MUMBAI, SEPT 18: A pack of lethargic dogs form part of the welcome committee. Bored peons and non-medical staff make up the rest of it. Nobody gets in the way ofmedical staff on emergency duty because no emergency case ever comes to this hospital. And on October 1, it will become the first hospital in Maharashtra to be closed down because of the sorry state of affairs. Only its OPD will function. The Employee's State Insurance Scheme (ESIS) Hospital in Kandivli (E) is less of a hospital, more of a dharamshala where patients and their relatives can check in - boarding, lodging and food are free for all. This structure may collapse anyday. Iron columns support the first and second floors because the roof could cave in. The fourth and most of the third floors are a dumping ground for empty medicine bottles and twisted cots. The operation theatre functions only to impress a visiting bureaucrat. The best part of this is the dream-like staff-patient ratio: three for every patient.For these dubious distinctions, ESIS Commissioner (Maharashtra) A. Ramkrishnan has decided to close down the Kandivali ESIS Hospital. But he is quick to add:``Kandivli is the worst but it isn't an exception. Others are only a notch better.'' Maintenance and repair jobs are done by the Central Public Works Department (CPWD) and the ESI Corporation foots the bill. The Corporation spends for upgrading the equipment. ``We have always acted upon the CPWD recommendations,'' says the Additional Commissioner. Regional Director of the ESI Corporation A.J. Pawar says: ``As soon as we were told about Kandivli, we allocated Rs 96 lakh for repair work.'' CPWD officials claim that the Corporation always knew of the deteriorating conditions yet no funds were sanctioned for repair work. Scaffolding was recently put up because it ``vibrated'' everytime someone walked the corridor. A technical report prepared by the Medical Director, ESIS (Maharashtra), Dr H.C. Bharati, recommends immediate closure as the ambience, equipment and facilities are not attuned to those of a hospital.Ramkrishnan believes that an investment of Rs 5-6 crore is required to get the hospital back on its feet. The Corporation is ``ready to do everything that needs to be done'' but would not like to close the hospital. Says Dr A. M. Patil, Deputy Medical Commissioner of ESI Corporation (west), ``At any given time, there are about 220-250 inpatients in Kandivli. Where will they be accommodated if the place shuts down?''However, hospital sources tell another story. Designed for 600 beds, the hospital's present capacity is barely 400. The occupancy is said to be 60 per cent. However, the real occupancy could be much lower as many ``patients'' really have no medical problems. The old ones stay on because their families cannot afford round-the-clock nursing. Their attendants are also admitted so that they can save on commuting and food.The staff strength is 700 because it was originally meant to cater to about 600 patients. Ironically, in its 20-year history, the hospital has never had even 400 patients. So, the staff itself depends upon civil hospitals or private clinics in case of any personal medical complaints. The ESI Corporation reimburses their expenses. Most of the staff lives on the premises. Some of the doctors have a cosy private practice in the vicinity. They fear that if the hospital closes down, this convenient arrangement will go haywire. There are 13 ESIS Hospitals in Maharashtra, eight of which are in Mumbai and Thane.300 crore is collected from 15 lakh state government employees in Maharashtra who pay almost Rs 5,000 annually for the scheme.The ESI Corporation shares the expenses with the state government in the ratio 7:1 but only upto Rs 600. If the expenses on the patient exceed this amount, the state has to bear the cost. Out of the Rs 600, 360 are ``administrative charges'' while Rs 50 is for special conditions such as cancer.
