MEDICAL AND PUBLIC HEALTH SERVICES

THE MEDICAL DEPARTMENT

Organisation.

The medical organisation of the State, as distinct from its public health organisation, is essentially a hospital organisation designed to render curative medical relief to the general population with ancillary specialist sections providing medical relief, medical teaching, training of nurses and mid-wives, X-ray and laboratory technicians and research etc.

Civil Hospital Satara.

In Satara district, the Civil Hospital, Satara is the main Government Hospital at the headquarters. It is owned, staffed, financed and controlled by Government. There are also three other Government medical institutions in this district each at Mahabaleshwar, Phaltan and Aundh. Besides, there are also a number of Government-aided dispensaries which are scattered throughout the district. The aided dispensaries are mostly owned and managed by municipalities and the District Local Board, Satara. Government have prescribed that the municipalities and the District Local Board must devote at least 4 per cent. and 10 per cent. respectively of their annual income to medical activities to entitle them to receive grant-in-aid from Government.

Medical Officers.

The medical officers in charge of the municipal and the District Local Board dispensaries are for the most part, Government servants, who' draw their salaries direct from Government. The local bodies pay contribution to Government at the rate of Rs. 2,355 per year for Allopathic doctors and Rs. 1,827.75 for Ayurvedic doctors, on account of pay of the medical officers lent to them and the Government pays equal amount as grant-in-aid to the municipalities and the District Local Board for maintenance of their dispensaries. The municipal and District Local Board dispensaries are governed by the Rules for the Regulation of Government-aided Charitable Dispensaries 1928, whereby among other things, the medical officers are required to perform the medico-legal and post-mortem work. The institutions are under the management of respective local bodies and the affairs of the institutions are supervised by a Dispensary Committee appointed by the respective local body. Grant-in-aid is also given to private charitable hospitals and dispensaries equal to the ¼ of their approved expenditure or the amount equal to their deficit whichever is less in case of deserving cases.

Administration.

The Civil Surgeon, Satara, is the administrative head of the medical organisation in the district and is directly sub-ordinate to the Deputy Director of Medical Services, Poona Division, Poona. He is in charge of the medical arrangements of Civil Hospital, Satara, and exercises complete control over the medical officers in the district. He is also the head of Government medical officers in the district, and is responsible for the proper performance of duties on their part. He is in addition the inspecting officer of all Government and Grant-in-aid Hospitals and Dispensaries and that of Subsidised Medical Practitioner Centres in the district. As regards sanitary administration and public health matters the Civil Surgeon also takes active part in them in collaboration with the District Health Officer. He has under him inclusive of the institutions in the District, a medical staff of five salaried graduates, nine salaried licentiates, two honorary graduates and two honorary licentiates.

The Civil Hospital, Satara, is situated on the main road on the eastern side of the town. It is an old type structure with an accommodation for 75 beds. It is well-equipped. There is an X-ray plant with screening arrangement of 100 milli ampere. There is a fairly well-equipped Laboratory conducted by a qualified and trained laboratory technician. There is an Out Patient Department with separate blocks for male and female patients, and a dispensary. There is also a maternity ward with eight beds and separate wards for lunatics and tetanus patients. The patients with the infectious diseases are kept separately in the segregation ward outside the hospital compound at a distance of about 100 yards. There is also a T.B. Ward for accommodating 10 patients. T.B. clinic is held twice a week for pneumetherapy to out-door patients. The total number of indoor patients treated in 1958 was 3,417 and out-door patients 16,156 and daily average was 9.9 and 44.2 respectively. The expenditure in 1957-58 was Rs. 1,16,225.

There is an advisory committee attached to the Civil Hospital consisting of the Civil Surgeon as Chairman and six other members. The functions of this committee are to help the management of the hospital by keeping the authorities informed as to the needs of the hospital as viewed by the public for the welfare of the patients. The departmental rules provide for the election of members of the committee, of representatives from the District Local Board, municipalities and from prominent citizens and two ladies.

The present staff (1960) of the hospital consists of the Civil Surgeon (M. M. S., Class-I), the Sub-Charge (M. M. S., Class-II) and three M. M. S., Class-III Officers including one lady doctor. The Honorary staff consists of four medical officers. There are 14 staff nurses and one mid-wife.

In addition to the Civil Hospital there are three Government hospitals and dispensaries in this district, viz., (1) Morarji Gokuldas General Hospital, Mahabaleshwar, (2) State Dispensary, Phaltan and (3) State Dispensary, Aundh. The latter two institutions were taken over from the former princely States. There is one private Government aided ayurvedic hospital in Satara open to the public. The Satara Borough Municipality also runs a maternity home in the town for the public.

Besides the above, there are eight dispensaries either maintained by the District Local Board or by respective Municipalities and the services of medical officers are lent to them by Government. The dispensaries are at Panchgani, Wai, Rahimatpur, Mhaswad, Pusesavali, Dahiwadi, Patan and Medha. Of these the dispensary at Medha is ayurvedic. The Karad municipality maintains its own dispensary. The Civil Surgeon is the inspecting authority of the dispensary and as the medical officer in charge of the dispensary he is allowed to do post-mortem and medico-legal work for which he is paid Rs. 4 per case.

Subsidised Medical Practisioner Centres.

There are 22 Subsidised medical practitioner centres in the district located at 21 places viz., Kudal, Helwak, Parli, Kaledhon, Kiwal, Bahule, Pusegaon, Pimpode Bk., Kukudwad, Dhom, Undale, Limb, Chinchner-Vandan, Vaduj, Mhopre, Chaphal, Uchat, Rethare Bk., Girvi, Jawle and Kinhai.

This scheme was introduced in 1936 with an intention to encourage qualified medical practitioners to settle in rural areas and to provide medical aid to the public in remote areas. Under this scheme, the practitioner gets a monthly subsidy of Rs. 150 if he is an allopathic practitioner, Rs. 120 if he is an ayurvedic practitioner and Rs. 80 in case of an unqualified registered medical practitioner — plus fixed travelling allowance of Rs. 37.50 and petty contingencies of Rs. 7 per month. Grants of Rs. 500 and Rs. 300 per annum are sanctioned to the allopathic and the ayurvedic centre, respectively. The expenditure of the above Subsidised medical practitioner centres excepting one at Kinhai is borne by Government and District Local Board in the proportion of 4:1 respectively. The expenditure of subsidised medical practitioner centre at Kinhai is borne by Government alone. During the year 1957-58 the expenditure incurred by Government on the subsidised medical practitioner centres was Rs. 47,005.18.

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