This is the first under a series of articles The Kochi Post is running on access to healthcare.
The tertiary care health sector in Kerala comprises private and government hospitals. At the top tier of government hospitals are medical colleges, premier institutions which function as referral centres. Government hospitals are by themselves ill-equipped to meet public health demands.There are exceptions to this sweeping statement. Emergency care in government hospitals is usually good and there is an efficient system of referral to the tiers above, from the primary health centre to the teaching hospital, which is able to take care of most demands. Emergency care is free of cost in government hospitals, although this depends on the availability of medicines, implants and other consumables.
However, when it comes to elective cases, like an open heart surgery or a kidney transplant or a knee replacement surgery, this system often involves prolonged waiting periods. Some specialised procedures need highly skilled personnel or costly equipment. These may be available only at a few centres. Highly skilled professionals are scarce. It is difficult for government hospitals to retain their services over time as the salary paid by the government is meagre as compared to that in a private hospital. An exception to this is the highly skilled academician who likes to teach or do research, but this is a rare animal indeed.