DR.FIAZ MAQBOOL FAZILI
The healthcare system in Jammu and Kashmir (J&K) presents a paradox. While the region has witnessed the establishment of multiple Government Medical Colleges (GMCs), the introduction of AIIMS (All India Institute of Medical Sciences), a welcome step and the emergence of corporate hospitals, the fundamental gaps in healthcare services remain glaring. These deficiencies expose the inadequacies in policy planning and execution, raising a pertinent question: who is responsible for this non-visionary approach? Will merely adding more institutions suffice to address the systemic issues. I appreciate Health Minister Madam Sakina ji who reaffirmed the government’s commitment to ensuring quality patient care across hospitals in Jammu and Kashmir, stressing that no negligence will be tolerated. During her visit to the hospitals Madam Itoo addressed concerns regarding patient care and internal challenges faced by medical staff. “The purpose of these visits is to address complaints about inadequate patient care and to resolve issues faced by doctors, superintendents, and paramedical staff,” she said. The minister made it clear that hospital inspections aim to improve healthcare services, stating, “There should be no compromise on patient care. Where challenges exist, the government will intervene to ensure smooth service delivery.”
Glaring Gaps in the Healthcare System; The healthcare system has long grappled with glaring gaps, including inadequate infrastructure, delayed services, and lack of accountability. However, the proactive approach of the MOH, marked by her surprise visits and Gemba Rounds, has ignited a new wave of hope. These unannounced inspections reflect her commitment to understanding ground realities and ensuring quality care delivery. By stepping into the shoes of both care receivers and providers, she is bridging the gap between policy and practice. Such initiatives inspire confidence and set a precedent for a transparent and efficient healthcare system. Let these surprise visits to hospitals by the Ministry of Health not become mere knee-jerk reactions or publicity stunts; whether such surprise inspections persist throughout the tenure or fade away remains to be seen. Consistent follow-up is the real test of commitment. As stakeholders—patients, families, and healthcare professionals—we must support her by embracing accountability, adhering to standards, and providing constructive feedback. Together, we can transform the system into one that prioritizes dignity, safety, and excellence in care for all. Her leadership, paired with collective responsibility, can lead to meaningful and lasting change.
Patient’s Lament: A Call for Healthcare Improvement; As an expert in improving healthcare standards, quality, safety, and strategic operational planning, I find the concerns of patients to be both valid and deeply distressing. There are critical areas that demand immediate attention to bring relief to the majority of patients.1. Reducing Appointment Times;The long wait for appointments, sometimes extending to three or six months, renders medical consultations meaningless for patients in need of urgent care. Time spent waiting in queues should be minimized to allow more time with doctors. Efficient scheduling systems and better resource allocation can help address this issue.2. Access to Diagnostic Facilities; Every district hospital should have essential diagnostic tools such as MRI and PET scan facilities, along with radiotherapy and oncology units. It is shocking that a hospital like SMHS, which has its own oncology department, lacks a PET scan system. This gap is unacceptable, especially in a region where cancer treatment is a critical need. 3. Cost of Treatment; The high cost of PET scans, even at subsidized rates, even a newly fixed rate of Rs ₹10,000 at SKIMS, remains unaffordable for many, particularly in a low- and middle-income region like ours.. The administration should take steps to significantly reduce these costs to ensure that no patient suffers due to financial constraints.
Cancer Treatment Affordability and Accessibility; Cancer treatment drains families emotionally and financially, not a day passes when we see desperate crowd funding appeals seeking help.The state must intervene by bringing cancer care and dialysis under PMJAY or other subsidized schemes. Establishing district-level cancer treatment units can reduce the burden on tertiary care centers and improve accessibility.
Non-Visionary Policy Planning: The Root of the Problem; At the heart of J&K’s healthcare woes lies an absence of visionary policy planning. Successive governments and health administrators have focused more on infrastructure expansion and less on addressing the root causes of systemic inefficiencies. Here are some glaring gaps in planning:
Workforce and Training Deficiencies; The opening of new medical colleges has not been complemented by adequate recruitment and training of faculty, paramedics, and support staff. As a result, many GMCs struggle with faculty shortages and fail to deliver quality education or healthcare. Policy planners have overlooked the need for comprehensive skill development programs for healthcare workers to bridge this gap.
Infrastructure Without Operational Efficiency; Despite significant investments in building hospitals and medical colleges, some hospital buildings define operational inefficiency and continue to plague the system. Basic facilities like functional equipment, uninterrupted power supply, and advanced diagnostic tools are often unavailable. Poor hospital management exacerbates patient dissatisfaction.
Neglect of Preventive Healthcare; Preventive care, including immunization, maternal and child health, and public awareness campaigns, receives scant attention. The focus on curative care has overburdened hospitals, leading to long waiting times, delayed treatments, and compromised patient outcomes.
Non-Integration of Health Information Systems; The lack of a unified health information system prevents efficient monitoring of health indicators and resource allocation. This gap in data-driven decision-making undermines effective policy planning and resource utilization.
Will More GMCs, AIIMS, and Corporate Hospitals Fill the Inequitable Access: The urban-rural healthcare gap in J&K is glaring, with rural areas lacking doctors, specialists, and diagnostic facilities. The absence of effective outreach programs has worsened the disparity.
Fragmented Focus: Rural areas, which house a significant portion of J&K’s population, suffer from a lack of doctors, specialists, and advanced diagnostic facilities. While the establishment of more GMCs, AIIMS, and corporate hospitals is a welcome step, it is not a panacea for J&K’s healthcare crisis. Efforts have prioritized secondary and tertiary care meanwhile, primary healthcare still needs a top-heavy, sustainable healthcare system.
Quality Over Quantity; Expanding medical institutions without ensuring quality serves no purpose. The government must focus on improving the standards of existing teaching hospitals through better faculty recruitment, training, infrastructure upgrades, and setting auditable KPIS key performance indicators for all institutions. Accreditation by NABH like independent agencies and regular audits can ensure compliance with national and international standards.
Strengthening Primary Health Care; Primary healthcare should be the cornerstone of any effective healthcare system. Strengthening sub-centres, primary health centres (PHCs), and community health centers (CHCs) with adequate staff, resources, and infrastructure is essential. This will reduce the burden on secondary and tertiary care facilities.
Retention of Skilled Professionals and Financial incentives.
The healthcare system in J&K faces challenges due to the exodus of skilled professionals, driven by inadequate financial incentives and career opportunities. Retention policies with competitive salaries and growth prospects are critical to addressing the workforce vacuum and ensuring health equity. The migration of healthcare professionals to the private sector poses a significant threat to public healthcare.
Role of Corporate Hospitals, while offering advanced care, remain inaccessible to many due to high costs. Transparency in pricing, collaboration with public institutions, adverse event inquiries and accountability measures can make these facilities more inclusive.
Improved Health Governance requires robust mechanisms such as key performance indicators (KPIs), regular performance reviews, accountability frameworks, and patient feedback systems to ensure efficient healthcare operations. An independent monitoring and evaluation body comprising specialists and quality control experts can enhance transparency, identify gaps, and recommend actionable solutions, fostering greater accountability in the system. The integration of technology, such as telemedicine and e-health solutions, can bridge the urban-rural divide. Investments in research and development can foster innovation in tackling region-specific health challenges.
Has there been Non-Visionary Policy Planning? This question has always baffled me. Healthcare in J&K faces challenges ranging from inadequate infrastructure and workforce shortages to poor patient management systems. Even with a relatively better doctor-patient ratio compared to some states, the system struggles with accessibility, quality, and equity in service delivery. The introduction of new GMCs, AIIMS, and corporate hospitals has created opportunities for advanced treatment and medical education. However, their impact has been diluted by deeply entrenched issues such as uncoordinated planning, lack of a cohesive healthcare vision, and insufficient emphasis on primary and preventive care. An uncoordinated referral system, coupled with weak peripheral infrastructure at district and sub-district levels, is overwhelming tertiary care facilities, leaving them to bear the brunt of excessive patient loads.
Strategic Reforms Committee of Healthcare Professionals.; The role of healthcare Quality professionals in advocating for systemic changes has been limited. Their involvement in shaping policies and addressing deficiencies is crucial. A dedicated committee of healthcare quality professionals should be formed to identify gaps, recommend reforms, and oversee the implementation of changes in healthcare delivery. Addressing these issues is not just about improving healthcare but about restoring dignity and hope to the patients who depend on it.
The healthcare system of Jammu and Kashmir requires a paradigm shift from reactive, infrastructure-heavy approaches to proactive, patient-centred care. While new GMCs, AIIMS, and corporate hospitals provide better healthcare facilities, without visionary planning and coordinated efforts, the dream of a robust healthcare system in J&K will remain elusive. Strengthening primary health care, retaining skilled professionals, ensuring equitable access, and adopting technology-driven solutions are vital to creating a resilient healthcare system. The responsibility lies with policymakers, healthcare administrators, and society at large to adopt a holistic approach that prioritizes quality, accessibility, and sustainability.
The author is a clinical auditor and healthcare policy analyst specializing in healthcare quality standards and patient safety. An expert in healthcare reform and quality improvement, Accreditation can be reached at drfiazfazili@gmail.com.