Citizens turn around public hospitals,IAS S.R Mohanty Madhya Pradesh India

The story of change begins with the 1,000-bed Maharaja Yashwantrao (MY) Hospital of Indore. When the hospital was inaugurated way back in 1955, it was Asia's largest government hospital. Decadence slowly crept in, creating an inefficient system with absolutely no finances for upkeep.
Under the Indore collector, S R Mohanty, in 1994 Operation Kayakalp was launched to rid MY of thousands of rodents, and nearly 150 truckloads of garbage and junk. That was also when public participation first came in. When the administration appealed to people for money for the clean-up operation, donations poured in. Within no time Rs 48 lakhs were collected.
The question now was how to keep up the tempo. “The hospital had only bare infrastructure in place. And no funds were forthcoming from the state government. Left to itself, the hospital would have reverted to the old ways,” recalls Mohanty.
That was when the concept of the Rogi Kalyan Samiti (RKS) took root. RKS is a people's body consisting of elected representatives, municipal corporation members, donors, doctors and members of the public, who would manage the hospital. The RKS was empowered to fix reasonable user charges and raise funds through loans and grants. It started by introducing a Rs 2 ticket for the OPD (out patient department), which now costs Rs 5. Even specialised services such as a bed in Intensive Care are as low as Rs 150.
Some broad guidelines were laid down for the levy of user charges. Thus, all hospital facilities were to be charged. Persons below the poverty line are totally exempt from any payment. For the latter a mere declaration was enough, without the usual complicated paperwork.
Monthly collection from user charges came to around Rs 8 lakhs; earlier it was nil. Money thus collected is distributed to the different departments, for upgrading equipment and employing contractual labour for maintenance.
The success of MY Hospital has led to the adoption of the RKS as state policy by chief minister Digvijay Singh. Thus all over the state, Rogi Kalyan Samitis have been formed in over 2,000 allopathic hospitals and dispensaries, 197 Community Health Centres and in most of the 1,690 Primary Health Centres in the last year. In Mandsaur, a Rs 175 lakh project for modernisation of the district hospital has been launched. Total monthly collection in the state through user charges is now estimated at Rs 50 lakhs.
Mohanty says the strength of the Rogi Kalyan Samiti lies in the fact that the people can now decide their own priorities. But the greatest success of the RKS lies in bringing about an attitudinal change and boosting the morale of the medical personnel and staff. Even they have begun to donate something for the hospital; like Roop Singh Karode, an accountant with MY hospital, who donated the marble benches for the orthopaedic department.

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