Clean up TUTH

Established nearly three decades ago as the country’s premier medical institution, the Tribhuvan University Teaching Hospital (TUTH) today stands on the brink of becoming an example of institutional inefficiency and mismanagement, thanks to politicization. Incidents including last year’s threat by faculty doctors to quit the institution if their children were not given MBBS quotas, this year’s alleged rigging of the entrance exams for postgraduate studies in medicine that led to a 17-day strike by doctors, subsequent report by government’s probe committee that saw irregularities in the handling of Institute of Medicine’s affairs, and the latest disclosure by our newspaper of the extent of mismanagement in the hospital adequately point out that TUTH is straying from the lofty goal of its founders.



It is disappointing to note that the incentive of 50 percent extra salary provisioned by the institution to win undivided commitment of doctors has only ended up turning the institution into a lucrative pasture. Staff doctors and lab technicians continue outside practice defeating the very purpose of the incentive. The incentive has ironically led to overstaffing, to the extent that the institution pays Rs 350 million every year to its staffers in salary and allowances. Apart from enjoying 90 percent waiver on medical facilities as well as medicines, hospital staffers also reportedly encourage the hospital’s patients to visit private labs by deliberately delaying medical tests and making the queues intolerable. On an average, 1,500 patients visit the hospital every day, and diverting only a section of them to private labs can be lucrative. But this badly hurts the hospital’s revenues as lab tests generally entail big margins.



The cumulative effect of all these irregularities is that the hospital is making a loss of Rs 100 million every year. With pervasive mismanagement, the hospital has lost the trust of Japanese donors. Also, repeated incidents of bitter internal disputes have damaged its public image.



As rightly pointed out by former director of TUTH, the best way to stop politicization and overstaffing in the institution is granting it autonomy and entitling it to direct grant from the government, rather than leaving it at the mercy of Tribhuvan University. But this is a big decision and probably needs a long time to mature. On the other hand, there are several doable things that don’t have to wait even a single day. For instance, the labs can be made efficient by making it mandatory that a certain number of tests are conducted every day. The time commitment of doctors and lab technicians can be monitored. Even a simple decision like placing notices and complaint boxes ubiquitously in the hospital premises asking patients to drop their complaints if they sense someone is deliberately delaying their access to medical service could serve as a good start.

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