 per month for nursing students, contractual lab staff and GNM third-year students.

Dr Wankhedkar calls this a “cruel  joke  by  the Himachal Pradesh government”, reminding us that it works out to just Rs 100- Rs 50 per day.

The Supreme Court had to intervene before the May 3 decision from the PMO.  The apex court’s April 30 response to a PIL asked for details on medical oxygen supplies, medicines and procuring vaccines for all. It also asked the government how many families of medical personnel who died of COVID-19 were still awaiting clearance of their insurance claims under the Pradhan Mantri Garib  Kalyan Package  which  had  been  extended  to  around  22  lakh  healthcare  professionals.

The apex court also drew attention to how health-care professionals who got infected in the line of duty were often left to fend for themselves without beds, oxygen or medicines for themselves or their family members.

The SC’s response also mentioned that the central government should examine and ensure that in addition to the schemes it had framed, other facilities such as the availability of food, resting facilities between work, transportation, non-deduction of leave etc should be provided to healthcare professionals on COVID-19 duty.

It is these facilities that will motivate healthcare professionals, more than the monetary incentives, but it is sad that the Supreme Court had to step in before we realised that we cannot fight COVID-19without doctors, nurses, lab technicians, etc. After all, as Dr Devi Shetty put it, beds and ventilators don’t treat patients, it’s doctors and nurses who treat and save lives.

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