Vacancies have increased in the Brihanmumbai Municipal Corporation’s (BMC) health department, affecting healthcare, according to a white paper released by NGO Praja Foundation on Tuesday. BMC’s health expenditure has also remained poor against allocated budget. In the last three years, 58 per cent of capital expenditure allocated for health has remained unutilised, it says.
Shortage of medical personnel, including doctors, rose from 27 per cent in 2015 to 46.6 per cent in 2019. In case of paramedics, the shortage increased from 33 per cent to 43 per cent in the same period.
Mumbai witnessed a shortage of health personnel, especially doctors and nurses, soon after the pandemic hit in March. From 11 per cent vacancy in 2015 for nursing staff across BMC hospitals and dispensaries, the gap rose to 16 per cent in 2019. In 2019, of 7,306 posts for nurses, 6,110 were filled. There was a 17 per cent vacancy of lecturers in medical colleges in 2015, which rose to 34 per cent last year. BMC has four medical colleges attached with KEM, Sion, Nair and Dr RN Cooper hospital. Of these KEM, Sion and Nair are major facilities to admit Covid patients.
Poor utilisation of funds
Compared to state budget, BMC allocates more funds for the health sector but where it lacks is in implementation of policies and utilisation of funds. Shortage of doctors has pinched the system hardest. The Praja report indicates this has led to an inability to provide crucial healthcare to non-Covid patients, who are especially dependent on public health institutions and cannot afford private care.
The most acute gap is for doctors at BMC-run hospitals. Of 881 posts for medical staff, only 337 were filled until 2019. In the health department, of 779 doctors’ posts, 548 were filled. In municipal hospitals, of 2,696 paramedics posts, 1,502 were filled and in the health department of 884 posts, 543 were filled. “We looked at infrastructure and how it affected Mumbai during the pandemic. Lack of infrastructure overburdened institutions and affected Covid treatment,” said Nitai Mehta, Praja’s managing trustee.
BMC’s health expenditure has also remained poor. In 2018-19, Rs 393 crore remained unspent of Rs 732 crore allotted; in 2017-18, Rs 262 crore (47 per cent) and in 2016-17, Rs 659 crore (73 per cent) was unspent. “BMC has remained consistently poor in utilisation of allocated budget for health,” said Milind Mhaske, project director, Praja.
Praja has recommended urgent need to appoint more doctors and increase number of dispensaries to provide health facilities in neighbourhoods.
About 70 per cent deaths due to Covid are of patients with co-morbidities like diabetes or hypertension. Praja’s Right to Information data shows Mumbai has an existing burden of diabetes and hypertension. There were 10,458 diabetes-related and 3,731 hypertension-related deaths in Mumbai in 2018. About 25,962 deaths were linked to heart disease and 10,073 to cancer.
Meanwhile, data shows while malaria cases have reduced over the last few years, dengue cases have increased by 31 per per cent from 2017-18 to 2019-20. So have tuberculosis cases due to increased detection and testing centres.
TB cases rose by 7.5 per cent from 2018 to 61,271 cases in 2019.
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