13. HEALTH AND FAMILY WELFARE Health and Family Welfare 13 HEALTH AND FAMILY WELFARE c‰wh‹ msΫ ÃâmsΫ fhyK« f‰wh‹ fU¢ braš. - ÂU¡FwŸ 949 The habitudes of patient and disease, the crises of the ill: These must be learned leech think over well, then use his skill. - Thirukkural 949 Vision Tamil Nadu 2023 envisages that Tamil Nadu will be India’s leading State on social development and will have the highest Human Development Index (HDI) amongst all Indian States. Introduction even among those who are financially secured. High health care costs can lead to The health of the people in the State impoverisation or exacerbation of poverty. is an essential component of development, The importance of public provisioning of vital to the economic growth and internal quality health care at affordable costs and stability of the State. Assuring a minimal and provision of reliable heath services cannot be universal level of health care to the population underestimated. is a critical constituent of the development process. Human Development Index consists Health makes education possible of three components namely Education, Life and vice versa. Education of women delays Expectancy at Birth and Command over age at marriage, improves knowledge of Resources i.e. purchasing power parity. The contraceptives and enhances their status healthier the population, the more will be in society. Considering the above facts, the Index Value. Loss of health is most often the Government of Tamil Nadu has been irreversible and the potential loss of output bestowing more attention on female education for the individual cannot be compensated. and focused health care. The Government’s Considerable achievements have been made principal health policy is to ensure “Health over the last six decades to improve health for all” and universal guarantee of basic standards such as Life Expectancy, Child health and education. In Tamil Nadu, both Mortality, Infant Mortality and Maternal public and private sector hospitals have been Mortality. The strong link between poverty catering to the health care requirements of and ill health needs to be recognised. Ill the public. The State’s objective is to ensure health and morbidity create immense stress that health care services are rendered with 585 Twelfth Five Year Plan Tamil Nadu the core principles of accessibility, equity, The delivery mechanism provides curative, excellence and affordability by building a wide preventive and rehabilitative care. health care network throughout the State. UNIVERSAL HEALTH COVERAGE BY 2022: THE VISION ENTITLEMENT NATIONAL HEALTH PACKAGE CHIOCE OF FACILITIES Universal health Guaranteed access to an People are free to entitlement to every essential health package choose between citizen (including in-patient and out- patient care provided free-of- • Public sector cost) facilities; and • Primary care • Contracted-in • Secondary care Private • Tertiary care providers Source: High Level Expert Group, UPC – 2011 Fig. 13.1: Universal Health Coverage Vision Vision Tamil Nadu 2023 • 15 new Medical Colleges attached to The Vision Tamil Nadu 2023 sets the district hospitals will be established and plan for infrastructure development of the the already existing 17 medical colleges State to reach the desired outcomes by 2023. attached to hospitals will be upgraded to It envisages Tamil Nadu to become not only international standards. the Numero Uno State in India in terms of • The State Government aims to establish social indicators, but also to reach the levels and strengthen ten or more Centres of attained by developed countries in human Excellence - these would essentially be development by ensuring universal access to world class organisations that are at the health care facilities. The key infrastructure cutting edge in their respective domains, development in the Health sector is in which would include life style diseases for providing universal access. Some of the key the health sector. initiatives proposed are: • Tamil Nadu is already renowned • Increase the capacity of primary and for healthcare facilities and the key secondary healthcare network by factors responsible for promoting improving the infrastructure of the Medical Tourism Industry are world hospitals such as enhancement of bed class treatment at competitive rates, strength, laboratory and radiology facilities international connectivity, availability of and diet provisioning and ensuring that professional healthcare skills, knowledge a referral centre is available within a and resources. It will further develop this maximum distance of five kilometres from reputation by aggressively positioning every Sub-Centre. itself as the medical tourism destination 586 Health and Family Welfare of South Asia. Medical Tourism would laboratories, collection centres, radiology emerge as a thrust area as per the Vision centres will be networked. 2023. • Electronic Medical Records Management • Two Medi-cities will be created in Southern and Hospital Management System will and Western Tamil Nadu with a mission be implemented in all District and Taluk to serve the medical tourism industry hospitals. by investment in hospital and education • The State will ensure availability of facilities, logistics and hospitality services. items on the Essential Drug List (EDL) • Trauma, ambulatory and disaster to all citizens. The State will also ensure management care facilities will be improved 100 percent availability of drugs at all across the State. Diagnostic services like locations. Fig. 13.2: Rajiv Gandhi Government General Hospital 587 Twelfth Five Year Plan Tamil Nadu 13.1 MEDICAL EDUCATION AND RESEARCH Medical Education in the total bed strength of these hospitals is 25,413 Government Sector and their daily average in-patients and out- patients strength is 22,002 and 70,919 Good health provisioning and respectively. planning in the State would require quality health workers in various categories. There The Tamil Nadu Dr. M.G.R. Medical is a need to focus on Medical Education to University is conducting various courses provide leadership in research and practice in Medicine and allied health sciences in different medical conditions and research through the 328 institutions affiliated to the themes. University. Selection to the courses are made by the Selection Committee, Directorate Medical Institutions in the of Medical Education and the respective Government sector which are offering medical Institutions by the merit list. The University and paramedical education including nursing Library serves as a Regional Medical Library is given in the Table 13.1.1. and Medical Informatics Centre. Review of Eleventh Plan Table 13.1.1: Government Medical Institutions in Tamil Nadu Strengthening of teaching institutions and their attached hospitals in terms of Institutions Numbers additional infrastructure, provision of modern Government Medical 17 medical equipment and strengthening of Colleges diagnostic facilities were the priority areas of Government Dental College 1 the Eleventh Plan. Physiotherapy Colleges 2 During the Eleventh Plan period, Nursing Colleges 4 three new Government Medical Colleges Schools of Nursing were opened at Dharmapuri, Villupuram and 23 (Diploma) Thiruvarur. Additional buildings including Total 47 hostel buildings were constructed in the existing medical colleges and the statutory Source: Dept. of Health and Family Welfare, requirements in terms of staff, equipment GoTN etc.,were provided in order to create additional The above Medical Institutions and seats in the postgraduate, super speciality the 63 Hospitals attached to the medical and nursing courses. The Table 13.1.2 gives colleges are functioning under the control the overall increase of seats in the various of the Directorate of Medical Education. The disciplines during the Plan period. 588 Health and Family Welfare Table 13.1.2: Physical Performance of the Eleventh Plan No. of seats S.No. Name of the Course Beginning End (2007-08) (2011-12) I Diploma Course 1 Diploma in Nursing 1795 1875 II U.G. Courses 1 M.B.B.S. 1645 1945 2 B.D.S. 100 100 3 B. Physiotherapy 50 50 4 B.Sc (Nursing) 50 175 5 B. Pharmacy 106 120 III P.G. Courses 1 P.G. Degree (Medical) 429 706 2 P.G. Diploma 349 403 3 M.D.S. 36 37 4 Higher Specialities 69 187 5 M. Pharmacy 32 64 6 M.Sc. (Nursing) 8 65 7 M.Sc. (Medical Physics) - 10 Source: Dept. of Health and Family Welfare, GoTN The Government Arignar Anna In the Eleventh Plan period, an Cancer Institute, Karapettai, Kancheepuram initiative was taken to create a network of was made the Regional Centre of Excellence super speciality hospitals to afford quality for Cancer and a Linear Accelerator was tertiary health care to the people. A super established at a cost of `10.00 crore to provide speciality hospital with trauma block was set modern medical care to poor cancer patients. up at a cost of `139.10 crore in the Mohan Mammography units were established in Kumaramangalam Medical College Hospital, Rajiv Gandhi Government General Hospital, Salem with the GoI assistance of `100.00 Stanley Medical College Hospital and Kilpauk crore under Pradhan Manthri Swasthya Medical College Hospital, Chennai. Suraksha Yojana. The Paramedical education was During the Eleventh Plan, an outlay given priority by opening two new Nursing of `2,730.00 crore was allocated for the Colleges at Salem and Chengalpattu and a Health Sector and the expenditure incurred new Nursing School at Vellore. The number was `4,719.00 crore. of M.Pharm seats were increased in Chennai Twelfth Five Year