We need to focus on innovative thinking which enables us to find solution of numerous existing problems, engulfing healthcare delivery system of Municipal Corporation of Greater Mumbai (MCGM), said Ajoy Kumar Mehta, the then municipal commissioner of MCGM, while delivering a speech at Urban Healthcare Summit, Mumbai.
He spoke at length on various challenges on delivering patient care and how one can find best solution of it.
‘Swelling population leads to many issues’
The first challenge is population concentration. Mumbai today has population of 12.4 million and by 2030 it will become 12.79 million. Thereafter it will decrease probably and by 2036 it will go down to 12.44 million. Population will decrease not because of any great family welfare programme but because of satellite cities which are being developed. People are shifting outside the city. At that point we expect population to go down.
12.44 million on 4,76 square kilometer, that gives you 12 square meter per person in Mumbai. And if we subtract natural areas, hill slopes, mangroves, and roads, you get hardly 10 square per person for work, residence and any other social amenities, the corporation provides them.
When population lives in such a concentrated area, there is bound to be diseases which you may not see in other places. The disease would spread in fast pace as comparison to other places. There is bound to be issues regarding sanitation, healthcare, that the corporation renders.
In this kind of situation what can be done? You can’t whisk away the population and you can’t wish for a larger area. We all need to find solution.
The first challenge is swelling population. Then what are the diseases we are looking at. What is the speed with which these diseases spread if there is an outbreak? How it can be controlled, that is the issue. That’s the major challenge as an administrator. As a doctor you should be engaging yourself to find solution.
‘Second challenge is awareness’
Awareness is good but it has its downside as a service provider. Awareness makes one informed about kind of services hospital provides. Where one would get best services among private and government hospitals?
When population becomes more aware, it becomes more demanding which perturbs service providers. But it should be taken with right tone and attitude. Rather getting irritated, providers should focus on finding solution. One should also toy all ideas to improve things.
‘Awareness while proving to be a problem at times can be a solution’
How do you convert awareness from being a problem to a solution, is next big issue in the minds of service providers. Corporation provides lots of services including health, education, sanitation, water supply, lighting, and hundreds of other services. Most noble service we provide is healthcare services.
Third issue is infrastructure. Our capacity is to deal with about 70 lakh OPD patients every year. We are performing hundred thousands surgeries a year. Our existing infrastructure is not sufficient enough to meet this demand. Our doctor-patient ratio and nurse-patient ratio are not ideally what it should. Similarly on front of ICU front, we require 30 beds per ten thousand populations, but we have only 10-15 beds. I agree there are issues, but we need to chalk out ways to deal with them. We can’t shirk away from our responsibilities.
Innovative practices need to work upon to improve delivery of services
We need lots of innovative thinking, while dealing with volume of patients. There can be innovating thinking on front of technology, processes, and management.
We are primarily meant to cater primary level of treatment, but then if some patients seek tertiary level of care, we have to make them available. We can’t whisk them away. We need to draw a line somewhere. We need to resolve huge medico administrative issue. We need to introspect whether we need such equipment or some specialties.