G.O.Ms.No.16 Dated: 4.2.2004 Health and Family Welfare (F1) Department

GOVERNMENT OF TAMIL NADU

ABSTRACT

Medical and Rural Health Services – Upgradation of Krishnagiri Taluk Hospital to that of District Headquarters Hospital for the newly formed Krishnagiri District - Orders issued.

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Health and Family Welfare (F1) Department

G.O.Ms.No.16 Dated: 4.2.2004

Read:

1. G.O.Ms.No.569, Revenue Department, dated 20.11.2003

2. From the Director of Medical and Rural Health Services, lr No.5567/ P&D II/2/04 dt:23.1.2004 and 27.1.2004.

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Order:

In the Government Order first read above orders were issued for the bifurcation of Dharmapuri District into two Districts namely Dharmapuri District with Headquarters of Dharmapuri and Krishnagiri District with headquarters at Krishnagiri.

2. The Special Officer, Krishnagiri District has proposed for the immediate upgradation of Taluk Head quarters Hospital to District Headquarters Hospital as Honourable Chief Minister has proposed to inaugurate the District on 9.02.2004.

3. The Director of Medical and Rural Health Services has accordingly sent proposals to the Government for the upgradation of existing Taluk Hospital, Krishnagiri to the District Headquarters Hospital. He has stated that the bed strength of Government Hospital, Krishnagiri is now 193. For increasing the bed strength and improving the infrastructure facilities of the said Hospital to be upgraded to that of District Headquarters, necessary action is already under process under Health System and other infrastructure facilities needed for a District Headquarters Hospital will be taken up in the first year itself. Hence no extra funds are requested from Government for upgrading the said Taluk Hospital to that of District Headquarters Hospital in respect of construction of buildings and improving of infrastructure facilities.

4. The Director of Medical and Rural Health Services has also stated that a District Headquarters Hospital should be managed by the Hospital Superintendent in the cadre of Senior Civil Surgeon. The present Medical Officer in-charge of Government Hospital, Krishnagiri is already a Senior Civil Surgeon. Hence it is adequate if the present Senior Civil Surgeon Medical Officer post is redesigned as Hospital Superintendent. Four Civil Surgeon posts are already available at Government Hospital Krishnagiri out of which one post may be designated as Resident Medical Officer(RMO) to make the District Headquarters Hospital a full fledged one.

5. At present the following special Departments are available at Taluk Hospital Krishnagiri.

1. Dental Clinic

2. Eye Clinic

3. S.T.D. Clinic

4. Paediatric Clinic

5. Blood Bank

6. Accident and Emergency Services

7. Post Partum Ward

8. T.B.Clinic

9. Intensive Caronary Care unit

10. Leprosy Ward

11. Burns Ward

12. X-ray Unit

13. Operation Theatre

14. Laboratory

Besides the special Departments for a District Headquarters Hospital the following specialists are essentially required to give improvised medical care to the poor people living in and around the village of Krishnagiri.

1. Medicine (General Medicine)

2. Surgery

3. Obstetrics and Gynaecology

4. Paediatrics

5. Ophthalmology

6. Orthopaedic Surgery

7. E.N.T

He has suggested that out of 15 Assistant Surgeons posts now in existence in the Hospital. 7 posts may be redesignated as Assistant Surgeon specialists to manage the above specialities. By implementing the above arrangements, the purpose of upgrading the said Taluk Hospital to that of District Headquarters Hospital will be fully served without any extra expenditure to the Government.

6. The proposal of the Director of Medical and Rural Health Services has been examined in the light of the Developments of the Health System Development Project, In Health System Development Project no major upgradation has been proposed for Krishnagiri because the existing beds strength is sufficient to cater to the population. As per the norms developed for the Hospitals under Health System Development Project. It has been decided to designate Krishnagiri Taluk Hospital as Headquarters Hospital, with the existing beds strength. All other appropriate speciality services as for a District Headquarters Hospital could be provided according to the norms. In the circumstances Government issue the following orders:

i) Krishnagiri Taluk Hospital is upgraded with immediate effect as Krishnagiri District Headquarters Hospital with a bed strength of 200. It will function as District Headquarters Hospital for the Krishnagiri District.

ii) The existing Medical Officer in the Taluk Hospital, Krishnagiri in the cadre of Senior Civil Surgeon be redesignated as Hospital Superintendent.

iii) The one Civil Surgeon post in the Hospital be redesignated as Resident Medical Officer.

iv) Out of 15 Assistant Surgeon posts in the Hospital, 7 Assistant Surgeon post be redesignated as Assistant Surgeon specialits.

7. The Director of Medical and Rural Health Services is requested to take follow up action for the functioning of the District Headquarters Hospital with immediate effect.

8. This order issues with the concurrence of the Finance Department vide its U.O.No.371/FS/P/04 dated 3.2.2004.

(BY ORDER OF THE GOVERNOR)

SHEELA RANI CHUNKATH

SECRETARY TO GOVERNMENT

To

The Director of Medical and Rural Health Services, Chennai-6

The Special officer, Krishnagiri District

The Treasury Officer, Krishnagiri and Dharmapuri

The Accountant General, Chennai-18

The Accountant General (CAS), Chennai-18

The Pay and Accounts Officer(South), Chennai-35

The Revenue Department, Chennai-9

The Senior Personal Assistant to Minister for Health, Chennai-9

The Under Secretary, Chief Minister Office, Chennai-9

Copy to:

All Heads of Department under the control of

Health & Family Welfare Department

All Sections in Health & Family Welfare Department

/Forwarded By Order/

`Defective' question booklets for medical PG entrance exams

From http://www.hindu.com/2004/01/12/stories/2004011202450400.htm

THIRUVANANTHAPURAM. Jan. 11. There has been an allegation that some candidates who appeared for the All India, Entrance Examinations for admission to MD and MS courses, on Sunday, were issued `defective' question booklets.

No examination officials were available, here, for comment.

One of the candidates, S. Chandrasekharan, told The Hindu that after question 278, in the question booklet issued to him, the subsequent questions were numbered 271, 272, and so on. In a complaint given to the All-India Institute of Medical Sciences (AIIMS), New Delhi, which conducted the examination, Dr. Chandrasekharan alleged that the faulty numbering indicated that the `remaining questions in the booklet was of some other series'. He was issued the question booklet numbered 84730.

"As soon as the defect was detected, we had brought it to the notice of the invigilator and requested for replacement, which was not complied with due to lack of replacement material," he said in the complaint.

Dr. Chandrasekharan, who wrote his examination at the Government VHS School for Girls, Mancaud, said when he contacted the centre superintendent, he was able to learn that nearly 40 candidates had faced a similar problem. It is also learnt that several candidates who appeared for the examination at the Cotton Hill Government Girls High School and at the Model High School, faced similar difficulties.

In some cases, the invigilators are reported to have read out the `correct' questions from `non-defective' booklets. In some other instances, the invigilators reportedly told the candidates to answer the questions in the sequence found in the booklets issued to them.

The candidates had to answer 300 questions in three and a half hours.

Medicos against privatisation

Medicos against privatisation

T.S. SUBRAMANIAN

Medical students in Tamil Nadu, backed by their seniors in the profession, resist bitterly what they see as moves that would dilute the quality of medical education and produce a surfeit of doctors as a result of the setting up of more medical colleges in the private sector.

S.R. RAGHUNATHAN

A demonstration by agitating medical students in Chennai on April 28.

A LARGE section of the medical fraternity in Tamil Nadu, including principally about 12,000 medical students, is pitted against the State government over the issue of the virtual privatisation of medical education. The students, who initiated the struggle, have made another important demand: the scrapping of a quota of seats for non-resident Indians (NRIs) in government medical colleges, to which admissions are made on the basis of a higher payment structure. The students' agitation, which entered the 27th day on May 19, has the backing of the Tamil Nadu Government Doctors' Association. Doctors in government service pursuing their postgraduate education have joined the protest.

According to a Government Order dated August 13, 2001 issued by the State Health and Family Welfare Department, since "it would be prohibitively expensive to open more number of colleges in the state sector", it has been "decided to consider the request of the private organisations for the request of NOC (no-objection certificate) to start medical and dental colleges in backward areas". The government directed the Director of Medical Education (DME) "to consider the requests of private organisations for issue of essentiality certificate to start medical/dental colleges in the backward/rural areas of the state... "

The students termed the G.O. "an invitation to open private medical and dental colleges" and expressed the fear that such institutions would proliferate, in the process bringing down the quality of medical education. The vice-president of the Tamil Nadu Medical and Dental Students' CRRIs', Senior House-Surgeons' and Postgraduate Doctors' Association, D. Karal, said: "Seats will be sold for Rs.25 lakhs to Rs.35 lakhs. People with money will buy them... " After private organisations were allowed to start engineering colleges, more than 230 such colleges had sprung up in the State leading to dilution of standards in education. "This should not happen in medical education because it is tantamount to playing with the life of patients," said Karal. This Association is spearheading the agitation. (CRRI stands for Compulsory, Rotatory Residential Internship).

One of their key demands relates to barring new private medical and dental colleges by law. The essentiality certificate given by the government to the Meenakshi Ammal Trust, Chennai, to start a medical college near Kancheepuram, triggered the trouble.

State Health Minister S. Semmalai said that the power to clear private medical colleges lay with the Centre, not the States. "Despite the existence of the G.O., no essentiality certificate has been issued to any private medical or dental college by this government. The Meenakshi Ammal Trust received the essentiality certificate on the orders of the Supreme Court." The Madras High Court had directed that the Trust be given the certificate. The State government appealed against this in the Supreme Court, but the court upheld the High Court's order, Semmalai added.

The Minister said separately that in the matter of granting permission to set up private medical colleges, the State government's powers were limited compared to those of the Centre. The Supreme Court had specified these powers in a case filed by the Kirubananda Variar Medical Trust, he said. In another case, he said, the apex court had ruled that even when a State government refused to give permission for a dental college being started, the Dental Council of India could take a decision. He contended: "As per the Supreme Court ruling, only the Centre had the powers to permit private medical colleges to come up. It is meaningless for the students to agitate against the State government when they should be protesting against the Centre, which has the power to sanction private medical colleges... "

But the students insist that the State government has the power to block new colleges, for the power to grant no-objection and essentiality certificates were its. They point out that the Supreme Court had said a mere policy decision by a State government not to allow private medical colleges would not do; there should be a law to back such a decision.

There are 11 government-run medical colleges and one government dental college in Tamil Nadu. These 12 colleges offer about 1,120 seats. Besides, there are six private medical colleges and 11 private dental colleges. The government recently announced that it will set up medical colleges at Theni, Vellore and Nagercoil.

After two rounds of talks between Semmalai and the students' leaders failed on May 17, the government acted tough. About 5,000 medicos were suspended. Of them more than 1,200 would not be allowed to sit for their examinations beginning in the first week of June, he said. Undaunted, the students asserted that their agitation would continue.

When the medicos launched a token strike on April 9, their demands, other than that relating to privatisation, were that the State government should get Medical Council of India (MCI) recognition for the MBBS course offered by the K.A.P. Viswanatham Government Medical College in Tiruchi and the Thoothukudi Government Medical College, and postgraduate courses offered by the government medical colleges, and provide more facilities in the Government Dental College, Chennai. The government was also requested to withdraw the increase in fees for postgraduate medical courses and restore the 10 per cent increase in stipend for MBBS and BDS students during their one-year period of internship.

Subsequently, the agitators discovered the existence of the G.O. of August 13, 2001, which they felt smacked of a privatisation drive. According to the G.O., the government had reviewed the guidelines and constituted a committee to suggest norms for the issue of essentiality certificates to private organisations to start medical and dental colleges in backward areas.

V. GANESAN

State Education Minister S. Semmalai in discussion with the representatives of medical students at the Secretariat in Chennai.

The G.O. said: "The starting of new institutions would go a long way in improving the medical facilities in these areas. A large number of students from the State are going to neighbouring States to pursue medical studies and the students will be able to pursue their studies nearer to their homes." The G.O. mentioned that while the Ninth Plan target was a doctor-patient ratio of 1:1000, the present doctor-patient ratio in Tamil Nadu was 1:2000. "Due to the present ratio, shortage of doctors in the rural areas is felt," it stated.

However, according to Dr. R.M. Krishnan, chairman of the ethics committee of the Indian Medical Association, Tamil Nadu unit, the doctor-patient ratio in Tamil Nadu has reached saturation point. He said that there were 6,000 unemployed or underemployed doctors in the State. According to Karal, the WHO-stipulated doctor-patient ratio is 1:3,500 while in Tamil Nadu it is 1:1000. There were 67,000 registered doctors in Tamil Nadu for its population of 6.2 crores, Karal said.

The students insisted on the withdrawal of the August 13 G.O. When the government failed to provide any assurance on the matter, they launched the strike on April 23. They demonstrated before the office of the Director of Medical Education. They squatted on the road and blocked traffic. They observed a silent protest. They wore masks. They donated blood and ran makeshift outpatient centres.

Dr. K. Prakasam, president, Tamil Nadu Government Doctors' Association, announced the association's support to the students. Its members struck work on May 9. The doctors are planning to start an indefinite strike from May 21.

The government warned the doctors that the Essential Services Maintenance Act (ESMA) would be invoked against them. It transferred Dr. Prakasam and several other doctors. Yet the doctors struck work on May 9 and then on May 14. As they intensified their agitation, patient care was hit in government hospitals. Wards remained empty, and many poor patients were affected.

Medical students in Tamil Nadu have had an extended record of opposing the setting up of private medical and dental colleges. "We started our agitation against privatisation in 1989. In February 2000, we struck work for more than two weeks, expressing our protest against privatisation," Karal recalled.

The fate of their agitation this time around remains uncertain in the face of the seemingly inflexible stand taken by the All India Anna Dravida Munnetra Kazhagam government in the State.

From http://www.hinduonnet.com/fline/fl2011/stories/20030606006713300.htm

As per GO (Ms) No.214 dt 31/10/2002

NEWS

As per GO (Ms) No.214 dt 31/10/2002

The Govt has sanctioned a sum of Rs. 4,01,000/- to the Director of Medical Education to Deposit the same in the District consumer Disputes Redressal forum, Thanjavur.

The Dean, Thanjavur medical college Hospital, Thanjavur is authorized to draw and deposit the same in the District consumer Disputes Redressal forum, Thanjavur.

The District consumer Disputes Redressal forum in its judgement dated 5.4.2002 has ordered the Dean, Thanjavur medical College Hospital, Thanjuvur to pay compensation of Rs.4,01,000/- to Tmt. Rajeswari wife of the Deceased, in the cases O.P. No 22/2002 and 23/2002 filed by Tmt Rajeswari w/o Thiru Kumaresan and Aruna D/o Thiru. Kumaresan in the District consumer Disputes Redressal forum Thanjavur. Thiru Kumaresan died due to Myelogram Test at Thanjavur Medical College.

The Director medical education has also reported than as appeal was preferred in the state consumer Disputes Redressal commission Chennai on 10.7.2002. The state consumer Disputes Redressal commission, Mylapore, Chennai has given interim stay and ordered the Dean to Deposit the sum of Rs. 4,01,000/- in the District consumer Disputes Redressal Forum Thanjavur within six weeks.

Counselling for transfer and promotion Letter No. 35497/A1/2002-1 dated 18-10-2002

GOVERNMENT OF TAMILNADU

Secretariat,

Chennai – 600 009.

Health & Family Welfare Department

Letter No. 35497/A1/2002-1 dated 18-10-2002

From

Tmt. Girija Vaiyanathan, IAS

Secretary to Government.

To

All Heads of Departments.

Sir,

Sub : Establishment – Health and Family Welfare Department –

Counselling for transfer and promotion – Guidelines – Further

Instructions issued.

Ref :- G.O (Rt) No.2143, Health, dated 8-10-2002.

I am directed to issue the following further instructions is continuation to the Guidelines issued in the Government Order citied :-

i) Medical Officers and Para Medical staff who are newly recruited as well as the Medical Officers who report for duty on completion of the Post Graduate Degree Course should be posted only in the Districts which come under category 4(iii) in the case of Directorate of Medical and Rural Health Services and category 4(v) in the case of Primary Health Centres mentioned in the Government Order cited.

ii) During Counselling for transfer of Medical / Para Medical staff within the Directorate, Station seniority will be criteria meant for priority whereas in the case of inter directorate transfers, CML seniority will be criteria for priority for counseling.

iii) Whenever situation arises for filling up of vacant post due to retirement or otherwise in the Ministerial Service under the control of health and Family Welfare Department by promotion, Counselling should be conducted for placement on promotion

Yours faithfully

For Secretary to Government

Copy to : All Officers in Health and Family Welfare Department, Chennai -9.

All Service Sections in Health and Family Welfare Department, Chennai -9.

Senior / Special Personal Assistant to Minister for Health, Chennai -9.

Counselling for transfer and promotion G.O.(Rt.) No. 2143:08-10-2002

GOVERNMENT OF TAMIL NADU

ABSTRACT

Establishment, Health and Family Welfare Department – Counselling for transfer and promotion – Guidelines – Certain modifications – issued.

HEALTH AND FAMILY WELFARE (A1) DEPARTMENT

G.O.(Rt.) No. 2143 Dated:08-10-2002

Read :-

(1) G.O.(D) No.508, Health, dated 10.04.2002.

(2) From the Director of Medical and Rural Health Services letter No.57622/E1/1/2002, dated 04-04-2002.

(3) From the Director of Medical and Rural Health Services letter No.55018/E3/1/2002, dated 04-04-2002.

(4) From te Director of Public Health and Preventive Medicine letter
No. 96973/5E/A4/2002, dated 02-07-2002

ORDER :

In the Government order first read above, the Government have issued guide-lines for conductiong counseling for transfer and promotion to the personnel working in the Health Departments. The Heads of Departments have reported that they are facing certain practical difficulties while conducting counseling and suggested certain modifications to the guidelines , for effective and fair administraton.

2. The Government have examined the suggestions of the heads of departments in detail and decided to issue certain modifications to the guidelines issued in the Government Order first read above.

4. In partial modifications of the orders issued in the said Government Order first read avove, the Government issue the following guidelines:-

(i) Counselling for transfer within the Directorate be held once in 3 months : during January, April, July and October.

(ii) Counselling for transfer inter-Directorate be held once in a year during March.

(iii) In a District where there is 15% and above of the total sanctioned strength of medical Officer/Para medical staff in the Medical Instittions under the control of Director of Medical and Rural Health Services, are vacant, the Medical officers/para medical staff from that district are not eligible to take part in counseling till the vacancy position in that district improves.

(iv) 75% of the total sanctioned post in a particular medical institution under the control of DME/DMS should not be kept vacant.

(v) In the case of Primary Health Centre, in a District where there is 10% and above of the total post of medical officers/para medical staff are vacant, the medical officers/para medical staff from that district are not eligible to take part in counseling.

(vi) Further, in the case of PHC, where there are only 2 sanctioned posts of Medical Officers, atleast one Medical officer should be available and in the case of PHCs where there are 3 sanctioned posts of Medical officers, minimum 2 Medical officers should be available. Wherever there are no lady doctors available in a Primary Health Centre, vacancies in such Primary Health Centre shall be reserved for Women.

(vii) Medical Officers/Staff who were transferred and not joined but went on long leave should not be entertained for counseling.

(viii) Medical Officers/other para medical staff who have been transferred on disciplinary grounds be declared not eligible for counseling till the disciplinary case is over.

(ix) Lady Medical Officers recently appointed through Tamil Nadu Public Service Commission and the Medical Officers appointed in PHC through Employment Exchange recently should not be considered for counseling till they have completed one year or till April 2003 whichever is later.

(x) No transfer should be effected in-between the counseling periods, other than those required on administrative grounds based on allegations and charges, which should be recorded in writing.

(xi) Director of Public Health and Preventive Medicine and Director of Medical and Rural Health Services should first identify the overall vacancies in the Medical Institutions under their control. Based on the current level of vacancies, the vacancies available in Medical Institution nearby City or Urban area where other medical facilities are easily available be identified and such vacancies need not be notified at present for filling up during counseling, and the posts be kept vacant till the over all vacancy position improves after fresh recruitment of Medical officers/para medical staff.

(xii) Station seniority in the present posting alone will be the criteria for determining the priority for transfer counseling.

(xiii) All criteria meant for priority in counseling as issued in para 3 of the annexure of the G.O.D.No.508 Health, 10-04-2002 be discontinued.

(xiv) Existing as well as resultant vacancies for counseling / date for counseling shall be made available on the web-site and also in the Notice boards of the Medical Institutions.

(xv) Vacancies of the posts wherein the incumbent is on leave for more than 2 months and as well as vacancies that will be filled by promotion during the next quarter will also be notified for counseling.

(xvi) Outcome of the counseling shall be determined and exhibited (except the cases where the Government is the transferring authority) on the same day itself.

(xvii) Medical Officers with Post Graduate / diploma qualification / super specialities shall not be considered for posting in ESI Dispensaries. Those already working in such dispensaries shall be moved to Government. Hospitals where their services are required in a phased manner.

(BY ORDER OF THE GOVERNOR)

Girija Vaidyanathan

SECRETARY TO GOVERNMENT

G.O.(M.S.) No : 133, Health : 09.07.2002 Justice M. Maruthamuthu Committee

GOVERNMENT OF TAMIL NADU

ABSTRACT

Committee – Justice M. Maruthamuthu Committee –Recommendations of

Committee –Acceptance of certain findings – Orders – issued.

HEALTH AND FAMILY WELFARE (E.1) DEPARTMENT

G.O.(M.S.) No : 133, Health Dated : 09.07.2002

Read : -

1. G.O. (MS) (2D)) No : 23, Health, dated:21.04.2002.

2. G.O. (MS) No: 407, dated:19.12.2000

Read also:-

1. Report of Justice Thiru. Maruthamuthu, dated:31.01.2002.

ORDER :

1. In the Government order first read above, a Committee was constituted to look into mishaps occurring during Professional duties of Doctors working in government and Private Hospitals and to submit a report suggesting the guidelines and measures to be adopted by government in respect of litigations in Court arising out of the mishaps. In the Government order second read above, Thiru. Justice M.Maruthamuthu, retired High Court Judge, was appointed as Chairman of the Committee.

2. The Committee which looked into the above issues in detail submitted its report to the Government on 31.01.2002. The Government have examined ¾ the recommendations of the Committee and pass the following orders to adopt the procedure whenever litigations arise due to the mishps that occur during the Medical/Surgical Treatment given by Doctors in Government Hospitals/Private Nursing Homes/ Hospitals.

I. To follow the existing procedure of allowing the Police registering the complaint under section 304 (a) I.P.C., and investigate.

II. To permit an officer of the rank of Deputy Superintendent of Police or Asst. Commissioner of Police to do the investigation.

III. To issue Departmental instructions for., not to arrest Doctors, as a matter of routine and to effect arrest only when it is legally justified and with the Consultaion of Senior Police Officers.

IV. To Create a Corpus Fund from the contribution of Rs. 10/- p.m. from every Doctor.

V. To make the Government Doctors, to Pay Compensation awarded, by Court in the Court first and then to apply for the refund of amount paid in the Court by Doctors from the Corpus Fund, thus created.

VI. To frame certain guidelines for the regulation of nature of cases eligible for re-imbursement from Corpus Fund and for administration of Corpus Fund.

VII. To Consider the creation of Corpus Fund as a trial measure only and to revise the subscription of Corpus Fund depending upon the functioning of this scheme after one year.

3. The Director-General of Police is requested to follow the procedures mentioned in the items (i), (ii)&(iii) in the paragraph 2 above, whenever occurrence of such cases take place in the Government Medical Institutions/Private Nursing Homes / Hospitals.

4. The Director of Medical and Rural Health Services is requested to take necessary action on the items mentioned in the paragraph 2(iv);(v);(vi) and (vii) above in the Government Medical Institutions.

(BY ORDER OF THE GOVERNOR)

Syed Munir Hod

Secretary to Government