PUNJAB HEALTH SYSTEMS CORPORATION
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ANNEXURE - 1
PUNJAB HEALTH SYSTEMS CORPORATION
Introduction
The Punjab Health Systems Corporation was incorporated by the State Govt. in the year 1996 through enactment of Legislative Act, “The Punjab Health Systems Corporation Act, 1996” (Punjab Act No.6 of 1996), with the main objective of implementation of a World Bank assisted Health Systems Development Project for revamping of existing secondary level health care services. Under this project modernization and updation of 157 hospitals was envisaged through systems supports such as Computerization, HMIS, Disease Surveillance, Training of Personel, Quality Assurance, Bio-waste Management, Strengthening of Physical Infrastructure (Buildings & Equipments) etc.
Now the Corporation has taken over 166 Institutions which includes District Hospitals, Sub-Divisional Hospitals and Community Health Centers. The 86 Medical Institutions are situated in rural areas and 80 are in Urban areas. In addition, two Training Institutes viz. State Institute of Health and Family Welfare, Mohali, Distt. Ropar and State Institute of Nursing and Paramedical Sciences, Badal, Distt. Mukatsar as well as the Institute of Mental Health Amritsar have also come under the control of the Corporation.
MANUAL- 1
Information Under Right to Information Act
INFORMATION REGARDING ITEMS SPECIFIED IN RULE 4 (1) (b) (i)OF THE RIGHT TO INFORMATION ACT, 2005
(The particulars of the organization, functions and duties)
Punjab Health Systems Corporation
Objective
The Punjab Health Systems Corporation was incorporated with the objective to integrate and synergies the existing Secondary Level preventive, promotive and curative health services in the Punjab State since the healthy community holds the key to the Socio Economic Development of the Country. The main objectives of the Corporation are:-
i) To formulate and implement the schemes for the comprehensive development of the dispensaries and hospitals;
ii) To construct and maintain dispensaries and hospitals and maintenance of cleanliness therein;
iii) To implement National Health Programmes as per the directions of the State. The State Government and Central Government shall make available funds for this purpose;
iv) To purchase, maintain and allocate quality equipment to various dispensaries and hospitals;
v) To procure, stock and distribute drugs, diet, linen and other consumables among the dispensaries and hospitals;
vi) To provide services of specialists and super-specialists in various hospitals;
vii) To enter into collaboration for super specialties with Health Institutions both within the country or abroad to provide better medical care;
viii) To receive donations, funds and the like from the general public and institutions from both within and outside India;
ix) To receive grants or contributions which may be made by the Government on such conditions as it may impose;
x) To provide for construction of houses to the employees of the dispensaries and hospitals, and the maintenance thereof by mobilizing resources for financing dispensaries;
xi) To plan, construction and maintain commercial complexes, paying wards and providing diagnostic services and treatment on payment basis and to utilize the receipts for the improvement of the hospitals and institutions;
xii) To run public utility service and undertake any other activity of commercial nature for the delivery of health care within or without the hospital premises directly or in collaboration with private or voluntary agency or contract basis;
xiii) To engage specialized agencies or individuals in the relevant disciplines, directly or from external sources for the efficient and expeditious conduct of any of the functions detailed above; and
xiv) To provide immediate treatment in case of emergency and for un-accompanied patients.
Brief History of the Punjab Health Systems Corporation
Hospital Services at the Secondary level play a vital and complementary role. After prevention, the cure is only remedy. The Government sector is mainly taking care of preventive measures and insignificant sum of the total is being spent on curative part. It was noticed that district Hospitals, Sub-Divisional Hospitals and Community Health Centers lack the basic medical equipment, and having critical gaps in buildings and unable to provide the required diagnostic services. To revamp the whole system, a proposal was drafted seeking aid from the World Bank. The TEAM visited Punjab in March 1995, held discussions with His Excellency the Governor, the then Chief Minister, the then Health Minister, the then Chief Secretary and the then Secretaries of the Finance & Planning Department and visited a number of medical institutions. As per recommendations, a workshop was held to ascertain kinds of improvement required for providing better health care facilities to the people of the State.
THE WORKSHOP AND THE RESOLUTION:
The Department of Health & Family Welfare, Punjab, organized a Workshop from 27th to 29th April, 1995 at Kharar in which 33 Senior Doctors including the Director Health Services, all the Civil Surgeons, the Deputy Directors and Senior Medical Officers besides senior level Administrators/ Managers participated. Different groups deliberations on policy management, surgical, medical and laboratory services and identified the category of services to be provided at CHC, Sub-divisional and district hospitals including requirements in terms of staff, space, instruments and equipment. The Workshop adopted the following resolution:
"The group is of the considered and genuine opinion that there should be a fully autonomous and self-sufficient Corporation named Punjab Health Systems Corporation. This Corporation should be headed by a Chairman, who shall be the Secretary Health & Family Welfare, Punjab."
THE PROJECT
The World Bank sanctioned the Second State Health Systems Development Project of US$ 106.10 million to upgrade the envisaged areas of upgradation.
Loan Rs. 252.00 crore
Grant Rs. 127.00 crore
Share of the State Govt. Rs. 43.00 crore
To be spent as follows:
i. Civil works for renovation, Rs.174.07 crore
new construction & extensions
ii. Major/Minor equipment, surgical Rs. 66.09 crore
packs & Furnitures
iii. Vehicles & Ambulances Rs. 08.49 crore
iv. Medicines, Medical Lab. supplies Rs. 26.51 crore
v. Information Systems & Computers Rs. 11.14 crore
vi. Training & Workshops Rs. 49.66 crore
viii. Price Contingencies Rs. 73.47 crore
Total : Rs.421.88 crore
Figure are based on original allocations, which has now revised to Rs. 456.00 crore)
As per the suggestions, the Project for revamping the Secondary Level Health Care Services was proposed to help in:
(a) Adding & renovating hospital buildings at the block, sub-divisional and district headquarters;
(b) Supplementation of accommodation for essential staff;
(c) Provision of more ambulances and better machinery and equipment;
(d) Increase in body strength at some places;
(e) Additional hospital linen and accessories; and
(f) Maintenance funds for buildings, vehicles, machinery and equipments.
WHY PHSC - ADDED ADVANTAGES :
The Project itself envisaged as followed:
(a) Overcoming routine obstacles involved in the traditional administrative process, particularly in regard to release, utilization and control of funds;
(b) Retention and utilization of the User Charges (Patients Fee, etc.) at the point of collection;
(c) Collaboration with sister institutions and assistance from financial institutions;
(d) Central control over maintenance workshops; and
(e) Better financial & personnel management.
THE BENEFITS TO THE GENERAL PUBLIC :
(a) Free consultation for all;
(b) Free diagnostic analysis, medicines and also treatment like operations, etc. for Yellow Card holders, Punjab Government Employees, Pensioners, past & present Members of Legislative Assembly, Hon'ble Judges, Freedom Fighters, under trial Prisoners, under emergencies and natural calamities and under National Programmes;
(c) Full availability of equipment and chemicals, etc. for diagnostic facilities;
(d) Cleanliness, repairs and up-keeps of all buildings would be better; and
(e) The whole of the State is to be covered through 86 Government Health Centres in the rural areas.
STEPS FOR THE BETTERMENT OF EMPLOYEES :
(a) Chance of foreign training for all Doctors and Para-medical staff;
(b) Substantial training opportunities and fellow-ships, etc. within the country;
(c) Doctors would also get a chance to work in their areas of specialization; and
(d) No change in the terms & conditions of the services. Establishment matters will remain wherever they are.
IMPROVEMENT IN FUNCTIONING :
(a) The Corporation would allow quick flow of funds as permission of Finance and Planning Departments would not be required on a day to day basis;
(b) There would be quick construction of buildings, operation theaters, trauma wards and houses, etc. as the civil construction wing would be a part of the Corporation;
(c) In house repair of medical equipment will ensure smooth running of diagnostic facilities;
(d) Speedy availability of new equipment and medicines as provided in the Project agreement; and
(d) All specialized jobs where the incumbents are not available in the Department can be filled up quickly.
LEGISLATIVE MEASURES & SIGNING OF THE AGREEMENTS :
The World Bank procedures for release of soft term loans are very stringent and inflexible. As the condition necessary for negotiating the loan in Washington, the World Bank had desired that an Ordinance be passed whereby the detailed structure of the Corporation should be enacted. After approval of the World Bank Attorneys, the Ordinance was passed on 20th October, 1995. It was approved in a tripartite meeting of the World Bank, Government of India and the State Government. The World Bank in its Board of Directors meeting approved the Project on 24th March, 1996. As per the assurances given by the State Government from time to time to the World Bank, the State Government passed an Act in April 1996 establishing the Punjab health Systems Corporation and brought 150 hospitals (included in the proposed Project) under the purview of the Punjab Health Systems Corporation with some changes in the Ordinance which were agreed upon in Washington during negotiations. Specifically the Article regarding privatization was deleted and Chairman could be a Doctor of eminence. Subsequently, the Government of India, on behalf of the State Government signed Project Agreement on 18th April, 1996 and also signed directly Credit Agreement on even date with the World Bank. On the basis of legal opinion of the Advocate-General, Punjab dated 10th June, 1996 (regarding execution of Agreements on behalf of the State of Punjab/ PHSC), a valid and legally binding obligation on the part of the State of Punjab, the World Bank, opened the Credit for the Project on 29th June, 1996.
Duties / Functions of the Corporation
The main duties and functions of the Punjab Health Systems Corporation are:-
· to make regulations for fulfilling the objectives of the Act;
· to make decisions for mobilizing and borrowing money for carrying out the activities of the Corporation;
· to have linkages or agreements with specialized institutions or agencies both within the country and outside or imparting training to its personnel;
· to consider and take such action, as may be deemed fit on the basis of the annual report, the annual accounts and the financial estimates of the Corporation;
· to decide and regulate all matters concerning the regulations of this Act;
· to exercise such other powers and perform such other functions, as may be conferred or enjoined upon it by this Act or the regulations made there under;
· to hold, control and administer the properties of the Corporation;
· to administer the funds placed at the disposal of the corporation for specific purpose;
· to raise on behalf of the Corporation loans from the central or any other state Government or the public;
· to levy and collect such fees, as may be specified by regulations for various services rendered;
· to construct and maintain dispensaries and hospitals;
· to purchase, maintain and allocate quality equipment to various dispensaries and hospitals;
· to provide housing facilities to the employees of the dispensaries and hospitals, as may be specified by regulations;
Services being provided by PHSC to its Health Institutions
Secondary level health care services in Punjab have been completely revamped/ upgraded with the help of World Bank assistance to the tune of 450 crore. In all 163 secondary levels health institutions i.e. District Hospitals, Sub-Divisional Hospitals, Area hospitals and Block level Community Health centers have been revamped. Civil Infrastructure have been added in majority of these hospitals in the form of OPD block, Indoor block, Operation Theatre complexes, diagnostic blocks & administrative blocks. The old buildings have been repaired and connected with each other to form one complete hospital. Various modern, medical, surgical & diagnostic equipment in the form of X-ray machines, Ultrasound Scanner, cardiac Monitors, Defibrillators, Eye & ENT Equipment, Laparoscopes, Operation tables, Operation lights, Autoclaves, Lab. Equipment, Laundry Units, Mortuary Refrigerators, Blood Bank Refrigerators have been provided as requirement of the facility as per world Bank norms, In addition 3 memo graphic TMT machines, Operating laproscopes and operating microscopes have also been provided in selected few hospital. 50 hospitals have been computerized. In addition to 17 offices of DMCs & HMIS system have been made functional.133 new additional ambulances and 17 surveillance vehicles have been added. Extensive training has been given to the service providers to enhance their clinical skills. As a result, as compared to base year of 1996, no. of out patients has increased to 65%, no. of the surgeries to 652%, no. of X-rays to 518%, and, no. of lab. Tests to 1126% in the year 2004.
Preventive, Promotive and curative health care services are being provided in the State through a good network of Public Sector Medical Institutions. There are 39 Sub-Divisional Hospitals,117 Community Health centers (each for a population of 1.00 lakh),484 Primary Health centres (each for population 30000) 1336 subsidiary Health Centres/Dispensaries(each for population of 10000), 2858 sub centres (each for population of 5000 manned by one Male and one Female Health Worker).All the Pubic Sector health Institutions are quite accessible through metalled roads. In addition, six Rajiv Gandhi Mobile Hospitals are operating in far flung rural areas of six districts i.e.Bathinda, Jalandhar, Hoshiarpur, Ferozepore, Gurdaspur and Patiala. The State Govt. has planned to raise the strength of such Mobile Hospitals to 20 by the end of this financial year. The state Govt. is also in the process of setting up of four advanced Regional Diagnostic centers at Amritsar, Patiala, Faridkot and Ferozepore.
Facilities Available at PHSC Hospitals
· Facilities for Radiological Investigations at all levels of hospitals.