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NEIGRIHMS’ Rebuttal to Special article NEIGRIHMS: The withering away of a premiere health care and research institution

             My critics are my best friends is the philosophy of the present director, the North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. He has to embrace people of different shades, but not at the cost of maintaining discipline and conduct rules laid by Central Government. Ignorance of these rules and going to media and press by faculty, staff members or students, cannot be ignored by the institute but has to be noted. Just declaring an institute “an Institute of National Importance (INI)” in parliament, but not making really a fully autonomous institute by an act of parliament, taking out of the purview of Medical Council of India still a far reality. In the last year (June 2017), with the intervention by Honorable Chief Minister Conrad Sangma and Honorable Health Minister A L Hek, Ministry of Health and Family Welfare, Government of Meghalaya, MOHFW, New Delhi took up the discussion on giving full autonomy to this institute. The question asked was which area the institute has achieved “Excellence” as at present all departments have not even set up the postgraduate programmes as there are shortage of faculty in many of these department. For postgraduate programmes to be established, there are minimum standards and norms of the Medical Council of India which the Institute needs to fulfill. The current faculty members are yet to be given any incentives out of the “Institution of Excellence”, and continuation of the Assessment Promotion Scheme from 2014. Promotion through the Assessment Promotion Scheme to the faculty members is yet to happen from 2014, for no fault of theirs.  In pay scales, the faculty has parity with AIIMS, New Delhi, but the learning resource allowance has been discontinued from 2013 onwards on the observation of audit. For last 2 years, efforts are on with Ministry of Health and Family Welfare to implement “Assessment Promotion Scheme” for Faculty posts, learning resource allowance at par with AIIMS, New Delhi, and enhanced academic allowance. Under the circumstances, I salute the faculty of NEIGRIHMS who are serving this institute with sincerity and fervor. Certainly, lack of promotion avenues to NEIGRIHMS faculty affects their career progress as well as their morale. Since joining of the Director, interaction is taking place every Saturday interactive programme with each specialty, through hospital council, medical faculty council, interaction with head of departments at regular interval. Time to time special meetings are being arranged with faculty members to sort out various issues related to their department. Regarding vacation, it is being clarified that even before joining of the present director, the faculty of NEIGRIHMS was taking 39 days vacation in two parts in a flexible way against the norms of any other autonomous institute. On the other hand, Nursing college was strictly following the nine days summer vacation schedule and thirty days winter vacation schedule. To bring uniformity, same Nursing College schedule was put in place as people were taking split vacation like earned leave disrupting the normal routine in busy days when MBBS teaching programmes are being organized and vacation schedule to match with MBBS and Nursing students vacation schedule.

        Four postgraduate courses in the discipline of Radio-diagnosis, General Medicine, General Surgery and Anesthesiology were facing recognition problem in April-May 2017. With due interventions, MD Radiodiagnosis got recognition for 5 years in March 2018 for 2 seats per year and MD General Medicine got recognition for 5 years in March 2019 for 2 seats per year. Efforts are on to rejuvenate MS General Surgery and MD Anesthesiology. One additional seat in MD Pathology got recognition in 2018.

       Major issue in the General Surgery is lack of one Associate Professor and four Assistant Professors. Some of these posts are reserved for OBC and SC, no faculty member has been selected for last two decades or so in spite of repeated advertisements. This department requires three units with 30 beds each. First unit to be headed by Professor, rest two to be headed at least by Associate Professors. Hence, other super-specialty surgical departments faculty (who are not running MCh programme) were asked to support General Surgery. In the absence faculty and necessary bed strength, how department of General Surgery can achieve magic figure in operative procedures.

         Another department facing various issues is Anesthesiology department, which maintains state of art “Intensive care unit”. It has requisite faculty to support postgraduate programme, but one of the Associate Professor does not fulfill criteria.  At present, just 4 senior residents are working against the sanctioned strength of 12 posts. Gas Manifold (Gas pipe line system) non-existence was another issue pending for last 12 years in this hospital.  From August 2018, its installation process had begun and had disrupted some services for short duration of 10-15 days in those areas. Gas Manifold will be soon operational in next 2-3 months. To strengthen operative procedures, eight modular operation theatres proposal are being processed and to strengthen Anesthesia services, proposal for according sanction of creating 15 faculty posts and 30 senior resident is in advanced stage with MOHFW.

        The department of Pediatrics is running with half the strength of faculty. Unfortunately, in spite eight senior resident posts available, none is available as none applied for these posts as they are in great demand.

        In the December 2018, ministry had sanctioned 301 posts in nursing. This will help to overcome the shortages of nurses in NEIGRIHMS. These posts will be advertised after code of conduct period for parliamentary elections is over.

       MCI cell was created in 2017 to give inputs regarding starting new courses. Necessary infrastructure requirements were put in place and finally in 2018, we applied for starting six new postgraduate courses in the discipline of ENT, Dermatology, Venereology and Leprosy, Forensic Medicine, Ophthalmology, Biochemistry and Pharmacology. The applications for the same were sent to Director General of Health Services for the same in September to December 2019. Assessments were held in December 2018 to March 2019. As a consequence of that letter of permission was obtained from Ministry of Health and Family Welfare in March 2019 for starting new courses in MS ENT (2 seats), MD Dermatology, Venereology and Leprosy (2 seats), Forensic Medicine (3 seats). These PG seats will be filled through NEET PG counseling.

        This year NEIGRIHMS has added 9 additional postgraduate seats from 4 departments a major boost to postgraduate programme.

        In December 2018, Cardiothoracic and vascular surgery (CTVS) department had a meeting with director to start MCh programme in 2019 and put a proposal for the same as they had full compliment of faculty and infrastructure probably the best in whole North East India. But rather, Dr. JP Kalita, Associate Professor of CTVS department put forward his resignation letter which MOHFW has accepted. How Director is thus against the development of superspecialty departments?

       Administration is open to any suggestion from Faculty of resident doctors and students studying here, for their upliftment and betterment. All the issues related to resident doctors will be looked into and sorted out as per the norms and rules of this institute. Medical fraternity is involved in all the spheres of this institute and working with the cooperation of the all.

      Inspite of all the efforts, the Director has been targeted by vested interests as only because he wanted to bring discipline and vigilance in the institution. This temple of learning “NEIGRIHMS” has to revered with dedication, director has to act as guardian for students and public to be treated its customers with respect. Affordable health care is the motto of this institute for its patients who are its valuable clients.

      NEIGRIHMS is known for affordable healthcare that is being visited on daily basis by more than 2000 patients per day. Pharmacies in the institute are being strengthened. They provide subsidized drugs, stents, valves, pacemakers, implants etc. If some of these implants are not available, orders can be placed with them, so that same can be made available within 24-48 hours to them. People can approach AMRIT pharmacy, Life care pharmacy (inside the hospital) and Lucky pharmacy in Public Utility Block (near Bank of Baroda and Post Office).

           As per the Central Government directive, it has been instructed that poor patients may be directed to buy their medicines, stents, pacemakers, valves, implants from hospital pharmacies so that they can avoid paying double the price for the same from pharmacies outside the hospital. Ministry wants this information to be widely distributed.

      Recently, AMRIT pharmacy at NEIGRIHMS, Shillong has started providing stents at subsidized cost inside the hospital and it is also taking order for providing pacemakers, valves, and implants etc. Any patient having any complaint related these services inside NEIGRIHMS may contact Medical Superintendent (Near OPD entrance) or Vigilance Officer (at First Floor at Pain and Palliative care unit).

      Governing council agenda was given to the ministry last year but date is still awaited. Two governing members names were recommended by the director last year on ministry request, and approval is still awaited. The director is not vary of facing governing council. Rather he wants to hold the meeting at the earliest so that important issues facing the institute are taken up and direction from its members and president is utilized.

        The present institute started working from present campus in Mawdiangdiang Shillong from year 2006. From the year 2017, major expansion programme for Nursing College and its hostels for 100 BSc Nursing students and 20 MSc Nursing students, Medical College building for 100 MBBS student admission including Hostels for 600 students, and Internee Hostel, and Regional Cancer Centre with 252 beds, state of art equipments, guest house for patients with 28 rooms. Nursing college with hostels and guesthouse are likely to be completed by April 2019 or so. Other projects are likely to be completed by 2019-year end. The completion of these projects will provide many job opportunities and enhance patient care services.

       Let the people guess now, whether institute is on the verge of collapse, withering away or standing up and blooming in spite of various challenges. Northeast India should demand attention of stakeholders and others so that people wishes can be fulfilled. Whether Dr. Thappa stays here or not for long, he will continue to strive his best with dedication, for the overall upliftment of this Premiere Institute and benefit of the patients at large to the best of his abilities.                 Press Release

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