SURAAJ SANKALP – MUMBAI JUNE 5-6, 2010 PRESENTATION BY PROF. LAXMI KANTA CHAWLA HEALTH MINISTER, GOVERNMENT OF PUNJAB 1. BUDGET - Total budget of the health department - Rs. 1258 Crore Non Plan - Rs. 846 Crore Plan - Rs. 412 Crore - Sharing of budget State Contribution – Rs. 958 Crore Government of India Contribution - Rs. 300 Crore - Health Expenditure as percentage of GDP – 0.80% of GDP as against the desired level 2-3% - Per capita expenditure on health – Rs. 511 per year per person IMPORTANT CENTRAL SCHEMES 1. NRHM - Important Scheme having an outlay of Rs. 310 crore for 2010-11 - Progress over the years – substantial jump in expenditure Expenditure Budget Year Incurred % of Utilization (Rs. in crore) (Rs. in crore) 2005-06 98.21 59.71 61% 2006-07 162.72 83.26 51% 2007-08 190.38 104.69 55% 2008-09 199.24 186.97 94% 2009-10 252.45 220.84 87% 2010-11 310.00 2. OTHER SCHEMES - Punjab Nirogi Scheme - Assistance upto Rs. 1.5 lakh to BPL families for life threatening diseases annual outlay of Rs. 2.00 crore - Rashtriya Swasthya Bima Yojana - Insurance coverage upto Rs. 30,000 for BPL families. Insurance premium shared by GOI and State Government and no contribution from beneficiaries. Introduced in 8 districts in 2008-09 and remaining 12 districts 2009-10. So far about 60% of BPL families have been covered. - Trauma Centers- 3 Trauma Centres at Amritsar, Pathankot and Jalandhar already setup in 2008-09 and 2009-10. 4th Trauma Centre being setup in Khanna 2010-11. 2. ELECTION MANIFESTO AND ACHIEVEMENT 1. BJP ELECTION MANIFESTO (1) Strengthening & Upgradation of Village Level Primary Health Centre - 216 Primary Health Centres of 445 PHCs strengthened for 24x7 hours delivery services. One Female Medical Officer and 3 Staff Nurses posted on contract under NRHM in strengthened 24x7 PHCs . Remaining PHCs to be strengthened by 2012. - 114 Community Health Centres have been strengthened as First Referral Units. One Gynaecologist, One Paediatrician and 5 staff nurses posted on contract under NRHM - Sub Centres – 545 posts of ANMs filled up and 950 new ANMs posted in bigger Sub Centres . - Regular Supply of Medicine and equipment. (2) Strengthening & Upgradation of Village Level Primary Health Centre - 216 Primary Health Centres of 445 PHCs strengthened for 24x7 hours delivery services. One Female Medical Officer and 3 Staff Nurses posted on contract under NRHM in strengthened 24x7 PHCs . Remaining PHCs to be strengthened by 2012. - 114 Community Health Centres have been strengthened as First Referral Units. One Gynaecologist, One Paediatrician and 5 staff nurses posted on contract under NRHM - Sub Centres – 545 posts of ANMs filled up and 950 new ANMs posted in bigger Sub Centres . - Regular Supply of Medicine and equipment. (3) Providing Super Specialty Health Facilities at all District Head Quarters - Super specialty Hospitals at Mohali & Bathinda are being established under Public Private Partnership with Max Health Care. Land given on lease by Government against up front fees of Rs. 5.00 crore and share of 5% of gross annual income. Hospitals to be completed by 31/12/2010. - Punjab Institute of Medical Science has been handed over to a private party. The college would admit 100 students every year for MBBS course at a fees prescribed by Punjab Government and treatment would be made available at PGI rates. - 5 District Hospitals are under upgradation at an estimated cost of Rs. 16 crore by adding 226 beds. Equipments like – Blood Component separators, Aphaeresis Machines, Dialysis Machine, Phaco Machines etc. have been provided in all District Hospitals. (4) Strengthening of Mobile Dispensary System • 24 Medical Mobile Units fitted with latest diagnostic equipments and GPS system were introduced in the 20 districts in 2008 to provide health services in the far flung areas. • One Mobile Bus equipped with Mammography Machine has been hired for detection of cancer in the 4 Districts of Punjab. • Ranbaxy to provide 12 more Mobile Vans in the 4 southern districts of Punjab where there is some shortage of doctors. (5) The PNDT Act will be strictly enforced to check female foeticide in the state - 109 Court Cases/ FIRs have been launched. 371 centers have been suspended/ cancelled. - Prizes announced for decoy customers, informers and for sting operations in regard to violation of PNDT Act. - 83 Panchayats with sex ratio 1000 and above have been honored with Rs1.50 Lac each. - As per latest SRS survey of GOI, the child sex ratio which was 798 in 2001 has improved to 841 in 2008. (6) Health Insurance to all People - Bhai Kanhaiya Health Insurance Scheme is being implemented by the Punjab Government for providing treatment upto 1.5 lakh for members of Co-operative societies and their family members. - Rashtriya Swasthya Bima Yojna has been implemented in all the 20 districts to provide health insurance to the BPL families. - There is a proposal to utilize the amount received from Max Health Care in Mohali and Bathinda for providing Insurance coverage to BPL families in these two super specialty hospitals. 2. ELECTION MANIFESTO Of SHIROMANI AKALI DAL (1) Insurance Scheme for Farmers and BPL Families - As above (2) Super specialty Cancer Hospitals for subsidized treatment to be set up - As above (3) Easy and subsidized access to health services - Free deliveries in all Government Hospitals since December 2008. - Free treatment of school children in Government Hospitals since June 2009. - Free treatment of school children for congenital heart disease and cancer in PGI at a cost ranging from 1 to 1.5 lakh per student. - Jan Aushdi Stores for supply of generic medicines manufactured by Government PSUs setup in all District Hospitals in 2009. Punjab is the only State to cover all districts and out of 39 such stores in India 20 are functional in Punjab alone. - Effective implementation of Punjab Nirogi Scheme for BPL families for assistance upto Rs. 1.5 lakh. - Free treatment of BPL families without charging any user charges in all Government Hospitals. - Supply of regular medicines in all Government Health Institutions for poor people. (4) New Health Institutions in uncovered areas - 216 PHCs and 114 CHCs have been upgraded for 24x7 hours institutional deliveries. - One new District Hospital, 4 SDH and 31 Community Health Centres to be constructed in the next one and half year in uncovered areas. Besides 2 District Hospitals, 2 SDH and 3 Community Health Centres to be upgraded/ constructed at the same location. (5) To bring down Infant Mortality Rate and Maternal Mortality Rate - Punjab’s IMR of 43 in 2007 and MMR at 192 in 2004-06, much above the National figures of 55 and 254, but not as good as in the states of similar income levels. - Recruitment of over 412 doctors, 1500 staff nurses and 1600 ANMs during the last one and half year for ensuring availability of staff in all health institutions. - Upgradation of PHCs and CHCs for 24x7 hours deliveries. - Provision of free deliveries since December 2008. - Appointment of over 17000 ASHAs. - Effective implementation of Janani Suraksha Yojna for financial assistance for deliveries to BPL and SC families. Quantum jump in number of cases from 16079 in 2006-07 to 96721 in 2009-10. - Effective implementation of Janani Suraksha Yojna for financial assistance for deliveries to BPL and SC families. Quantum jump in number of cases from 16079 in 2006-07 to 96721 in 2009-10. - Institutional Deliveries – Major focus on Institutional Deliveries in government Hospitals. For BPL and SC families, a new scheme Surakhiat Janepa Yojna introduced for deliveries in Private Hospitals for Rs. 2500 per case was introduced in 2009. - Big jump in number of institutional deliveries of 50% and 33% during the last two years. - The latest SRS survey of GOI of 2008 has shown 2 point reduction from 43 to 41 in IMR. The new survey for MMR yet to come. 3. IMPORTANT NEW SCHEMES/ INITIATIVES (1) Special campaign for recruitment – Following staff was recruited after gap of nearly 10 years on regular basis: - Specialist doctors -101 - Medical Officers - 312 - Staff Nurse - 380 - ANMs - 514 Recruitment on regular basis in offing - Specialist doctors - 128 - Medical Officers - 214 - MO Dental - 34 - Drug Inspector - 37 - Ayurvedic Doctors - 133 Recruitment on Contract Basis - Medical Officer Female - 94 - Gynaecologists & Paediatricians - 50 - Ayurvedic Medical Officers – 216 - Homeopathy Medical Officer – 112 - Ayurvedic/ Homeopathic Dispensers - 328 - Staff Nurse - 1300 - ANM - 954 (2) Rationalization of postings – The practice of doctors and para medics being posted in excess of their strength and doctor working some where and drawing pay elsewhere has been completely stopped. Effort was made to post doctors in remote and uncovered districts. (3) Establishment of Jan Aushadi Stores in all the District Hospitals for providing generic medicines manufactured by GOI companies at cheaper rates. (4) Emergency Medical Response Services being introduced - 240 ambulances to be deployed. FD has already approved the proposal and the work is likely to be allotted by 15/6/2010. (5) Construction of Super Specialty Hospitals under PPP Mode through MAX Health Care in Mohali & Bathinda is in progress and to be completed by 31/12/2010. (6) Free treatment of School Students for Congenital Heart Disease and Cancer in PGI since November 2008. (7) Mobile Medical Unit- 24 Mobile Medical Units well equipped with diagnostic tools and two doctors for all the districts since December 2008. (8) Surakhiat Janepa Yojna, a scheme for BPL and SC families for institutional deliveries in Private Hospitals @ Rs. 2500 per case was introduced in 2009. (9) Bio Metric Attendance System has been installed in all First Referral Units and 24x7 PHCs. (10) Doctor wise daily OPD is monitored online through website. (11) Mobile Phones provided to all ANMs for systematic monitoring of their performance in respect of important parameters. (12) Pregnancy Tracking System being introduced. (13) Advanced dental implant centre established at Mohali under Public Private Partnership where dental implant will cost Rs. 16,000 as against market price of Rs. 35,000. (14) Dialysis Machines, Phaco Machines and blood component separators/ Aphaeresis Machine have been provided in all the District Hospitals for the first time. (15) Trauma Centres at Amritsar, Pathankot and Jalandhar already setup in 2008-09 and 2009-10. 4th Trauma Centre being setup in Khanna 2010-11. (16) Panchkarma Unit has been made functional at Civil Hospital Mohali to provide ancient system of Auyrveda. (17) 3 Arogya Melas organized in Punjab with assistance of Government of India. (18) First Ayurvedic Drug Testing Laboratory in the state established at Patiala. (19) Ayurvedic and Homeopathic Units provided in all Primary Health Centres/ community Health Centres to provide AYUSH services under one roof. 4. OTHER IMPORTANT SCHEMES/ ACHIEVEMENTS (1) Steps taken for Controlling Drug Abuse - 559 joint raids were conducted, drugs seized from 493 chemists shops. - 20 Licenses were cancelled, 92 licenses were suspended due to contraventions relating to habit forming drugs. - 200 licenses of chemists suspended due to general contraventions and 55 prosecutions have been launched against defaulters. - So far drugs worth Rs. 8 crore have been seized since March 2007 when this Government came to power. - A 20-bedded Drug De-addiction Centre at Talwandi Sabo with an outlay of Rs. 1.55 crore has been constructed and operationalized. - Psychiatrics have been provided in all 20 District Hospitals. - 2 new drug de-addiction centers were made functional in the Civil Hospitals at Ferozepur and Phagwara. As of now 10 Civil Hospitals in the state have drug de-addiction centers. (2) Prevention of Food and Adulteration - State wise vigorous campaign against food adulteration was continued in the year 2009. A total of 3767 samples of food items were picked up out of which 792 samples failed. The corresponding figures for the year 2008 and 2007 are 3232 (254 failed) and 2377 (413 failed) respectively. - 22900 Liter milk, 13630 Kg Milk Products etc were destroyed on the spot that were found unfit for human consumption. (3) Up gradation of Health Institutions - Work for Upgradation of 5 District Hospitals. A total of 226 beds will be added in these hospitals. - Upgradation of 3 Sub Divisional Hospitals. A total of 90 beds will be added. - Upgradation of 2 Primary Health Centres to 30-bedded Community Health Centres. - Construction of 2 new 30-bedded CHC have been taken up. - Maternity Wards in all district hospitals to be strengthened as State of Art maternity units. (4) Consultation and Treatment through Telemedicine has been introduced in all the districts in the State. (5) Other Achievements - Immunization - as per latest DLHS survey, Punjab was placed at number 3 in Immunization with 79% coverage - State was placed at number 2 in India in Non Scalpel Vasectomy in the country in 2009. - State adjudged one of the best for Swine Flu Management 5. MONITORING MECHANISM OF SCHEMES (1) Community Monitoring - Health Planning and Monitoring Committee has been constituted at District. Block and PHC level - Village Health and Sanitation Committee has been constituted at Village Level (2) Regular Field Inspections and Feedback - Inspection format designed for inspection of District Hospital, Community Health Centres, Primary Health Centres and Sub Centres. - Regular field visits by the State, District and Block level officers and feedback. - Mobile Phones for all ANMs for better monitoring - Monitoring of work of doctors and functional status/ usage of major equipment through daily online monitoring 6. ACCESS TO AFFORDABLE HEALTH CARE (1) Recruitment – filling up of vacant post of doctors and para medics and their postings in all hospitals including the remote districts. (2) Strengthening of PHCs, CHCs and Sub-Centres in terms of manpower and medicines. (3) Free treatment without charging any user charges for BPL families in all hospitals (4) Free deliveries in all hospitals. For SC and BPL families, Rs. 2500 allowed for delivery in private hospitals under Surakhiat Janepa Yojna. (5) Check up of about 30 lakh school students through School Health Programme and distribution of medicines. (6) Free treatment of school children for congenital heart diseases and cancer. (7) Effective implementation of Punjab Nirogi Scheme and health insurance schemes. (8) 24 MMUs for all districts. 7. DECISIONS AND THEIR IMPLEMENTATION 1. The ruling alliance and the cabinet have been supportive of initiatives of the Health Department . 2. Hon’ble CM has recently approved an ambitious programme of Rs. 350 crore - - For construction of 1 DH, 5 SDH and 31 new CHCs - For upgradation of 3 DH, 2 SDH and 3 CHCs - purchase of latest Equipments for health institutions The work would be completed in next one and half year. 3. Hon’ble CM has also approved the proposal for continuous recruitment of doctors. 4. The officers are by and large quite enthusiastic about implementation of the departmental schemes. 5. Availability of funds is a constraint.
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