Friday, October 28, 2016

Karnataka finally set to create cadre for public health, says health minister

BENGALURU: Health Minister K R Ramesh Kumar on Thursday announced the reorganisation of the Health Department by creating a public health cadre and revising the Cadre and Recruitment (C & R) rules.
“Creation of a public health cadre will lead to reallocation of the existing cadres and new positions at the state, district and taluk levels,” he told reporters.
After a struggle of over 10 years by public health experts to create a public health cadre in the state, the proposal is finally out of the cold storage. It was first proposed during the S M Krishna government.
Currently, clinicians who are meant to practice medicine are made block/taluk health officers, district health officers, deputy directors, joint directors and directors in public health. They have to learn on the job with no prior qualifications in public health to hold such positions.
V
arious high power committees had recommended that right from taluk to state-level hospitals, the state needs to create a public health cadre. They had also recommended that after six years of rural service, medical officers should be given an option of pursuing post-graduation in public health, clinical services or hospital administration.
Giridhara R Babu, Additional Professor, Public Health Foundation of India, said, “Now, officials know about national health programmes by virtue of clinical practice.
There is no ownership and no review of progress. There are frequent transfers. There have been at least 13 reports since 2011 to the state government recommending the creation of a public health cadre, but to no avail. Now that the Health Minister has announced revision of C&R rules, it shows political will.”
“Around 500 positions in the public health cadre need to be created. Currently, in 176 taluks, more than 200 officials are qualified, but at least 350 need to be trained. Now, the focus is on clinical services. There are other aspects like non-communicable disease prevention, sanitation, immunisation, etc. You need a multi-sectoral approach,” Babu said.
Prashanth N S, a faculty member at the Institute of Public Health had earlier told Express, “Currently, clinicians get posted in administrative positions in governmnet hospitals that they have no understanding of. One needs to know about epidemiology, disease burden and health planning in public health.”  
“Tamil Nadu has been a pioneer on this front. After six years of service there, a clinician gets to choose whether he wants to practise medicine or indulge in health planning or preventive health programmes like immunisation. The Health Department in Karnataka needs a hospital management cadre to know how to organise a hospital,” he added.
Major Recommendations
Currently, the Director of the Health Department looks after both public health and clinical aspects. MBBS graduates with about six years of experience in rural PHCs are appointed as block and taluk health officers, district health officers, deputy director (public health specialities), Director (public health) and other senior posts.
Public health experts recommend that the minimum qualification for those in public health administration be increased to post-graduation in Public Health and for those in hospital services administration, to PG in a clinical speciality. They also suggest an increase in minimum experience in sync with the seniority of the post.