THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 21, NO. 2, 2008 95 Letter from Mumbai

THE BANE OF PUBLIC SECTOR MEDICAL COLLEGES Teachers in smaller medical colleges, woefully lacking AND THEIR HOSPITALS credentials in all three branches of their calling—teaching, patient Dr M. K. Mani and I have referred to this deterioration in our care and research—have successfully pulled strings to dislodge letters from Chennai and Mumbai but as the rot continues, politically unconnected but meritorious teachers in the medical reiteration is necessary. colleges in Pune, Nagpur and Mumbai. Seeking life in the fast lane The progressive deterioration of medical colleges and attached and in proximity to those in power—ministers and bureaucrats— hospitals in the public sector continues to cause much concern. the unmerited professors and deans occupy positions in hallowed Once the esteemed source of well-trained, bright and motivated medical colleges and their hospitals without loyalty to them or young doctors and of the best medical care available in their concern for their well-being. The consequence: dislodged respective cities, they are now pitiable shadows of their former meritorious teachers have preferred handing in their resignations selves. At their acme, they were avidly sought-after institutions by and entering private practice where they have soon emerged as students intending to specialize in medicine and by distinguished very successful practitioners. professionals wishing to teach, do research and attend to the I shall not dwell on the corruption that pervades everywhere— multitude of patients attending their hospitals. They now witness selection of professors, deans, examinations in medical colleges, mass emigration of their staff members to greener pastures. This inspection of medical colleges and hospitals by the Medical leaves several departments desperately short of teaching staff and Councils and purchase of equipment. They are further nails that in imminent danger of being shut down. securely fasten the coffin lid.

How has this come about? Who are the losers? Many analysts put political interference high on the list of causes. Youngsters entering medical colleges are denied the opportunity The recent unseemly and undignified exchanges between Dr of learning from and being inspired by these displaced merited Venugopal, who has recently left the post of Director at the All consultants. They are now ‘taught’ by those who have never India Institute of Medical Sciences and Dr Anbumani Ramadoss, considered teaching a worthy task. As they continue their the Union Minister of Health, are fresh in our minds. manipulations to ascend the ladder of success to such posts as In Mumbai, my alma mater, the Grant Medical College and Sir dean, director of Medical Education and Research and finally the Jamsetjee Jejeebhoy Group of Hospitals have been brought down vice-chancellor, these ‘teachers’ have little time for students. from their pinnacles by the machinations of politicians in the Patients who have been deprived of the best brains in the Government of Maharashtra, bureaucratic inefficiency and medical profession have suffered an equal loss. Research is the ambitious but unmerited medical professionals in towns such as third casualty. Ambejogai where medical colleges and hospitals were set up not Students and researchers are also deprived of an atmosphere for the benefit of the local poor but for local legislators seeking where questions are asked, answers sought and the intellect rapid advancement up the ladder leading to power and pelf. stimulated. Instruments and equipment freely used in private The creation of such institutions is driven by the blatant self- hospitals in Mumbai are not available in the government medical interest of senior cabinet ministers in private medical colleges and college laboratories and hospitals. Should the keen student wish hospitals run by themselves or their offspring. Such activity is to learn their capabilities, he must make arrangements on his own aided by the downgrading of public-sector medical colleges and to visit institutions such as Bombay Hospital, Jaslok Hospital or their hospitals with the result that there is neither the will, nor time Hinduja Hospital. He will not be permitted hands-on experience or energy to take steps to keep institutions such as the Grant but can at least see them in action. Medical College in prime position. The tragedy is compounded when at last the government Powerful and pushy ministers do not seek the portfolios of hospital does purchase equipment such as a magnetic resonance Health and Medical Education. Likewise, it is the hapless bureaucrat scanner or positron emission tomography scanner. Neither teacher, who is saddled with the post of secretary in these ministries. Far- nor student nor patient can rest in comfort that such a facility sightedness, drive and enthusiasm to further medical education, is now available. The crated equipment may lie in a basement public health and medical research are thus missing at the very or in already narrow corridors for months or even a year. Often, helm. when the crates are finally opened, outdated or damaged parts Planning (short-term and over the next 5, 10, 15 and 20 years), need replacement, which, of course, will take more months for incorporation of new research applications as soon as they are sanction, funding, procurement and installation. available, raising standards all the time, fund-raising, effective supervision and reward to the meritorious while punishing the Is there any proof of this decay? inefficient and corrupt are essential components in the Analyses of the academic activities within government medical administration of any ministry. Instead, senior bureaucrats in the colleges, publications by their staff members in reputed medical ministries of health and medical education spend most of their journals and texts and the avidity with which these professors are time and energy fire-fighting, framing answers to questions that consulted in difficult cases in other institutions (especially those expose deficiencies in their ministries in legislative assemblies in the private sector) will show the extent to which they have fallen and dealing with legal cases in a multitude of courts of law. in the estimation of the profession at large. ‘Where is the time or energy for any constructive activity?’ a An even more telling index is the number of times the high and senior bureaucrat asked a group of concerned doctors. mighty—let us restrict ourselves for the moment to the governor

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of the state, ministers and secretaries in various sections of the of the original Professors’ room on the second floor have government—seek medical care in government medical colleges disappeared. The entire second and first floors are in danger of and hospitals. When was the last time you saw these ‘worthies’ collapse as teak beams are rotting and the ceilings and walls are attending the Sir Jamsetjee Jejeebhoy Hospital in Mumbai or leaking profusely. David Sassoon Hospital in Pune? It would be a great loss to the medical community and the city Why do they prefer turning to consultants at such institutions of Mumbai were this remnant of the buildings envisaged by Sir as the Bombay Hospital or Jaslok Hospital or Hinduja Hospital? Robert Grant and created by Sir Jamsetjee Jejeebhoy, Dr Charles Morehead and others to crumble. This building has seen the likes RESTORING A HERITAGE BUILDING of Dr Charles Morehead, Dr John McLennan, Dr Bhau Daji Lad, A group of committed alumni of the Grant Medical College and Dr Atmaram Pandurang Turkhud, Dr Henry Vandyke Carter, Dr Sir Jamsetjee Jejeebhoy Hospital have undertaken a formidable Sohan Lal Bhatia, Dr Shantilal J. Mehta and other legendary task. Under the chairmanship of Dr Noshir Wadia, this group aims figures working, studying and teaching in it and in the corridors at restoring the original building that housed the Grant Medical of the affiliated hospital named after the first Parsi Baronet. College. The restoration is an uphill task, involving as it does the The college building was opened for use in 1845 and was onerous chore of getting the Government of Maharashtra to hailed by a contemporary reporter of The Bombay Times (as The sanction and, if possible, fund it; obtain the services of an expert Times of India was known then) thus: ‘The college is fast skilled in bringing the building to its original glory, put it to approaching to a finished state and when completed will form one commendable use and eventually ensure that it remains in this of the most striking objects in the island. Viewed from the Malabar state. Much sweat, toil and some tears will be necessary ere this Hill, and its vicinity, it presents something for the eye to repose project comes to fruition. Given the will and enthusiasm of the upon with pleasure, independent of the human and generous members forming this group, there is reason for optimism. emotions to which the view is calculated to give birth….’ This Certainly, it is a laudable goal, worthy of support. historic building is in a poor state. The roof, side walls and floor SUNIL PANDYA

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