public health service in india

in govt we have three tier system phcs for primary care basically aimed at..preventing and referring any complicated health problems to referral centre.they also aid in treating in minor ailmentsas well as family planning operations.
for secondary care we have community health centres..where ..specialist. .care to some problems...like obg, pediatric, ortho pedic,radiology available
for tertiary care...we have teaching institutions. .where they deal with the above specialities as well as..other super specialities. .besides they do teaching !
govt is funding all these programmes.. from budget[that is tax payers money].
the drugs, the beds, the nursing care,the hygiene care,the investigations, diet, electricity, water, toilets, as well as doctors consultation is all worked out ..with the above budget and provided free of cost to the patient.
govt employs doctors, staff nurses,pharmacists, lab technicians, and also fourth class employees.the diet, drugs, and some accessories for hospitals will be provided on tenders system. those who provide them at lowest cost..will be offered a contract.
now this system has failed to provide a decisive care..simply becoz..

1]the wages of the employess is too poor and also a lot of work...more than required..for the patient.poor wages with over burden work,,leads to less motivation.. from health workers.since you are blamed if you totally absent from work..rather than not doing proper work.so they chose later..hence delayed health care

2]the drugs, are coated through tender system rather than the best available drugs. so very quality drugs are given in public health care.so the patient is not provided with best available pharmacological service.

3]the equipment supplied is very poor. i never heard of a company..name. .which is producing, warmers, incubators,. when we got them in our IPCU..THEY STOPPED WORKING, SO THEY REMAIN SPACE OCCUPYING LESIONS IN IPCU..so poor quality of equipment

4] the corruption among fourth class employees is very high...even our gate man at my dept earnds more than HOD of dept.there is no supervision over them.. poor punishment as wll as..patients ignorance to brought the issues to authorities. .leading to rampant..corruption .now with inroduction of arogya sri..it is acting like a mafia.

5] the hospital care...is also very poor. the beds are full of bed bugs. the elctiricity is erratic. the fans never work full of dust.the toilets are not maintained.. at all. always filled with bad smell.the diet is very poor quality. if some eats that rice and other items. he will be diseased.there is no supervision over the quality...of food served.this is largely becoz of tender system.

6]teaching. it used to be very good. under graduates were taken regular classess. ugs and pgs read in library. listen bed side rounds. and learn the art of history taking and physical examination. the whole faculty..including the HOD, assist professors,senior pgs used to take clasess..regularly. this helped in retaining some of the basics..in medical education.becoz we have such a huge case load..we have variety of cases..and experience in managing wide variety of conditions.
but now what is happening..from ugs to pgs.. their main aim is..to pass exam..rather than learning medicine.the motto is some how pass the exam, take a dowry, open a clinic,then if you are lucky and you have strong community., public relations, then you are settled. if you dont get that lucky, then join some hospital or you are finacially more independent go abroad or work out side the state.there is no passion for them.no satisfaction through service. i am seeing impatience among present genaration.. unwilling to be have patience with time.they are also comparing our profession with soft ware profession.. which is totally unjustified. i am sure all of you agree that the name you earn through this profession and the satisfaction you get from this profession is un matched..with any other profession
no body is interested in spending time in library referring wide variety of books written by various authors. no research work..at all. i rarely see a genune paper presentation.
i believe all this is leading to severe erosion of confidence about them selves.this is exhibeted... when they are dealing with patients.the human bonding is missing.they rely on investigations. .thats all.hence the society is facing severe heath care mis management.

i am sure in coming days public health care in india is going to face tough time.