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SRINAGAR — Heart patients from Kashmir Valley falling victims to illegal referrals reveal a nexus between local heart specialists and touts from Delhi and Haryana-based hospitals, that needs to be exposed.

Information gathered about tertiary care hospitals of Valley under the Right to Information Act (RTI) makes it clear that to grab money from helpless heart patients, heart specialists resort to criminal referrals fleecing and cheating the patients as well as attendants.

Information has been received from Heads of two Tertiary Care Health Institutions namely SMHS and SKIMS, particularly from their Cardiology Departments regarding the data of patients with heart attacks and their treatment in their hospitals during the year 2018-2019, through various RTI Applications under RTI Act, 2005, Vide RTI Application No. RTI/MC/344-45, Dated: July 25, 2019, and RTI No: 143/2019, Dated: July 29, 2019, respectively.

Incharge Head, Department of Cardiology, SMHS Hospital Srinagar, through Public Information Officer and HOD, Medicine, GMC Srinagar Vide No: PA/PO/RTI/047, Dated: September 23, 2020, has reported that 786 patients with heart attacks were admitted from January 2018 to December 2019 while as 1295 patients were admitted from January 2019 to February 2020 and therefore, a total of 2081 patients with heart attacks were admitted and treated in their department from January 2018 to February 2020.

As per the information, the department has done a total of 1345 angiographies and 736 angioplasties from January 2018 to February 2020 including 377 angioplasties from March 2019 to February 2020. It further mentions that “surgical patients are referred for surgery to only one Institution viz. SKIMS, Soura, the only government institution having the facility in Kashmir region, where surgical treatment for such patients is available.”

It further reveals that a “Memorandum of Understanding” is existing between Principal GMC and Director SKIMS for emergency referrals from Cardiology to CVTS Department. “All heart attack patients requiring bypass surgery are referred to SKIMS” but there is no information about how many patients were referred from January 2018 to February 2020 for bypass surgery to SKIMS, which as per their reply is the only government hospital with a CVTS facility and the only designated referral institute for Super Speciality Hospital, Shireenbagh, Karan Nagar.

Principal, GMC Srinagar was requested on October 24, 2020, and December 7, 2020, to provide the details of all those patients who were referred out of 2081 patients to SKIMS for bypass surgery. The reply received through Public Information Officer, GMC, Srinagar Vide No: PA/PO/RTI/222, Dated: December 21, 2020, from I/C Consultant Department of Cardiology, SSH, Shireen Bagh, Karan Nagar reads that “regarding the details of patients referred to SKIMS for CABG, we currently do not have such mechanism in place to get the details of referred patients from ‘outpatient file system’ as such a facility does not exist for OPD patients.”

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As per information received from MS Office, Super Specialty Hospital, 11 doctors have been shown to be qualified in the department of Cardiology, however no proof of “Memorandum of Understanding” has been received from the department/SSH, Shireen Bagh. Therefore, the reply received makes it highly suspicious about the status of affairs in SSH, Shireenbagh falling under the administrative control of Principal GMC, Srinagar.

Reply received from Cardiology, SKIMS through Public Information Officer, Vide No: SIMS/RTI No. 143/2019-53-55, Dated: October 4, 2019, and SIMS/RTI No. 15/2020-260-62, Dated: June 4, 2020, revealed that 868 patients with heart attacks were admitted in his department and diagnosed by angiography during one year from July 1, 2018, to June 30, 2019.

Out of 868 patients, 595 were treated by medical means, angioplasty. 66 patients have died during the period and 48 patients were advised for bypass surgery out of which seven were referred to surgeons for bypass surgery at SKIMS. However, the department has not mentioned what happened to the rest of the 41 patients who too were advised surgery and therefore, endorsing that majority of patients have died for want of bypass surgery which is not possible or sent to hospitals other than SKIMS.

The detailed information received from departments of Cardiology, SSH, Shireenbagh GMC, Srinagar and SKIMS, was sent to Director SKIMS on October 15, 2020, for authentication and pointwise reply. Public Information Officer, SKIMS on receiving relevant information from the concerned section, has sent his report Vide No: SIMS/RTI No. 39/2020-5354-57, Dated: November 18, 2020, which reads that “records reveal not a single patient out of 2081 patients with heart attacks has been received from SMHS, Hospital for bypass surgery during two years period w.e.f January 2018 to February 2020.

However, he conveyed that as per records available with SKIMS, one patient, namely Wani Aisha who was very sick due to a complex heart attack was referred to SKIMS four years back on November 11, 2016, for bypass surgery by SMHS. After hospitalization in SKIMS under MRD No: 0945984, she was successfully operated on for a heart attack (Coronary Bypass Surgery and Ventricular Septal Repair under IABP) and discharged from SKIMS on January 4, 2017.

With regards to information received from HOD, Cardiology SKIMS, the Public Information Officer, SKIMS has replied Vide No: SIMS/ RTI No. 39/2020-5354-57, Dated: November 18, 2020, that as per official records received from the concerned section, only two patients instead of seven patients mentioned in the report, have been received by the concerned department for bypass surgery during one year w.e.f July 1, 2018, to June 30, 2019.

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The report further mentioned that rarely any patient with a heart attack is referred to surgeons by the Cardiology department and only those patients who are very sick and cannot afford to go outside or cannot be shifted to Delhi or elsewhere, are referred to surgeons for bypass surgery.

The Public Information Officer has further communicated that all gadgets and surgical expertise are available at SKIMS. He further informed that as per the feedback received from the concerned department, bypass surgery for heart attack patients has been started way back in 2005 at SKIMS but this program has never been supported and allowed to grow due to vested interests and unauthorized referrals. He informed that such surgery costs Rs. 1.0-1.50 lakh at SKIMS when the same surgery costs Rs. 6.0 lakhs to 15.0 lakhs in other hospitals in India.

Complaints from patients falling victim to illegal referrals have revealed that a nexus prevails between local heart specialists and touts from Delhi or Haryana-based hospitals. Circumstantial evidence has further revealed that many paramedics and specialists working at SKIMS, SMHS, SMGS, JLNM, GB Panth hospitals as well as private hospitals of Jammu and Kashmir are involved in the menace.

The complainants, as per news agency Kashmir News Trust, have even named various heart specialists of SKIMS, SMHS and other government hospitals who have been habitual of illegally referring such patients to private hospitals. There is a strong possibility that ulterior motives with financial nexus is behind this menace.

There are reports that admitted patients being fleeced under a unique design by the touts on the directions of specialist doctors, disappear suddenly from wards in tertiary care hospitals, in particular, SKIMS and SMHS. Not only heart specialists but even other types of specialists from departments of Neurology, Nephrology, Pediatrics, etc are involved in this malpractice, getting heavy cuts.

The information received from two tertiary care hospitals under RTI has raised many questions on the health care system and its management which requires urgent attention at a higher level.

“It’s a big mafia. If Anti-Corruption Bureau will take pains and deeply study this invisible scam, a massive scam will surface and top doctors will get trapped in the net,” said a medico on the condition of anonymity.

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