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					 STATE ADVISORY
   COMMITTEE

            6/10/2009

DEPARTMENT OF HEALTH & FAMILY WELFARE
             PHSC , Mohali


                                        1
           HISTORY
   PHSC created in the year 1995 through an
    Act to avail World Bank Assistance.
   It manages secondary level hospitals – CHC,
    SDH and DH.
   Total WB Assistance – Rs. 450 Crore from
    1996 to 2004.



                                              2
  HOSPITALS MANAGED BY PHSC

                     Institutions                        No.

DISTRICT HOSPITALS                                       19

SPECIAL HOSPITALS                                         2
(MATA KAUSHALYA HOSPITAL PATIALA AND CHILDREN HOSPITAL
BATHINDA)

COMMUNITY HEALTH CENTRES                                 114

SUB DIVISIONAL HOSPITALS                                 36

INSTITUTES                                                2
(IMH AMRITSAR AND SIHFW MOHALI)

                                                TOTAL    173


                                                               3
              EMPLOYEES
   PHSC has its own employees – Head Office,
    DMC and Supporting Staff Total – 350.
   The medical and para medical staff in the
    hospitals managed by PHSC are on Govt.
    roll.


                                            4
     MAJOR ACTIVITIES

IMPORTANT CENTRALLY SPONSORED SCHEMES:
 •     IMPLEMENTATION     OF    RASHTRIYA SWASTHYA
       BIMA YOJNA – ALL DISTRICTS COVERED – 1.07
       LAC CARDS ISSUED, WORK IN PROGRESS

 •     IMPLEMENTATION OF TELEMEDICINE.
       •      OPERATIONALIZED IN 16 DISTRICT HOSPITALS, 2
              SUB-DIVISIONAL HOSPITALS, 3 MEDICAL COLLEGES –
              LINKED WITH P.G.I.M.E.R., CHANDIGARH


 •     SETTING UP OF TRAUMA CENTRES
       •      AMRITSAR - COMPLETE AND OPERATIONAL
       •      PATHANKOT – OPERATIONAL (PARTIAL)
       •      JALANDHAR – OPERATIONAL (PARTIAL)
       •      KHANNA – CIVIL WORKS BEING TAKEN UP


 •     OPERATIONALIZATION OF STATE ILLNESS FUND
       •      MATTER TAKEN UP WITH G.O.I. FOR RELAXATIONS.

                                                               5
        MAJOR ACTIVITIES

   PROCUREMENT OF EQUIPMENT UNDER
    NRHM – EQUIPMENT AS PER IPHS UNDER
    NRHM WORTH RS.30 CRORE BEING
    PROCURED.

   UPGRADATION       OF     HOSPITALS       UNDER
    NRHM
    •    MOHALI FROM 70 TO 120 BEDS
    •    30 BED BURN UNIT IN CIVIL HOSPITAL, LUDHIANA
    •    GURDASPUR 100 TO 120 BEDS
    •    BATALA 50 TO 80 BEDS
    •    PATHANKOT 100 TO 130 BEDS
    •    BATHINDA, NEW OPD AND EMERGENCY BLOCK

                                                        6
        MAJOR ACTIVITIES

   CONSTRUCTION      OF    NEW     INSTITUTIONS
    UNDER NRHM :
    •    CHC AT DHAKOLI, ZIRAKPUR
    •    CHC AT MORINDA,
    •    CHC AT ADAMPUR
    •    40 SUB-CENTRES
    •    REPAIR OF 77 SUB-CENTRES
    •    REPAIR OF 10 PHCs


   SETTING UP OF 10 HOMOEOPATHIC WINGS
    IN 10 CIVIL HOSPITALS

   SETTING UP OF AYURVEDIC DISPENSARIES
    IN 10 CIVIL HOSPITALS.
                                                   7
        MAJOR ACTIVITIES

   SETTING UP OF 14 AYURVEDA SPECIALITY
    CLINICS IN CIVIL HOSPITALS.

   PURCHASE OF EQUIPMENT
    •    10 C-Arms
    •    5 DIALYSIS UNITS
    •    18 PHACO EMULSIFICATION MACHINES
    •    41 DENTAL CHAIRS


   DENGUE MANAGEMENT INITIATIVES.
    •    6 APHERASIS MACHINES     SUPPLIED,   UNDER
         COMMISSIONING.
    •    10 BLOOD SEPARATORS      SUPPLIED,   UNDER
         COMMISSIONING.


                                                      8
        MAJOR ACTIVITIES

   PURCHASE     OF            MEDICINES           &
    CONSUMABLES.
    •    RS.4.60 CRORE SUPPLIED IN P.H.S.C. HOSPITALS
    •    RS.5.75 CRORE SUPPLIED TO SHCs UNDER ZILA
         PARISHADS
   OTHER ACTIVITIES:
    •    CONSTRUCTION OF DRUG DE-ADDICTION CENTRE
         IN CIVIL HOSPITAL, TALWANDI SABO.
    •    CONSTRUCTION OF HOSTEL BLOCK AT SINPS,
         BADAL
    •    CONSTRUCTION OF C.H.C. TRIPARI.
    •    PROVIDING FIRE-FIGHTING EQUIPMENT IN CIVIL
         HOSPITALS
    •    HOT LINES IN CIVIL HOSPITALS HAVING 100
         BEDDED OR MORE.
    •    P.P.P. PROJECT AT MOHALI AND BATHINDA

                                                        9
  SOURCES AND APPLICATIONS OF
            FUNDS       RS. IN CRORES
                                 2008-09                     2009-10
                        SOURCES EXPENDITURE        SOURCES    EXPENDITURE
NON - PLAN               13.44             12.45    15.40              3.00
PLAN                     17.07             6.74     43.00               0
TELE-MEDICINE             1.50             0.51       0                 0
STATE ILLNESS FUND        1.50             0.03      2.00               0
R.S.B.Y.                  2.59             2.57      2.00               0
TRAUMA CENTRE             4.50             1.98      3.00               0
UPGRADATION OF            5.00             0.02     25.00               0
HOSPITALS
PURCHASE OF EQUIPMENT     1.98             1.63      1.00               0
OTHERS                     0                0       10.00               0
NRHM                     15.67             20.14    23.00              4.00
USER CHARGES             20.47             19.26     5.12              4.82


                                                                              10
        FUNDS RECEIVED FROM
               NRHM
PARTICULARS   06/07   07/08   08/09   09/10   Total

CIVIL WORKS   25.86   -       10.40   2.57    38.83

EQUIPMENTS 0.50       8.30    4.33    -       13.13

MEDICINES     -       6.00    -       -       6.00

OTHERS        1.70    0.86    .083    -       3.39
Total         28.06   15.16   15.56   2.57    61.35




                                                      11
        CRITICAL NEEDS
   MANPOWER SHORTAGE

   SHORTAGE OF HEALTH INFRASTRUCTURE

   SHORTAGE OF LOGISTICS

   INADEQUATE FUNDS FOR MAINTENANCE

   ADVANCED MONITORING SYSTEM AND
    MOBILIZATION SUPPORT

   STRATEGIC PLANNING
                                        12
CURRENT MANPOWER SHORTAGE
      (As on 31-12-2008)

   PARTICULARS           NORMS   AVAILA-   SHORT
                                 BILITY
                                  2008      2008
Senior Medical Officer    169      142       27
Specialist doctors        1301    1007      294
MBBS                      405      279      126
                TOTAL     1875    1428      447



                                                   13
      POSITION OF SPECIALIST DOCTORS
             AS ON 31-12-2008
   SPECIALTY                 POSITION
                Norms   Available   Short   Surplus

SMO              169      142        27       0
MEDICINE         176      142        34       0
SURGERY          176      151        25       0
GYNAE            176      121        55       0
PAED.            175       90        85       0
ORTHO            64        63        1        0
ANAES            64        54        10       0
PATHO            59        47        12       0
OPTHAL           59        74        0        15
RADIO            59        27        32       0
PSY              28        17        11       0
                                                      14
POSITION OF SPECIALIST DOCTORS AS ON 31-12-2008
                    (Contd..)

   SPECIALTY                     POSITION

                    Norms   Available   Short   Surplus

BTO                  28        17        11       0
MO (MBBS)            405      279       126       0
DENTAL               175       93        82       0
SKIN & VD            28        39        0        11
ENT                  28        59        0        31
MICRO                 6        13        0        7

            TOTAL   1875     1428       511       64




                                                          15
             PARAMEDICAL STAFF
           PARTICULARS              NORMS   AVAILA-   SHORT
                                            BILITY
Matron                               22       14        8
Nursing Sister / Staff Nurses        1797    1568      229
Lab. Technician                      418      360      58
Radiographer                         186      159      27
Pharmacist                           513      575      -62
O.T. Attendant                       187      31       156
Ambulance Driver                     349      216      133
Administrative Staff                 669      468      201
SA/CO/Accountants/Steno/ Store
   Keepers/Electrician etc.
Class-IV                             3175    2719      456
(Ward Boy / Sweeper/Peon)
                            TOTAL   7316     6110      1268

                                                              16
UPGRADATION OF INFRASTRUCTURE
                         TIER                              Number   Amount
                                                                    in Crore
                                                                       Rs.
Upgradation of existing bed capacity of District             5       24.70
Hospitals
Every district should have at least 100 bedded hospital.
Upgradation of Sub Divisional Hospital from                  10      22.00
CHCs.
New Sub Divisions don’t have at least 50 bedded
hospital.
Construction of new SDH                                      2       11.00
New Sub Divisions don’t have even CHC.
Upgradation of existing CHCs (Out of 114)                    8       26.40
These CHCs don’t have infrastructure for 30 beds.
Construction of new CHCs                                     11      36.30
Block not having CHCs
                                                            TOTAL    121.00
                                                                              17
UPGRADATION OF INFRASTRUCTURE

UPGRADATION OF EXISTING BED CAPACITY OF
DISTRICT HOSPITALS: (5)

   Amritsar ……………………….75 to 100
   Muktsar………………………...50 to 100
   Nawan Shahar………………..64 to 100
   Tarn Taran…………………….60 to 100
   Fatehgarh Sahib………………68 to 100




                                          18
UPGRADATION OF INFRASTRUCTURE

UPGRADATION OF SUB DIVISIONAL HOSPITALS:
These CHCs need to be upgraded to SDH by adding 20 beds: (10)

       Amritsar ……………..Khadoor Sahib
       Moga…………………Nihal Singh Wala and Bagha Purana
       Kapurthala…………..Bholath
       Ferozepur……………Jalalabad
       Ropar………………..Chamkaur Sahib and Nangal
       Mohali……………….Dera Bassi
       Ludhiana…………….Payal
       Sangrur………………Lehragagga


CONSTRUCTION OF NEW SUB DIVISIONAL HOSPITAL: (2)
       Sangrur ……………Moonak
       Barnala…………….Tappa


                                                                19
UPGRADATION OF INFRASTRUCTURE

UPGRADATION OF EXISTING CHCs: (8)

     Ferozepur……………….Khui Khera
     Gurdaspur………………Kot Santokh Rai & Sujanpur
     Hoshiarpur……………...Mand Mandher, Budha Bar & Kamahi
                        Devi
     Kapurthala………………Begowal
     Moga…………………….Badni Kalan



CONSTRUCTION OF NEW CHCs ( 9 )

     Amritsar…………………Hars Chinna
     Tarn Taran……………...Gandhiwind
     Pathankot……………….Bamyal and Darongal


                                                           20
UPGRADATION OF INFRASTRUCTURE

CONSTRUCTION OF NEW CHCs

    Kapurthala………………Dhilwan
    Jalandhar………………. Ruka Kalan
    Patiala…………………..Sanaur
    Fatehgarh Sahib ………Khera
    Ferozepur……………….Makhu
    Sangrur………………….Andana
    Barnala…………………..Mahal Kalan.




                                    21
    SHORTAGE OF LOGISTICS

   NO REGIONAL GODOWNS - NEED FOR
    SETTING UP 4 REGIONAL CENTRAL
    GODOWNS IN;
        I)     JALANDAHR
        II)    FEROZEPUR
        III)   PATIALA
        IV)    FARIDKOT


   GODOWNS SHOULD BE ONLINE WITH
    H.Q. PHSC MOHALI.
   GODOWN     SHOULD  FOLLOW   LATEST
    TECHNIQUE OF STORAGE AND SUPPLY OF
    MEDICINES AND CONSUMABLES.
                                         22
    INADEQUATE FUNDING FOR
         MAINTENANCE
   THERE IS VERY LESS AMOUNT AVAILABLE
    FOR MAINTENANCE OF CIVIL WORKS AND
    EQUIPMENT / INFRASTRUCTURE FROM THE
    FOLLOWING SOURCES.
        I)     PLAN SIDE
        II)    NON PLAN SIDE
        III)   NRHM


   HIGHER OUTLAY AND A COMPREHENSIVE
    POLICY IS REQUIRED FOR MAINTENANCE
    OF BUILDINGS AND EQUIPMENT.


                                         23
    MONITORING SYSTEM AND
    MOBILIZATION SUPPORT



   HMIS - ALL HOSPITALS SHOULD FOLLOW
    COMPUTERIZED HOSPITAL MANAGEMNET
    INFORMATION SYSTEM FOR HOSPITAL
    PERFORMANCE, EQUIPMENT TRACKING
    ETC.

   HIGHER   P.O.L.   AND    MOBILIZATION
    SUPPORT FOR     MONITORING OF NEEDED
    SECONDARY LEVEL HOSPITALS.

                                            24
LACK OF STRATEGIC PLANNING


   THERE IS   NEED FOR SETTING UP A
    STRATEGIC PLANNING CELL OR STATE
    HEALTH SYSTEM RESOURCE CENTRE.

   THERE IS NEED FOR MAINTENANCE OF
    STATE HEALTH ACCOUNTS ON THE
    PATTERN    OF    NATIONAL    HEALTH
    ACCOUNTS TO MONITOR      PUBLIC AND
    PRIVATE HEALTH EXPENDITURE CLOSELY.



                                          25
           12TH PLAN VISION

   VIABLE HEALTH INSURANCE POLICY TO MEET RISING
    HEALTH COSTS IN PUBLIC AND PRIVATE SECTORS.

   STRENGTHENING OF EXISTING HEALTH SERVICES
    THROUGH FOUR Ms

         MANPOWER
         MATERIAL
         MONITORING
         MAINTENANCE OF INFRASTRUCTURE


   IMPROVEMENT IN MANPOWER TRAINING.

   MODERNIZATION OF EXISTING EQUIPMENT.

                                                    26
        12TH PLAN VISION

   STRENGTHENING OF TRAUMA HEALTHCARE SERVICES
    AND TACKLING THE BURDEN OF LIFE STYLE
    DISEASES.


   REGULATION FOR PRIVATE SECTOR TO MONITOR PRICING
    AND QUALITY.


   PROMOTING STRATEGIC PLANNING FOR POLICY
    GUIDANCE .

   COMPUTERIZATION OF HOSPITAL MANAGEMENT
    INFORMATION SYSTEM.

   PROMOTING PUBLIC PRIVATE PARTNERSHIPS.

   PREPARATION OF STATE SPECIFIC HEALTH POLICY.
                                                       27
THANK YOU




            28

				
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