Tuesday, February 4, 2020

Permissions Required To Open A Hospital In India.

Permissions  Required To Open A Hospital In India.

The set-up of hospitals in India are mainly of two types: i.e. Government hospital and Private Hospitals. Furthermore, they could be general, specialty or multi-specialty hospitals. The rules and regulations that are required to comply for setting up a private hospital in India are;

First things first.
Decide first,What Facilities one has to going to be offered and whether its providing primary care?secondary or teritiary care? Depending on this,one should select the location which  is very crucial for successful running of any hospital.
Location of the Hospital is required to be chosen well.
Whether there are already some hospitals in the locality? Are they going to be competitive or symbiotic?
Whether the locality has a good transportation facility or is close to a railway station?
One must look for a non-agricultural land particularly designed for hospitals.
 All the electricity supply, as well as the water supply, should be easily available and that is required to be checked before purchasing any land for the hospital set up.
The Procedure for a small Hospital Set Up in India
Registration under the  central clinical establishment act, 2017 / or  hospital registration act of states where ever state act is present.
Depend upon the category,hospitals should fulfill the minimum requirement to get registered.

Permits to construct a new hospital:
Land and construction
A Hospital could be set up only on a no- Agriculture land could be used. The numerous approval, as well as permissions required from the local authority and the government, should be obtained before starting any hospital.

Electricity and water
A hospital needs approximately 100 liters of water per bed each day. The water requirement for the various hospitals would be different from project to project based on whether the hospital is a primary or  specialized hospital, etc. The concerned municipal authority permission should be obtained for making available the water as well as electricity facilities.

Sewage
well planned sanitary measures for disposal of waste as well as drainage system which includes tanks, pipelines, etc. and permission from the local authorities should be obtained.

Biomedical Waste
The large hospitals must have an incinerator for disposal of bio-disposal waste, for instance, body parts or tissues.
As  smaller hospitals are not able to afford such cost,they have to get the  Municipal corporation permission for such disposal of waste and it must not be harmful to the people living at a nearby location.

Fire and Health License
Approval of Fire Department is required for a large hospital as well as a health certificate from the local authority after installation of all the beds and equipment within the Hospital. A NOC from Fire the department shall also be required for small hospitals and it would be the responsibility of the hospital management to prove that the hospital would not cause any harm or loss of life and requires to be procured from the local municipal council.

Regulations relating to Employment of Staff
·        Employment of employees (Doctors, Nurses, Pharmacists) only after proper credentialing.
·        Prevention of sexual harassment of women employees at the workplace
·        Responsibility of the employer for the safety of work forces
·        Rules governing the employment of staff
·        Immunization / other measures for the protection of staff from Occupational Health hazards.

Sign Boards
Rules for the size, contents as well as the correct place for signboards (IMC Regulations 2002)

Information that requires be displayed at the Hospital are:
  • Certificate of registration of hospital with the District registering authority and municipal authorities
  • IMC/SMC  degree registration certificate.
  • Charges for consultation as well as other procedures/services .
  • Clinic timings, closed days.

For big corporate/ multispeciality hospitals:
>Registration under companies’ Act, 2013
This act is applicable when the hospital established it under the ownership of a corporation. The act needs that the corporation is registered and fulfills the requirement of incorporation like memorandum of association, articles of association, capital structure formation, securities allotment, account audits, etc.

>Director Index No (DIN NO) for each director
This comes under the Ministry of Corporate Affairs, Government of India. It is a compulsory registration required for each director who wants to be a part of a corporation. It is a onetime registration for directors.

>Registration under societies registration act, 2001
In case the hospital is being established under the ownership of society, the society registration act is required.


>FSSAI license for operating a kitchen
FSSAI license comes under the Food Safety and Standards Authority of India under the Ministry of Health and Family Welfare, Government of India. The license is necessary if the hospital runs an in house kitchen for the patients as well as attendants.

>Permit to store LPG cylinder
If the hospital store has an LPG cylinder in large quantity for usage in the hospital's Kitchen or hospital purposes, the hospital must have a permit of Controller of Explosives under the Petroleum act, 1934.

Pharmacy registration for medical shop
This comes under the Office of the Drug Controller. There are different licenses for medical shops attached to hospitals (IP) and standalone medical shops. There are minimum requirements for the registration like the minimum size of the shop ( 250 – 300 ft) as well as requirements of Air conditioner and Refrigerator. This license is valid for 5 years.

Trademark registration
Indian Trademarks Act 1999 is not a mandatory activity and is essential only if the hospital wants to trademark its logo or name

>Vehicle registration for ambulances
The ambulance bought by the hospital must be registered under RTO, Transport Department, and state government.

>Arms licenses under arms act 1959
If arms are possessed by the hospital or its employees (for example by security guards), a license for the same should be available

Planning the Hospital Infrastructure
  • One must take care of these things
  • Qualifications of Doctors as well as their registration numbers
  • Working hours for Nurses as well as their shift timings
  • Medical equipment as well as instruments purchased
  • Computers as well as other hardware devices set up
  • Engineers as well as staffs required for maintenance, plumbing, medical gas pipelines, air conditioning, etc.


The other important license required are (Depend on the applicability):
  • Regulations Building Permit and Licenses (From the Municipality)
  • No objection certificate from the Chief Fire Officer "License under Bio-Medical Management and Handling Rules, 1998.
  • No objection certificate under Pollution Control Act.
  • Narcotics and Psychotropic substances Act, 1985
  • Vehicle Registration Certificates (For all hospital vehicles.)
  • Atomic energy regulatory body approvals (For the structural facility of radiology dept, TLD badges, etc)
  • Boilers Act, 1923(If applicable)
  • MTP Act, 1971 (MTP stands for Medical termination of pregnancy. To be displayed in the Gynaec and Obs department)
  • License for the Blood Bank (To be displayed in the Blood Bank)
  • Transplantation of Human Organs Act 1994(If applicable)
  • PNDT Act, 1996 (PNDT stands for Prenatal diagnostics test. To be displayed in the Radiology department that this is followed. )
  • Dentist Regulations, 1976
  • Drugs & Cosmetics Act, 1940
  • Electricity Act, 1998
  • ESI Act, 1948 (For contract employees)
  • Environment Protection Act, 1986
  • Fatal Accidents Act 1855
  • Guardians and Wards Act, 1890
  • Indian Lunacy Act, 1912 (Applicable only if a Psychiatry dept is there in the hospital)
  • Indian Nursing Council Act 1947 (Whether nurses are registered with NCI).
  • Also one must check whether pharmacists are registered with Pharmacy Council of India.)
  • Insecticides Act, 1968
  • Lepers Act Maternity Benefit Act, 1961
  • Minimum wages act, 1948 (For contract employees)
  • Pharmacy Act, 1948
  • SC and ST Act, 1989
  • Protection of Human Rights Act, 1993
  • Registration of Births and Deaths Act, 1969
  • Urban Land Act, 1976
  • Right to Information Act 2005
  • Registration for transplantation of human organ Act, 1994 (in case the hospital varies out human organ transplantation or organ harvesting, it shall be registered under this Act)
  • Excise permit to store spirit (to store spirit beyond a certain quantity, the hospital must obtain a permit from state excise department)


All the Best

Monday, February 3, 2020

IF NOT MBBS,WHAT IS THERE FOR Bi.P.C. GROUP?

Here is the list of best course after 12th Science Biology PCB .

you can choose the best course based on your strengths -Aptitudes and Personality)-and preferences. 

Physics,Chemistry,Biology Courses

  1. MBBS Bachelor of Medicine and Bachelor of Surgery. AIIMS New Delhi is one of the Top Medical college in India.
  2. BHMS Bachelor of Homeopathy medicine and Surgery
  3. BAMS Bachelor of Ayurvedic Medicine Surgery. BAMS course is among the top choices of students after MBBS.
  4. BUMS Bachelor of Unani medicine and Surgery
  5. BDS- Bachelor of Dental Surgery
  6. B Sc Naturopathy
  7. B.Sc and AH-  Bachelor of Veterinary Sciences. This is one of the upcoming options and Bombay Veterinary college is among the Top colleges in India.
  8. B.Sc- Bachelor of Science Botany / Zoology / Chemistry Delhi University and Panjab University Chandigarh are Top universities for this course.
  9. B.Sc Microbiology- Bachelor of Science in Microbiology
  10. B.Sc Biotechnology- Bachelor of science in Biotechnology
  11. B.Sc Bio Chemistry- Bachelor of science in Bio Chemistry
  12. B Sc Bio Medical Science
  13. B.Sc. Forensic Sciences Get list of colleges that offer B Sc Forensic Science course
  14. B Sc GeneticsGet list of colleges that offer course in Genetics
  15. B.Sc Nursing. AIIMS New Delhi is among the Top institutions that offer this course.
  16. B PT- Bachelor in Physio Therapy ( Course duration 4 and half years) Get colleges that offer BPT course
  17. B Pharm- Bachelor in Pharmacy Panjab University Chandigarh is among the Top Universities that offers this course.
  18. .
  19. B Sc Allied Health Sciences
  20. B Sc Agriculture- Bachelor of Science in Agriculture
  21. B.Sc. Horticulture
  22. B.Sc Environmental Science- Bachelor of science in Environmental Science
  23. B F.Sc- Bachelor in Fisheries Sciences
  24. B.Sc MLT- Bachelor in Medical Technology
  25. B.Sc Occupational Therapists
  26. B.Sc. Audiology
  27. B.Sc Speech and Language Pathology
  28. B Sc Human Biology
  29. B. Sc Radiography
  30. B.Sc. Rehabiliation Therapy
  31. B.Sc. Food Technology
  32. B.Sc Nutrition and Dietetics Get list of colleges that offer course in Food and Nutrition
  33. B.Sc Botany
  34. B.Sc Zoology
  35. B.Sc Anthroplogy
  36. B.Sc Home Science
  37. B.Sc Psychology Get list of colleges that offer B Sc psychology course
  38. Integrated M.Sc Psychology
  39. Other than these PCB group students can opt for professional courses and courses from other streams like Journalism, Business Management, English Hons, law, Hotel Management, Fashion Design etc.

NEET 2020

National Testing Agency (NTA) will conduct NEET 2020 on May 3, in pen and paper based mode. NEET application form 2020 will be released on December 2, 2019, and can be filled till December 31.
NEET (National Eligibility cum Entrance Test) is the only entrance examination for admission to as many as 76,928 MBBS and 26,949 BDS seats across India in 532 and 313 medical and dental colleges, respectively. 

As per the Ministry of Health and Family Welfare (MoHFW), from the academic session 2020-21, AIIMS, New Delhi and JIPMER, Puducherry will determine NEET scores for admission to 1,205 AIIMS MBBS and 200 JIPMER MBBS seats offered in various campuses. 

Total MBBS/BDS Seats and Colleges in India
Type of Colleges
MBBS 
BDS 
Total Colleges
Total Seats
Total Colleges
Total Seats
Government Colleges
272
41,388
50
3,513
Private Colleges including Deemed Universities
260
35,540
263
23,260
Total Seats through NEET53276,92831326773
AIIMS & JIPMER institutions

15 AIIMS; 2 JIPMER1205 (AIIMS) + 200 (JIPMER)--
Grand Total
549
78,333
313
26773

Problems plaguing Medical Education in India

Problems plaguing Medical Education in India.

  • Medical education is the bedrock for country's Health!
  • Today’s health professionals are required to have knowledge and professionalism, to be proficient in handling disruptive technologies, be ethical, demonstrate empathy, understand the economics of healthcare and handle large and diverse teams.
  • Despite tremendous changes in health systems over the last century, medical education curricula have remained mostly outdated.


India’s Medical Education scenario

  • At present, there are 
  • there are now 70,978 MBBS seats in 529 colleges in India.
  • 529 Medical Collages across India, out of which 255 in Government and 285 are in Private sector.
  • Karnataka has the highest (57) number of medical colleges.

Schemes for Medical Education to raise more UG & PG Seats in a phased manner.

Schemes for Strengthening and Upgradation of State Government Medical Colleges For Increase of PG Seats (Phase I & II):
  • Phase I : The scheme was launched in XI Five Year Plan with the objective of increasing postgraduate seats in Government medical colleges. Funds are provided to the Government Medical Colleges for infrastructure development.
  • Phase II: The scheme was launched in February, 2018 with the objective of increasing 4000 more postgraduate seats in Government medical colleges.
Scheme For Establishment of New Medical Colleges Attached with Existing District/Referral Hospitals (Phase I & II):
  • The objective of the scheme is to utilize the existing infrastructure of district hospitals for increasing additional undergraduate seats in a cost effective manner by attachment of new medical college with exiting district/referral hospitals.
  • Phase I: Establish medical colleges in underserved areas of the country to create an additional annual intake capacity
  • Phase II: New colleges identifies to ensure the availability of one medical college for every 3 Parliamentary Constituencies and at least one Government Medical College in every State of the country.
Strengthening and Up-Gradation of State Government Medical Colleges for Increase in Intake Capacity of MBBS Seats:
  • Under the scheme, it is proposed to create additional 10,000 MBBS seats in existing Government medical colleges in the country.

why India lag behind in Healthcare?

  • severe shortcomings in conceptual as well as implementation in medical education.
  • The doctor to patient ratio has increased but these numbers do not align well with the overall quality of medical care in the country.

Corruption in medical education.

Fake institutes, fake records,fake faculty,fake patients,huge donations and in a nutshell its medical Mafia!
A change in the law in the 1990s made it easy to open private MEDICAL schools Which invariably commercialised medical education to a great extent.

Lack of skilled teachers

  • Teachers for medical institutes are selected based on their degrees and not their clinical experience. 
  • Moreover, no teaching training is provided and teaching innovations are also lacking.
  • The salary given to a full time government college professor needs to be rationalised. The lower salary ensures that only the poorest talent is available, because the more talented will go in for a private practice.
  • In government hospitals a constant threat of transfer also remains.

Backdated syllabus and teaching style

  • Regular breakthroughs take place in the medical field every day, but the medical studies syllabus in India is not updated accordingly. New domains of medical science are also barely touched upon.

Disparity in infrastructure across different states

  • Only four states – Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu – account for about 1.3 lakh out of nearly 2.4 lakh medical seats across India.

Craze of Super-specialty

  • It is not possible to create one type of doctors to cater to every disease in a country as big as India.
  • MBBS students specialise in certain fields to be able to get a job and thus, research is neglected and students miss out on learning about all the different sides of medical studies.
Brain drain:
  •  47,000 Indian doctors practicing in the US and around 25,000 in the UK. This makes India the largest exporter of doctors in the world.

WHAT SHOULD BE DONE?

  • To achieve higher standards of medical education, our goal should be to create an efficient accreditation system; promote an equal distribution of resources, redesign curricula with stricter implementation and improved assessment methodologies.

Reforms needed in Medical Education

Increasing medical seats without compromising quality

  • There is a pressing need to revisit the existing guidelines for setting up medical schools and the right number of seats.
  • Methods of education are undergoing changes on account of advances in e-learning methods, including remote learning, virtual classrooms, digital dissections, and simulation systems for imparting skills.
  • Extending teaching privileges to practising physicians and allowing e-learning tools will address the shortage of quality teachers across the system.
  • Together, these reforms could double the existing medical seats without compromising on the quality of teaching.

Continuing learning system

  • There are continuous ongoing innovations in medical education to prepare professionals for the complex and rapidly changing healthcare system.
  • However, it is estimated that to double the medical knowledge, it will require just 73 days in 2020 compared to 50 years in 1950.
  • At this pace of change, a student can be prepared to process information that is readily available than to know past knowledge.
  • Periodic re-certification based on continuing learning systems may become essential to keep up with the fast pace of change.

Other reforms

  • Students need to improve their basic management, communication and leadership skills and they must be trained by taking into account their social relevance as doctors.
  • Medical education needs to be aligned with the societal needs, which differ from country to country. Strong emphasis needs to be put on rural and social issues and making students strongly aware of their responsibilities towards the same.
  • Since health professionals work in teams, inter-professional combined learning methods should be introduced.
  • Integration of subjects, innovative teaching methods, and a more prevalent use of technology in classrooms is required.
  • More medical education platforms need to come up, which act as platforms where doctors and medical students can collaborate through real medical cases and other continuous medical education content.

Saturday, February 1, 2020

Health Budget 2020


ఆరోగ్య రంగానికి రూ. 69 వేల కోట్లు కేటాయించారు. జీవన శైలిలో మార్పులతో వచ్చే రోగాల నివారణకు
 నూతన పథకం ప్రవేశ పెడతామన్నారు. జీవ ఔషధి కేంద్రాల విస్తరణకు చర్యలు చేపడతామన్నారు. 2025 లోపు క్షయ నిర్మూలిస్తామన్నారు.  వైద్య పరికరాల కొనుగోలుపై వసూలు చేస్తున్న పన్నుల ద్వారా వచ్చే సొమ్మును దేశ వ్యాప్తంగా కొత్త ఆస్పత్రుల నిర్మాణానికి.. అభివృద్ధికి వినియోగిస్తామన్నారు. ఆయుస్మాన్ భారత్ కింద జిల్లాల వారీగా మరిన్ని హాస్పిటల్స్ ను ఎంపానెల్ చేస్తామని చెప్పారు. 
 దేశ వ్యాప్తంగా జనరల్ డాక్టర్లు, స్పెషలిస్టుల కొరత ఉందన్నారు. పీపీపీ విధానంలో జిల్లా ఆస్పత్రులను మెడికల్ కాలేజీల కు  అనుసంధానించి దీన్ని అధిగమిస్తామన్నారు. ఈ స్కీమ్ ఎలా ఉండాలన్న దానిపై త్వరలో విధి విధానాలు ఖారారు చేస్తామన్నారు.
సారాంశ మేమిటంటే 
ఈ బడ్జెట్ ఒక మూలకు కూడా సరిపోదు. భారతదేశానికి కనీసం 150000కోట్లు ఆరోగ్యరంగానికి కేటాయించినప్పుడే ఫలితాలు మెరుగుపడతాయి. అప్పటివరకు కేవలం కంఠ శోష తప్ప ఏమీ లాభంలేదు. 
దిగుమతి చేసుకొనే వైద్యపరికరాల ధరలు పెరుగుతాయి. 
ఆయుష్మాన్ భారత్ కు కేటాయించిన బడ్జెట్ ఏమాత్రం సరిపోదు. 
జన ఔషధి దుకాణాలు నెలకొల్పినా , "ఒకే మందు,ఒకే ధర- ఒకేదెశం" అనే విధానం రానంతవరకు సామాన్యుడికి లబ్ది చేకూరదు. కేవలం రిటైల్ షాపులవాళ్ళు మాత్రమే లాభాలు పొందుతున్నారు. 
ప్రాధమిక వైద్య కేంద్రాల లో మౌలిక వసతులు, నర్సింగ్ సిబ్బంది రిక్రూట్ మెంట్ , అలాగే , వెల్ నెస్ సెంటర్ల లో డాక్టర్స్ ను రిక్రూట్ చేసుకోకుండా ఎంత బడ్జెట్ కేటాయించినా గ్రామీణ భారతం ఆరోగ్యం కుదుట పడదు. 


 Rs. 69,000 crore allocated for overall Healthcare sector.roughly 2.5% of the total expenditure). 
However, It wasn’t even 1% of national income. 

According to the National Statistical Office, the average  medical expense at a government hospital is ₹4,452  in comparison to ₹31,845 at a private hospital .

Rs. 6400 crore (out of Rs. 69,000 crore) for PM Jan Arogya Yojana (PMJAY)
More than 20,000 hospitals already empanelled under PM Jan Arogya Yojana (PMJAY).
Viability Gap Funding window proposed for setting up hospitals in the PPP mode.
Aspirational Districts with no Ayushman empanelled hospitals to be covered in the first phase.
Targeting diseases with an appropriately designed preventive regime using Machine Learning and AI.
 Jan Aushadhi Kendra Scheme to offer 2000 medicines and 300 surgicals in all districts by 2024.

 TB Harega Desh Jeetega campaign launched - commitment to end Tuberculosis by 2025.

Rs. 3.60 lakh crore approved for Jal Jeevan Mission: Rs. 11,500 crore for the year 2020-21.
Augmenting local water sources, recharging existing sources, and promoting water harvesting and de-salination. Cities with million-plus population to be encouraged to achieve the objective during the current year itself.
Rs.12, 300 crore allocation for Swachh Bharat Mission in 2020-21
Committment to ODF-Plus in order to sustain ODF behaviour.
Emphasis on liquid and grey water management. o Focus also on Solid-waste collection, source segregation, and processing.