Work study report by P&ARD on department of Homoeopathy Kerala

Personal and Administrative Reforms Department  (P&ARD) of Govt. of Kerala conducted a detailed work study on Department of Homoeopathy in Kerala and submitted a detailed report to the Government for further action.

The Department of Homoeopathy in Kerala is the First separate homeopathy department in India and still among the very few which was constituted as per GO (MS) 101/73/HD dated 21-4-1973. Currently the Department has more than 650 dispensaries, 30 hospitals, 14 DMO offices and numerous specialty OPDs allied to District Hospitals along with a handful of projects and around 300 Ayush dispensaries under NRHM.

The homoeopathy Director vide DO letter No: EA 2/10071/2009/DH dated 15-1-2010 had requested the Health Department for a work study of the department and that was subsequently recommended by H&FWD in government to P&ARD. A work study on homoeopathy department commenced following this.

Summary of recommendations by the P& AR Department

• Necessary amendments be made in the homoeopathy service special rules to take out the qualifying norm of DHMS from Medical Officer recruitment.
• Redistribution of work among all sections in the Directorate should be done since there is greater unevenness.
• One post of clerk may be shifted from EA to EB section at the Directorate.
• The existing TA post may be identified as MO (HG) instead of the existing cadre of CMO.No new cadres are recommended among the proposed posts aside from the existing cadres of MO, CMO, HOSP.SUPRNT and DMO
• For maintaining good organizational streams and hierarchy and better service delivery in a medical Department, two Assistant Directors(AD) may be created at the Directorate, one at Administration and Vigilance and another at Planning in the existing cadre of DMO.
• One more Deputy Director post may be created at the Directorate to supervise Administration and Vigilance.
• For coordination of district propaganda activities and training and for state mass media purposes, one post of State Mass Media Officer may be created at the DH.
• Given the highly dipping standards of administration at DMO offices, urgent steps may be taken to give administrative training to ministerial staff using a separate fund.
• As part of better orientation of homoeopathy hospitals, RAECH fund, medicine may be shifted from DMO offices to the district homeo hospitals and under the control of Superintendents
• For better planning orientation and propaganda measures one post each of Project Officer and Assistant Mass Media Officer          may be created at DMO offices and one more vehicle on contract basis
• CME program may be revamped with the proposed bodies
• Given the vital importance of community service and the mileage it brings to the department and system, School Health Program should be continued with necessary modifications.
• The six types of staff patterns be unified at 179 government homeo dispensaries to the4-strengthstandardpattern.
• As part of unification of staff pattern, 90 posts of pharmacists and 89 posts of attenders may be created in the long term since the staff infusion required in the Department is heavy. Posts of OA, SCP, and WCS may be abolished in a phased manner.
• OPD duty hours at dispensaries may be unified to a single stretch from 9-2PM instead of the current two stretches.
• Induction training should be made mandatory for declaration of probation in the Medical Officer(MO)category
• GHDs may be e-connected through software and matters of indent, stock updating, attendance management and outpatient data and most importantly disease surveillance be made part of the software to be implemented at Government Homeo Dispensaries.
• Urgent steps may be taken to formulate a department Duty Manual to bring about discipline and clarity of functions.
• Service books of employees may be handed over to the Medical Officers (MO) themselves. Pharmacists may be made the custodian of medicines. Pharmacist may be entrusted with the duty to attend to local body and other outstation duties on behalf /direction of Medical Officer
• Urgent steps may be taken to resolve the issue of lack of sufficient pharmacists due to non-availability of pharmacy course at government sector. Steps may be initiated to start Diploma Course in Pharmacy at Government Homeo colleges.
• A team might be set up to study the possibility of Tribal Mobile Units in Iduki,Wayanad and Palakkad.
• For improving community service and towards development of organizational tiers, the administrative control of 152 GHDs under grama panchayats may be shifted to the administrative control of block panchayats without necessarily shifting the locations.These dispensaries maybe identified as CMO dispensaries with abrogation of both the current CMO cadre dispensaries and 1:3 ratio promotion.
• These152 block dispensaries may be identified as Block Homoeopathy Centres (BHC) and administrative mini layers be formed at the centres with further re-delegation of powers.
• Homeopathic IPD sector would be abandoned in a phased manner over 5 years if the proposals to revamp the IPD sector are not implemented and service delivery not improved. Among the mandatory proposals by the team come       standardization of nursing care, optional IPD pool, attaining ancillary skills, tertiary care,etc.
• Given the need of standard nursing care at IPD, the skill levels may be ensured and as such the current NCP nurses may be converted to pharmacists considering the exigency since the qualification for both the nurses and pharmacists remains the same.
• To maintain professionalism in promotions, Class IV posts of Cleaner, Cook etc should not  be promoted to Dispenser, Nursing Assistant categories and, instead, these Class IV posts should have separate promotional posts as proposed.
• Urgent steps may be taken for furthering relation between Homeopathy Colleges and the Department for more active involvement of homeopathic education sector.
• Towards development of tertiary care the select 6 hospitals may be round-the-clock having three shifts with different proposed staff strength with creation of  71          additional posts.
• RMO cadre should be raised to MO(HG).
• Due to falling IPD averages as analyzed over a three year IPD data, three 25-bedded hospitals may be downsized to 10 bedded hospitals with abolition of Hospital Superintendent post and being re-designated to CMO cadre in the immediate

Download the full report (279 pages)

Appeal: Organizations and Officials are requested to study this report and make necessary steps for planned  progress of Homoeopathy in Kerala