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New Delhi: Even as the National Democratic Alliance (NDA) government plans to set up several institutes on the lines of the All India Institute of Medical Sciences (AIIMS), concerns have been raised over their ability to provide the quality of medical care that New Delhi-based AIIMS is famous for.

The issue was discussed last week at a state health secretaries’ meeting called by Union health minister Harsh Vardhan to address various policy matters.

“The success of All India Institute of Medical Sciences (AIIMS) is not on account of its infrastructure, but the culture that drives the facility and staff there. How will the ministry of health ensure that this culture of AIIMS permeates into every AIIMS-like institute is a question difficult to answer. As a matter of fact, ministry of health struggles to manage the few institutions under its control," the agenda for the meeting said.

A copy of the agenda was reviewed by Mint.

In July, finance minister Arun Jaitley announced the governments’ plan to set up four AIIMS-like institutes in the country, setting aside 500 crore for the purpose. He said these would come up in Andhra Pradesh, West Bengal, Maharashtra and Uttar Pradesh. Later, Vardhan announced plans to set up an AIIMS-like institute in every state and asked state governments for 200 acres of land each.

The Union health ministry pointed out that managing these institutions poses a big challenge and that a separate hospital administration body was needed to manage them.

However, experts say this is just the tip of the iceberg.

“There are several practical problems with this plan. For example, there is already shortage of mid-level and senior faculty members in AIIMS and other government hospitals," said a senior public health official on condition of anonymity. “Where will the ministry of health find faculties for the upcoming institutes?"

In March, the health ministry discovered administrative and financial irregularities at AIIMS Patna, according to a report in Hindustan Times. This was one of six such institutes set up between 2009 and 2012, the others being in Raipur, Bhopal, Jodhpur, Bhubaneswar and Rishikesh. They are expected to be fully functional by the end of this year.

“To improve healthcare, the government needs to set up more district hospitals and strengthen primary and community health centres. This would ensure that less number of people go for tertiary care and more number of cases get diagnosed and treated at an early stage. By setting up more of these super-speciality tertiary hospitals without focusing on primary and secondary care, the cost of healthcare will also get escalated. With social insurance coming in, hospitals would also prefer doing operations and surgeries even if they are not needed," the public health official quoted above said.

A central inquiry committee found major lapses in recruiting teachers for six new AIIMS-like institutes and held the director of AIIMS Patna and private companies responsible, Hindustan Times reported on 17 September.

According to the report, of 69 people hired by AIIMS Patna, 18 had either wrong degrees or lacked the necessary qualification. A private firm was hired without open tendering and provided software which could be easily manipulated to favour candidates applying for teaching positions.

“I am not against accessible higher tertiary care for different states, but government’s idea of enhancing healthcare is completely disconnected from ground reality," the official mentioned above said.

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