Show zero tolerance for deaths in State hospitals
To avoid another Gorakhpurlike tragedy, Yogi Adityanath must ask for regular data collection and medical audits
The deaths of more than threescore children at the BRD Medical College Hospital in Gorakhpur, Uttar Pradesh has horrified people across India. Not because other tragedies are less disturbing — but because children’s vulnerability calls for the highest standards of protection. Within that healthcare tops the list.
The BRD hospital is a tertiary level public health facility. It is said to be the only facility with wherewithal to treat encephalitis within a 300 km stretch. Given all this one would have expected the highest levels of emergency preparedness and response. Instead, so many defenceless children had to die. Why?
Because a concern about healthcare does not bring active public endorsement, the way investment in infrastructure does. If a handful of hospital deaths are treated as normal, the administration becomes careless.
No chief minister or health minister, least of all in a state the size of UP, can possibly keep track of trends, warning signals, shortages of manpower, equipment; which is why they must administer by exception. This calls for data management to take stock of warning signals and to respond to those.
The emergency services at BRD were une- quipped to handle the crises. If they succumbed because of mismanagement of oxygen supply, it was atrocious; and, if it was because of delayed payments, it cannot be dismissed by holding one or two responsible.
Why weren’t there checklists for oxygen supply as a top commodity in a hospital’s inventory? A medical college hospital should have performed better — not worse.
Indeed it is paradoxical that the prices of tomatoes or onions can bring governments to their knees but not so the deaths of defenceless children. A lesson will only be learnt if the chief minister shows zero tolerance for needless mortality in government hospitals. He must direct district hospitals and medical colleges to publish monthly data on in-patient admissions and look at monthly reports of mortality trends by hospital-related causes and share this data publicly. Only systemic changes will work; but for that continuous data collection and medical audits are a must.
This Independence Day one would like to hear the PM and all CM’s commit themselves to giving top priority to public health and hospital management. Through a commitment that hospital data of mortality would be declared by all district hospitals and uploaded every month along with the outcome of reviews conducted by third party peer review committees. If the CM shows no lenience towards medical or administrative apathy by simply glancing through the exception reports and peer reviews of hospital deaths, things could still change dramatically.