Thursday, October 13, 2011

Pick & choose in registering ultrasound clinics


SYED ALI SAFVI

SRINAGAR, Oct 11:
Even as the state government recently sealed 200 ultrasound clinics in Kashmir valley alone and an unspecified number in Jammu region for “not adhering to PNDT act”, an official document has revealed that some “blue eyed” doctors have been allowed to operate their clinics despite failing to meet the requirements set out by the health department.
According to the official document, a copy of which is with Kashmir Times, as many as 43 ultrasound clinics have been duly registered and allowed to function in the Kashmir valley. 80 such clinics have got the go ahead in Jammu, Director Health Services, Jammu Division, Dr Madhu Khullar confirmed.
In complete violation of the recommendations of PNDT advisory committee, constituted by the government in 2002, at least in the Valley, the health department has allowed some blue-eyed doctors to run ultrasound clinics who have undergone four to eight months training.
Even as the health department seized 200 ultrasound clinics in the valley and atleast more than 25 in Jammu division on the pretext that doctors were not “fully trained” to do ultrasound, some clinics have been allowed to run their business for reasons best known to the health department.
According to the document, a doctor having undergone four months and 18 days training is also doing ultrasound at a clinic in Srinagar. Similarly, another doctor with six months training has been allowed to perform ultrasonography at Bemina.
The document further reveals that a doctor with four months training has been authorised to perform ultrasound at a clinic in Sopore. Similarly, another doctor with three months training is doing ultrasound at a clinic in Pulwama.
It is pertinent to mention here that Directorate of Health Service Kashmir had issued a circular specifying the area within which a doctor, working in government hospital, can perform private practice: 18 kms for MBBS doctors and 10 kms for specialists.
However, ironically, throwing all the norms and directives to the wind, the director has himself given registration to some doctors who have private clinics as far as 40 to 60 kms away from their place of postings. A doctor is posted at District Hospital Anantnag and he is running his clinic at Batamaloo. Similarly, another doctor is posted at District Hospital Budgam and he is running ultrasound unit at Nawpora.
Another doctor is posted at District Hospital Baramulla and he has been allowed to operate in a clinic at Karan Nagar Srinagar.
“The officials say that the registrations of some clinics, which have been allowed to function, are under review,” said President Private Diagnostic Centre Association (PDCA), Umar. “They have been under review for the last two years.”
According to Umar, in public sector only SMHS hospital is registered under PNDT act.
“All other hospitals including Lal Ded and SKIMS are not registered under PNDT Act,” he said.
Umar said that in June 2006, acting on the directions of High Court, Directorate of Health Services gave registration to ultrasound clinics in the state. However, since 2009, the directorate not only refused new registration, but also refused renewal of registrations.
“About 250 diagnostic centers have applied for registration and renewal of registration for USG, X-Rray and laboratories. Surprisingly, only a few have been registered for reasons best known to the authorities,” he added.
Significantly, in Delhi and many other states in India, any MBBS doctor, physician, gynaecologist, surgeon, neurologist, having six months training certificate from any recognised radiology department can apply for PNDT registration.
A senior doctor said, “I wonder if a doctor having four months or more training in sonography is competent enough to do USG in state run hospitals, how come he is not competent to do the same in private clinics.”
Pertinently, in the wake of disturbing disclosure in Census 2011 about alarming decline in sex ratio in J&K, the beleaguered state health ministry launched a crackdown against ultrasound clinics in the state.
The health ministry claimed in May last, that the sealed ultrasound clinics were involved in conducting banned sex determination tests (SDT). However, the official document reveals that not a single case has been registered in Kashmir against any Sonologist involved in SDT, as claimed by the government. Two cases were, however, registered in Jammu on June 14 and September 15, 2011 after Sonologists were caught red handed by the authorities while performing sex determination tests.
Despite legal experts and J&K Private Diagnostic Centre Association (JKPDCA) terming the clampdown as “illegal” and uncalled for, the state health department sealed 200 ultrasound clinics in Kashmir division and two clinics in Jammu division. Even as the government sealed a major chunk of ultrasound clinic in the state and refused to renew their registrations, the health department showed their generosity towards some ultrasound clinic by giving them license to operate, despite the fact that most of them fail to meet the requirements set out by the health department.
According to SRO, PNDT Act, registration can be given to doctors, who have undergone six months training. While throwing all norms to the wind, the directorate of health services Kashmir has given registration to “blue eyed” doctors who have undergone training of less than one year.
In brazen violation of the health department directives, seven doctors of the “registered” ultrasound units are working in more than one clinic.
When contacted, MoS Health, Javed Ahmad Dar, said that he did “know much” much about it. “Me thehra mamuli MoS (I am a simple MoS),” he told Kashmir Times. “Aap minister sahib se pooch lijiye (You ask minister). I don’t deal with all this.”
Director Health Services Kashmir, Dr Saleem, said that the government has appointed Dr Yashpal as nodal officer for PC-PNDT. “He (Dr Yashpal) will be a better person to talk on the matter,” he said.
When contacted, Dr Yashpal too refused to comment on the matter. “I’m nowhere involved in the process. Director sahib has sealed the clinics, so he will be a better person to reply to your queries,” he said.
According to sources, two ultrasound clinics were sealed by the health department in Anantnag district. However, they were reopened within 24 hours.
Some proprietors of ultrasound units this reporter spoke to alleged that the health authorities were asking them to pay Rs 50000 towards them if they want to restart their units.
Pertinently, as per the PNDT Act, even MBBS doctor having undergone training in ultra-sonography can do the ultrasound.
“To uphold the standard quality of USG clinics the registration is given to those ultrasound centers who have either a well qualified radiologist performing these investigations, possessing DMRD or MD or DNB in radiology, or an MBBS doctor having sufficient experience and having undergone training in ultra-sonography,” reads the Act (Page no 28 (3b) Para 1).