When Sangeeta Kharat noticed a lump near her neck, she sought treatment at MT Agarwal Municipal Hospital, Mulund, near her residence. Doctors diagnosed her with thyroid nodules, an abnormal growth of cells on the thyroid gland, and referred her to Lokmanya Tilak Municipal Corporation Hospital at Sion for further treatment.
Sangeeta’s son, Rajan, initially opted for treatment at Sion Hospital. However, due to the distance and frequency of trips with his job, they decided to switch to a nearby private hospital despite higher costs. Rajan said, ” If the MT Agarwal super-speciality hospital had been available, we wouldn’t have needed to go to the private hospital.”
Like Sangeeta, many residents in the suburbs of Mumbai are compelled to turn to private hospitals, leading to out-of-pocket expenditure, all because of delayed redevelopment of municipal hospitals in the suburbs.
To alleviate burden on tertiary hospitals like KEM, Sion, and Nair Hospital, BMC planned to upgrade hospitals in suburban areas and allocated budget for the same. However, these projects have been stalled for several years due to a lack of coordination and follow-ups with Health Infra Cell (HIC), issues with tendering, and contractor appointments.
The MT Agarwal Municipal Super Speciality Hospital in Mulund west is one such case. The hospital started in 1958 with 25 beds. Over time, it grew into a 110-bed hospital. However, in 2015, the hospital building was declared dilapidated. At that time, BMC decided to redevelop this hospital as a super speciality hospital with 470 beds. Until 2018, BMC could not finalise a contractor and was compelled to scrap the tenders thrice due to the project’s estimated costs.
Impact of delays on patients
For the redevelopment, all departments of MT Agarwal Hospital were relocated to two separate premises in Mulund: one in the T ward office area and the other behind R mall, spanning approximately 1.3 km. Hospital staff members said that patients from areas such as Bhandup, Vikhroli, and Thane frequently visit the hospital, and the constant commuting between the two facilities has become exhausting for them.
The first building houses departments for medicine, paediatrics, and emergency care, and the second building offers services such as sonography and X-rays, ophthalmology, orthopaedics and surgery. Patients admitted to the wards or emergency department often need to travel to the second building for these tests, which is inconvenient and time-consuming. An auto driver from Mulund, who wished to remain anonymous, shared that patients referred for sonography or X-rays in the OPD have to rush to the other facility for these tests.
Consequently, obtaining test results and revisiting doctors can take up to three to four days, causing delays in diagnosis and treatment. To avoid such delays, many people opt to undergo tests at private labs despite the increased financial burden it entails.
Read more: Mapping Mumbai’s hospitals
BMC initiated an ICU at this hospital and outsourced the facility from another organisation. However, it was discovered that the organisation had employed unqualified doctors, increasing ICU deaths. Subsequently, FIRs were filed against three doctors from the ICU, and BMC blacklisted the organisation last year. Now, the ICU facility has been closed for more than six months.
Hospital staff expressed that the super-specialty hospital had been constructed on time, and it could have prevented deaths in the ICU, sparing patients the need to seek treatment at Sion or Rajawadi Hospitals.
Another unintended consequence of the this hospital redevelopment project, which has been ongoing for the past seven years, is the pollution it causes. Residents in this area complained poor health due to dust pollution. “Despite complaints filed by some societies to BMC, no precautions were taken to mitigate the dust and pollution levels. It was only after the implementation of a dust mitigation policy that the contractor installed metal boards last year,” said a resident. He also mentioned that not all construction areas are adequately covered, so residents still suffer from dust.
Super-specialty services postponed
In this year’s budget, BMC asserted that 80% of the MT Agarwal hospital’s construction has been completed, and it will be operational by June 2024. However, a BMC official said that the facilities available in the old hospital will be functioning in the new building within the next six months. However, the commencement of super-specialty services is anticipated to require more than a year.
Former BJP corporator Prakash Gangadhar, who continually followed up on the redevelopment of M.T.Agarwal Hospital, said that despite budgetary allocation, the BMC administration failed to complete the hospital in time. He remarked that though BMC claims that 80 % of work has been completed, major interior work remains pending, and it will likely take nearly a year for the hospital to be fully operational.
Delays in upgrade of suburban civic hospitals
Like MT Agarwal, upgradation of several other civic hospitals is also delayed. Shri Harilal Bhagwati Municipal super-speciality Hospital Borivali (West), started in 1968, is one of the major peripheral hospitals. Due to the dilapidated building structure, the hospital shifted to Dr. Babasaheb Ambedkar Hospital, Kandivali (W), along with all departments in October 2013.
The first phase of the new hospital commenced in 2016, but offers only OPD services. In the second phase, BMC planned to redevelop the hospital with a 1,000-bed super-specialty. However, due to cost escalation, BMC reduced the number of beds to 490. The cost of this super-speciality hospital is estimated around Rs 500 crore. Over five years, 60% of the work was done, and according to BMC data, it is projected to be functional from October 2024.
Hemangi Raut of Shiv Arogya Sena criticised BMC’s handling of delays in Bhagawati super specialty Hospital building project. She said, “Despite inquiries, BMC blames contractors for incomplete work, leading to frequent contractor renewals or changes. Why hasn’t the BMC imposed penalties on contractors and compelled them to finish the remaining work?”
Patients from Malad to Palghar previously relied on Bhagwati Hospital. However, since the demolition of the old hospital, all patients are now redirected to Shatabdi Hospital in Kandivali or Cooper Hospital in Vile Parle.
Another example is the proposed super-specialty hospital proposed at Govandi’s Pt. Madan Mohan Malviya Centenary Hospital. This hospital will provide specialised services for the eastern suburbs of Mumbai, including Mankhurd and Bainganwadi, with an expanded capacity of 580 beds in addition to the existing 210 beds. According to BMC, 70% of the work on this hospital has been completed and it is expected to be fully operational by June 2024.
Similarly, redevelopment of Siddharth Hospital in Goregaon is stalled for the past five years. Originally built in 1998 with a six-story building, the hospital’s structure deteriorated over time, leading to its demolition in 2019. All departments were relocated to other peripheral hospitals in Kandivali, Jogeshwari, and Borivali.
The redevelopment plan aims to upgrade the hospital from its current capacity of 175 beds to 300 beds. According to BMC data, only 30% of the work has been completed, with the hospital expected to be functional by December 2025. BMC allocated Rs 25 crore for this hospital in the 2022-23 budget, but the funds were not utilised.
Five years ago, the 100-bed Krantiveer Mahatma Jyotiba Phule Hospital (KMJPH) in Vikhroli was closed due to its dilapidated condition. In response, the BMC established a temporary outpatient department (OPD) facility on the premises, while inpatient services were relocated to the nearby BMC-operated Ambedkar Maternity Hospital in Vikhroli.
A local resident highlighted that in cases of emergencies, there is no hospital in the entire Vikhroli-Bhandup belt. Even when residents go to Ambedkar Hospital, they are redirected to Rajawadi Hospital in Ghatkopar.
BMC decided to upgrade the hospital with 500 beds and allocated Rs 10 crore for the redevelopment of this hospital in 2022-23, but the funds were not utilised. BMC has stated that the hospital’s plan has been approved by MHADA, and the tendering process is currently underway.
Expansion of KB Bhabha hospital in Bandra to 500 beds is also underway from 2018. BMC officials said that 80% work of the new building is completed.
Struggling patients; BMC’s promises
In this year’s budget, the civic body specified that most hospital redevelopment projects would be expedited.
However, when Citizen Matters tried to reach Dr. Sudhakar Shinde, the additional municipal commissioner of BMC, he did not respond, despite repeated attempts.
Dr. Avinash Supe, former Director of BMC tertiary hospitals, said, “Now that most hospital buildings are constructed, the next challenge is to complete the interior works and set up the hospitals. If BMC utilises the capital expenditure budget effectively this year, hospitals will be functional by the end of the current year.”
However, he also expressed concerns about the upcoming election year. He said that fund utilisation tends to be lower during election years.
There is budget allocation and plans for redevelopment of hospitals, so the implementation will happen at some point. However, till then, patients like Sangeeta will continue to spend their limited resources on expenditure incurred at private hospitals.
(In the previous part, we analysed the budget spending for health by the BMC and found that it was the lowest in five years. This has impacted completion of the redevelopment of speciality hospitals severely.)
| Have you faced any problems in accessing facilities at public hospitals? What can be done to improve public health care? Please share your thoughts with us at mumbai@citizenmatters.in. |