In most developing countries, provision of basic preventive, promotive and curative services is a major concern of the Government and decision makers. With growing population and advancement in the medical technology and increasing expectation of the people especially for quality curative care, it has now become imperative to provide quality health care services through the established institutions.
Upgradation of CHCs to Indian Public Health Standards (IPHS) is a major strategic intervention under the National Health Mission (NHM). The purpose is to provide sustainable quality care with accountability and people's participation along with total transparency.
Rogi Kalyan Samiti (Patient Welfare Committee) / Hospital Management Committee is a simple yet effective management structure. This committee, a registered society, acts as a group of trustees for the hospitals to manage the affairs of the hospital. It consists of members from local Panchayati Raj Institutions (PRIs), NGOs, local elected representatives and officials from Government sector who are responsible for proper functioning and management of the hospital / Community Health Centre / FRUs. RKS / HMS is free to prescribe, generate and use the funds with it as per its best judgement for smooth functioning and maintaining the quality of services.
Objectives the RKS / HMS
The following are the broad objectives of the HMS :
- Ensure compliance to minimal standard for facility and hospital care and protocols of treatment as issued by the Government.
- Ensure accountability of the public health providers to the community;
- Introduce transparency with regard to management of funds;
- Upgrade and modernize the health services provided by the hospital and any associated outreach services;
- Supervise the implementation of National Health Programmes at the hospital and other health institutions that may be placed under its administrative jurisdiction;
- Organize outreach services / health camps at facilities under the jurisdiction of the hospital;
- Display a Citizens Charter in the Health facility and ensure its compliance through operationalisation of a Grievance Redressal Mechanism;
- Generate resources locally through donations, user fees and other means;
- Establish affiliations with private institutions to upgrade services;
- Undertake construction and expansion in the hospital building;
- Ensure optimal use of hospital land as per govt. guidelines;
- Improve participation of the Society in the running of the hospital;
- Ensure scientific disposal of hospital waste;
- Ensure proper training for doctors and staff;
- Ensure subsidized food, medicines and drinking water and cleanliness to the patients and their attendants;
- Ensure proper use, timely maintenance and repair of hospital building equipment and machinery;
The suggested composition of RKS / HMS is as follows:
- RKS / HMS would be a registered society set up in all District Hospitals / Sub District Hospitals / CHCs / FRUs/ PHCs. It may consist of the following members:-
- People's representatives MLA / MP
- Health officials (including an Ayush doctor)
- Local district officials
- Leading members of the community
- Local CHC/ FRU in-charge
- Representatives of the Indian Medical Association
- Members of the local bodies and Panchayati Raj representative
- Leading donors
The RKS/HMS will not function as a Government agency, but as an NGO as far as functioning is concerned. It may utilize all Government assets and services to impose user charges and shall be free to determine the quantum of charges on the basis of local circumstances. It may also raise funds additionally through donations, loans from financial institutions, grants from government as well as other donor agencies. Moreover, funds received by the RKS / HMS will not be deposited in the State exchequer but will be available to be spent by the Executive Committee constituted by the RKS/HMS. Private organizations offering high tech services like pathology, MRI, CAT SCAN, Sonography etc. could be permitted to set up their units within the hospital premises in return for providing their services at a rate fixed by the RKS/ HMS.
Functions and activities
To achieve the objectives, the Society undertakes the following activities/initiatives :
- Identifying the problems faced by the patients in CHC/PHC;
- Acquiring equipment, furniture, ambulance (through purchase, donation, rental or any other means, including loans from banks) for the hospital;
- Expanding the hospital building, in consultation with and subject to any Guidelines that may be laid down by the State Government;
- Making arrangements for the maintenance of hospital building (including residential buildings), vehicles and equipment available with the hospital;
- Improving boarding / lodging arrangements for the patients and their attendants;
- Entering into partnership arrangement with the private sector (including individuals) for the improvement of support services such as cleaning services, laundry services, diagnostic facilities and ambulatory services etc.;
- Developing / leasing out vacant land in the premises of the hospital for commercial purposes with a view to improve financial position of the Society;
- Encouraging community participation in the maintenance and upkeep of the hospital;
- Promoting measures for resource conservation through adoption of wards by institutions or individuals; and,
- Adopting sustainable and environmental friendly measures for the day-to-day management of the hospital, e.g. scientific hospital waste disposal system, solar lighting systems, solar refrigeration systems, water harvesting and water recharging systems etc.
Constitution of the RKS / HMS
- Chairperson : District Magistrate
- Member-Secretary : Medical Superintendent of the hospital
- Chief Executive Officer, Municipal Corporation
- Chief Medical and Health Officer
- Director, AYUSH of the District
- Up to 2 representatives of PRIs
- Up to 3 eminent citizens nominated by the District Collector
- MNGO representative
- Representative of local Medical College
- Representative of corporate sector / NGO hospitals in the city as may be nominated by District Collector
- Local MP/MLA
- Associate members : An individual who makes a one time donation of.a specified amount [e.g. Rs 5,000/- or as may be determined by the District Health Society], may be made eligible to become a Member of the Governing Body of the Society.
- Institutional members : Any institution, which donates a specified amount [e.g. Rs. 50,000/- or more or as may be determined by the District Health Society] or adopts a ward of the hospital and bears the cost of its maintenance, may be made eligible to nominate a person from the institution as a member of the Governing Body of the society.
Proceedings of the Governing body
- The meetings of the Governing Body shall be held at least once in every quarter and at such time and place as the Chairperson shall decide. If the Chair-person receives a requisition for calling a meeting signed by one-third members of the Governing Body, the Chair-person shall call such a meeting as soon as may be reasonably possible and at such place as s/he may deem fit.
- Following minimum business shall be brought forward and disposed off in every meeting of the Governing Body:
- Compliance to Standards and Protocols issued by Government.
- Review of the OPD and IPD service performance of the hospital in the last quarter and service delivery targets for the next quarter.
- Review of the outreach work performed during the last quarter and outreach work schedule for the next quarter.
- Review of efforts in mobilizing resources from the community, trade / industry and local branches of professional associations like IMA and FOGSI etc.
- Review the reports submitted by the Monitoring Committee.
- Review the status of utilization of funds, equipment and drugs received under different programmes of the Government.
- Review compliance to Citizens Charter displayed in the Hospital and the effectiveness of the Grievances Redressal Mechanism.
- In addition to the above regular items, the Annual Report of the Society relating to last financial year shall also be taken up for discussion in the quarterly meeting falling due after the close of every financial year.
- Every notice calling meeting of the Governing Body shall state the date, time and place at which such meeting will be held and shall be served upon every member of the Governing Body not less than twenty one clear days before the date appointed for the meeting. Such notice shall be issued by the Member Secretary of the Society and shall be accompanied by an agenda of the business to be placed before the meeting provided that accidental omission to give such notice to any member shall not invalidate any resolution passed at such meeting. In the event of any urgent business the Chair-person may call the meeting of the Governing Body at clear ten days notice.
- The Chairperson shall Chair the meetings of the Governing Body. In his/her absence, the Governing Body shall elect one from among the members present as Chair-person of the meeting.
- One third of the members of the Governing Body, including the substitutes nominated under Rule 5.3.8 present in person, shall form a quorum at every meeting of the Governing Body.
- The membership of an ex-officio member of the Society and of the Governing Body shall stand terminated when he/she ceases to hold the office by virtue of which he/she was member and his/her successor to the office shall become such member.
- Nominated members shall hold office for a period of three years from the date of their nomination. Such members will be eligible for re-nomination for another period of 3 years.
- The Society shall maintain a roll of members at its registered office and every member shall sign the roll and state therein his/her rank or occupation and address. No member shall be entitled to exercise rights and privileges of a member unless he/she has signed the roll as aforesaid.
- A member of the Society shall cease to be members if s/he resigns, becomes of unsound mind, becomes insolvent or is convicted of a criminal offence involving moral turpitude or removal from the post by virtue of which s/he was holding the membership.
- Resignation of membership shall be tendered to the Governing Body in person to its Member Secretary and shall not take effect until it has been accepted on behalf of the Governing Body by the Chairperson.
- If a member of the Society changes his/her address he/she shall notify his/her new address to the Member Secretary who shall thereupon enter his/her new address in the roll of member. But if a member fails to notify his/her new address the address in the roll of members shall be deemed to be his/her address.
- Any vacancy in the Society or in the Governing Body shall be filled by the authority entitled to make such appointment. No act or proceedings of the Society or of the Governing Body shall be invalid merely by reason of the existence of any vacancy therein or of any defect in appointment of any of its members.
- No member of the Society or its Governing Body shall be entitled to any remuneration.
Source: National Health Mission