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ohftT{ whfNzr w[Zy wzsoh ih d/ Bkb. f;js ns/ gfotko GbkJh ftGkr gzikp 4-9-2009. HEALTH DEPARTMENT. Wings – Director Health Services PHSC – Secondary level hospitals Drug Controller Food Safety – PFA Employee State Insurance Ayurveda & Homeopathy NRHM PSACS.
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ohftT{ whfNzr w[Zy wzsoh ih d/ Bkb f;js ns/ gfotko GbkJh ftGkr gzikp 4-9-2009
HEALTH DEPARTMENT Wings – • Director Health Services • PHSC – Secondary level hospitals • Drug Controller • Food Safety – PFA • Employee State Insurance • Ayurveda & Homeopathy • NRHM • PSACS
BUDGET FY (2009-10) Amount in Crores HSE (Excluding Medical Education) is 0.79% of the GDP against desired 2 – 3%. Per Capita Public Expenditure of Health – Rs. 448/- per year.
Requirement of New Health Institutions – Sub Centers • 2950 Sub- centers are functioning. • Shortage of 289 Sub Centers as per census 2001 and 687 Sub Centers as per estimates of 2011 population , as per norm of 1 sub centre for every 5000 population. Cost of new Sub Center is Rs. 7 lac.
Requirement of New Health Institutions – PHCs • 394 PHCs are functioning. • Shortage of 146 as per census 2001 and 212 PHC’c as per 2011 estimated population . Rs. 1 crore per PHC.
Requirement of New Health Institutions – CHCs • 142 Administrative Blocks in the State. • One CHC is to be provided in each block.
Posts - 8 New districts i.e. Mansa, Moga, Muktsar, SBS Nagar, SAS Nagar, Barnala, F.G.Sahib and Tarn Taran were created after 1992 but all the required posts for the office of Civil Surgeons have not been sanctioned. In all 274 new posts of other than Class-IV are required. • Office - There is no office accommodation for the office of Civil Surgeons in these 8 districts. The office of Civil Surgeon at Amritsar, Ludhiana, Patiala, Gurdaspur and Hoshiarpur required to be constructed at proper place. The total requirement of funds would be about Rs. 26 crore. • Residence - Civil Surgeons of districts Amritsar, Barnala, F.G.Sahib, Hoshiarpur, Kapurthala, Mansa, Moga & SBS Nagar do not have residential accommodation earmarked. They are staying in the premises of Senior Medical Officers or in Private Accommodation. Staff and Building for New Districts
Details of posts required at Newly created districts Shortage of Staff Contd..
Shortage of Staff Contd.. Details of posts required at Newly created districts Contd..
Drug Inspectors • 19 posts of Drug Inspectors are sanctioned in the state . 1 Inspector for 1 district. • Present strength is grossly inadequate for about 22000 shops. • 38 posts of Drug Inspectors are more required so as to have one Drug Inspector for every 600 chemist shop. Food and Drug Control
Food and Drug Control • Food Inspectors • 23 Food Inspectors – sanctioned. Only 1 inspector for a district. • There should be at least 1 Food Inspector in every Sub-Division. • 53 more Posts of Food Inspectors are required.
Requirement of funds for existing Health Institutions • Sub-Centres – Out of 2950 Sub-Centres 1030 are functioning from Dharmshalas etc. New buildings would require Rs. 60 crore. • PHCs - 80 PHCs out of 394 PHCs are similarly situated. A sum of Rs. 80 crore is required for these new buildings.
Requirement for Infrastructure [As per 2011 Estimates]
Shortage of Vehicles/ Ambulances • Ambulances were procured more than 10 years back and majority of them are not road worthy. • 172 vehicles (Ambassador (27), Gypsy(26), Trucks(10), Buses(39), Jeep(59) and Ambulances(11) were condemned and Rs.95.47 lacs was deposited in the State Treasury. • Due to its condemnation and auction there is huge shortage of vehicles. More Vehicles Required
CANCER CONTROL India – 200- 250 cases per one lakh population. Punjab - As per survey conducted by Health Department in Districts Mukatsar, Bathinda , Faridkot and Mansa the prevalence of cancer patients is 52.2 per lakh population (2005 survey).
CANCER CONTROLContd.. • The number of deaths because of Cancer in 2007 in Bathinda, Faridkot, Mansa, Muktsar, Sangrur, Barnala, Patiala, Ludhiana and Ferozepur (Malwa districts) was 591. • The number of Cancer patients in whole of Punjab in Government Institutions was 2300.
CANCER CONTROL . . .Contd.. Detection of Cancer Imaging: • X-Ray: CHC, SDH, DH and Medical College Hospitals. • Ultrasound: Sub-Divisional, District and Govt. Medical College Hospitals • CT Scan: All Govt. Medical College Hospitals. Biopsy: CH Jalandhar and Govt. Medical College Hospitals. Mammography: CH Bathinda and Mata Kaushalya Hospital, Patiala Laboratory : Fine Needle Aspiration Cytology, Peripheral Blood Smear examination available at District Hospitals and Medical College Hospitals
Cancer Control .. Contd.. Treatment : Surgery : Sub-Divisional, District and Medical College Hospitals. Chemotherapy : Medical College Hospitals. Radiotherapy : Medical College Patiala. PGIMER, Chandigarh has been approved as Regional Cancer Centre for Punjab by Govt.of India. Regional Cancer Centre provides comprehensive cancer treatment services and training to Medical & Para-medical staff for detection & prevention of cancer and supportive care to patients. It is also a referral centre for other hospitals. Palliative Care: It is provided at all levels. It includes relief of pain and symptomatic treatment of terminally ill patients. It also includes provision of psychosocial support and aims at improving quality of life of patients.
Cancer Control .. Contd.. Projects completed: Mammography unit at Civil Hospital Bathinda and Mata Kaushalya Hospital Patiala. Brachytherapy Machine costing Rs 70 lacs for the treatment of cancer patients has been installed at Govt. Medical College Patiala. Cobalt Source for the treatment of cancer patients has been installed at Sri Guru Ram Dass Institute of Medical Sciences and Research with assistance of Rs. 25.00 Lac from Govt. of Punjab.
Cancer Control .. Contd.. Ongoing Projects: Multispecialty & Cancer Hospitals are being setup at Mohali and Bathinda in Public Private Partnership mode in collaboration with M/S Max Health Care India. Regional Cancer Centre at Medical College Amritsar: Government of India has provided Rs. 2.00 Crore for machinery and equipment. Simulator and Treatment Planning system for Govt. Medical College Patiala. Government of India has provided Rs. 2.00 Crore for this purpose. Mammography unit is to be installed at Medical College Patiala. Rs. 30 lacs have been provided for this. Radiotherapy unit at Sri Guru Gobind Singh Medical College Faridkot. Rs. 3.00 Crore have been provided by Govt. of India for machinery and equipment and construction.
Cancer Control .. Contd.. Projects under consideration of Govt. of India : Onconet Service- A Tele Medicine Service is to be established by Govt. of India. Regional Cancer Centre PGI will be connected to four district Hospitals namely Hoshiarpur, Sangrur, Bathinda and Muktsar for this service. Setting up of a Cancer Registry in Districts Bathinda & Muktsar. District Cancer Control Programme for districts Hoshiarpur and Patiala. This programme is to be implemented by PGI Chandigarh.
Cancer Control .. Contd.. Other facilities to cancer patients: Financial assistance under State Illness fund to cancer patients belong in to below poverty line families up to the tune of Rs. 1.5 Lacs. School children suffering from cancer are provided free treatment by Punjab Government. Punjab Government provides free travel facility to cancer patient and one attendant. Health Education activities are under taken to make people aware about the causes signs and symptoms and prevention of cancer.
Preparedness to Combat Drug Abuse In The State • There are 12 De-addiction Centers functional, 3 in State medical Colleges i.e. Patiala, Amritsar and Faridkot and 9 in Govt. Hospitals Tarn Taran, Pathankot, Kapurthala, Jullandhar, Bathinda, Faridkot, Muktsar, Hoshiarpur and Badal. 2 De- Addiction Centers at Civil Hospitals Talwandi Saboo and Ferozpur are in the process of being established. A state level 50 bedded Drug Dependence Treatment Center is being set up at Government Medical College, Amritsar. • 22 De-addiction Centers/Counseling Centers in Punjab are being run under the control of Ministry of Social Welfare, Govt. of India. Out of this 13 centres are run by Indian Red Cross Society and 09 by Non-Govt. Organizations. 37 such centers in Punjab (33 functional and 4 under construction) is insufficient to handle the drug abuse problem in the State. In 33 functional DDTCs there are 142 beds out of which 30 beds are with State Medical Colleges and 112 are with the Department of Health and Family Welfare, Punjab in various Civil Hospitals.
Preparedness to Combat Drug Abuse In The State.. Contd.. • There are 26 Psychiatrists within the department working at different health institutions of the state and are providing services in drug abuse prevention at their place of postings. All of them can be judiciously and optimally utilized to manage/advisor to DDDAC/any drug de-addiction centers in every district.) The NDDTC, AIIMS has already trained 20 psychiatrists as Master Trainers in Drug Abuse Prevention. It has also trained 10 health personnel from four districts of the state (4 psychiatrists, 3 staff nurses, 3 laboratory technicians) for Opioid Substitution Clinics which are going to be established by GOI to prevent IDU in collaboration with NACO. • Health department has already commissioned a study on “Drug abuse in the border districts of Punjab” funded by National Rural Health Mission, (NRHM), Punjab at the cost of Rs. 5.0 lakh in 2009.The study will be completed by March 2010. There are many steps being taken to establish de-addiction centers like • DHS (16):- Annual Plan 2009-10- Rs. 200.0 lakh, Total Plan Outlay =Rs. 330.0 lakh • DHS (17) State Level Drug Dependence Treatment Center (SDDTC), Govt. Medical College, Amritsar (Swami Viveka Nand Drug Dependence Treatment Center ):-Annual Plan2009-10 Rs. 200.0 lakh, Total Plan Outlay =Rs. 334.0 lakh,
Preparedness to Combat Drug Abuse In The State.. Contd.. • Trained Manpower: -
Drug De-Addiction Program Contd.. • Drug Menace: During the year 2008, 617 Joint raids were conducted by the Drug Inspectors with the help of police department to check the menace of drug addiction. • 37 licenses of chemist shops have been cancelled and licenses of 294 chemists were suspended due to various contraventions of drug and cosmetics Act. • Drugs worth Rs. 3.18 crore have been seized during the year 2008 and action taken against the defaulters. • Drugs worth Rs. 1.34 crore have been seized during the year 2009 (upto July) and action taken against the defaulters. • 329 Joint raids were conducted and 119 licenses of chemist shops have been cancelled and 244 chemist's licences were suspended during 2009(upto July).
Prevention of Food Adulteration • During 2008, 290 samples out of 3520 samples were found to be adulterated. • During 2009 (upto July) 183 samples out of 1981 samples were found to be adulterated.
Summary – Issues and Challenges • Food Adulteration – Significant seizures but requirement for extra enforcement staff – 53 Food Inspectors (One per Sub-Division). • Drug Menace – Campaign launched and habit forming drugs worth more than Rs. 6.00 Cr. seized during last 2½ years. Need for increasing the strength of Drug Inspectors from 19 to 57 so as to have 1 Drug Inspector per every 600 Chemist Shops. • Sex Ratio – Latest data shows an improvement from 796 in 2001 to 838 in 2006 as per SRS 2007. Need for strengthening the schemes for girl child. Some States are depositing upto Rs. 30,000/- per girl child at birth to enable her to receive staggered payment through academic career.
Summary – Issues and Challenges • Access to Health Care – Free delivery, free referral for school students, free treatment for BPL families in Govt. Hospitals. Implementation of RSBY for BPL families in all the districts for cashless treatment upto Rs. 30,000/-. Implementation of Bhai Kanhaya by Cooperation Deptt. for cashless treatment upto Rs. 2,00,000/- for members of Co-op. Societies. State illness fund for BPL families. Need – Definition of BPL families restrictive and need for enlarging the scope of insurance scheme for greater number of poor people. Supply of free medicines – more medicines should be added.
Summary – Issues and Challenges • Telemedicine – Made functional but needs to be strengthened. Greater involvement of medical colleges. • PPP Projects – Two Hospitals awarded. Case of 3 Hospitals – Mother and Child Hospital, FGH Sahib, SDH Nangal and Nabha being referred to PIDB. • Jan Aushadhi Stores – 8 opened and remaining 12 would be opened by 30-11-2009 for sale of cheaper generic medicines manufactured mostly by CPSUs.
