Thiruvananthapuram, August 27: The Kerala government’s ambitious plan to provide specialized health services around the clock in district and general hospitals has encountered its first major challenge. Led by Chief Minister V.D. Satheesan, this initiative aims to extend expert healthcare beyond medical colleges. However, government doctors have warned that without the creation of new positions and filling existing vacancies, this reform could strain the public health system.
The Kerala Government Medical Officers Association (KGMOA) welcomed this initiative on Thursday, labeling it a long-standing demand. However, they cautioned against implementing it solely by reallocating existing doctors to different locations. Such a move could weaken, rather than strengthen, the three-tier public health service system.
Health Minister K. Muraleedharan described the government’s initiative as a significant step towards bringing specialized treatment closer to the people.
In the first phase of this plan, each district is expected to include at least one district or general hospital within six months, covering specialties such as medicine, surgery, orthopedics, pediatrics, and gynecology. The plan also includes provisions for emergency procedures and surgeries during nighttime.
The government hopes that a robust network at the district level will reduce reliance on medical colleges and alleviate the patient burden on these institutions.
However, KGMOA President P.K. Sunil and General Secretary Jobin G. Joseph stated that the available human resources in district and general hospitals are far from sufficient for a 24/7 operational model. They noted, “A medical college department providing round-the-clock care may have around 100 doctors, including faculty members, senior residents, and junior residents.” In contrast, many district and general hospitals have only three or four specialists in certain departments.
Doctors argue that deploying these specialists only when needed is not a safe approach.
The association highlighted that there are already about 800 vacant positions for doctors in the health department, including approximately 300 in the specialist cadre and 476 in the general cadre. In districts like Kasaragod, Kannur, and Palakkad, over 100 doctor positions remain unfilled. There are concerns that transfers could leave primary and community health centers without essential doctors.
These institutions provide crucial services such as vaccination, maternal and child care, and control of infectious and lifestyle-related diseases, which are vital for preventing unnecessary referrals to higher-level hospitals. The KGMOA has urged the government to create new specialist positions, recruit doctors to fill existing vacancies, and strengthen emergency departments with more emergency medical officers and an effective triage system.
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