Karnali Provincial Hospital, which receives up to 2,000 patients daily, is facing problems in expanding services due to a shortage of 50 doctors, specialists, and technicians.
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The largest government health institution in Karnali Province, Provincial Hospital Surkhet, is facing an overwhelming patient load. According to the hospital administration, around 1,500 to 2,000 people are regularly receiving OPD services from the hospital daily.
Along with Karnali, this hospital, which is a referral center for the Far West, also receives patients from Lumbini Province. Despite the pressure of patients in the hospital, there is a shortage of manpower.
The hospital has 325 vacancies for the 150 beds approved by the government. Of these, only 201 are working in permanent positions. The hospital administration has stated that about 50 doctor posts are still vacant.
There are currently 557 employees, including 46 on contract, 66 under the Hospital Development Committee and 244 on contract from various other sources. But the posts of specialist doctors, nursing and technical manpower are still vacant.
Although there are 14 specialist doctors in the hospital, only one is permanently employed. According to the hospital, almost all of the currently employed doctors are department heads and experienced doctors who have come to work from the association. Two have already been dismissed.
The hospital is operating its services based on doctors and contract workers who have come to work from the association. Anita Gyawali, the hospital's administrative chief, says that the specialist services are being affected as the number of doctors who have come to work increases. According to her, the hospital has not been able to provide the expected service due to the inability to manage the human resources. She said that if other employees who have come from the association continue to be dismissed, it will be difficult to continue the services provided by the hospital.
Gyawali said that the hospital, which was built to operate 500 beds, has been able to operate only 300 beds due to lack of staff. There is no way to operate a new structure due to the lack of necessary human resources. The pressure of patients is increasing every year. She said, ‘There are equipment worth crores in the hospital, but some of the equipment has not been fully utilized due to lack of manpower to operate it. Due to lack of manpower, it is becoming a challenge not only to expand services but also to continue the existing services.’
Medical Superintendent Dr. Ganesh Thapa, the director of the hospital, said that despite repeated requests to the provincial government for manpower management, the problem has not been resolved. He said, ‘Neither the hospital has been given the authority to fill permanent posts on its own, nor has the government filled the necessary posts.’ In such a situation, the question is how to expand services.’
According to her, special initiatives are required from the provincial and federal governments to immediately fill vacant posts, manage specialist doctors, pay health insurance arrears and ensure the necessary budget to fully operate the 500-bed structure.
According to the hospital’s data, 191,966 people used OPD services in the fiscal year 2079/80. This number had increased to 208,114 in 2080/81 and 2012,078 in 2081/82. Till Chaitra of the current fiscal year 2082/83 alone, 166,311 people have availed OPD services.
Departmentally, the highest number of patients come to the medicine service. Till Chaitra of the current fiscal year, 38,046 patients have availed services in the medicine OPD. After that, 23,923 patients have availed services in orthopedics, 13,807 in surgery, 13,237 in obstetrics and gynecology, 12,177 in general OPD and 10,961 in eye service.
The hospital has stated that the number of patients has also increased significantly in the emergency service. In the fiscal year 2079/80, 21,177 people sought emergency services, while in 2080/81 and 2081/82, the number increased to 24,326 and 25,379, respectively. As of Chaitra, 18,763 people have sought emergency services. Similarly, as of Chaitra, 18,601 patients have been admitted to the hospital. During the same period, 4,229 obstetric services, 1,197 cesarean sections, and 3,612 major surgeries have been completed.
Gyawali said that although the health insurance program has provided relief to patients, it has added new challenges for the hospital. As of Chaitra, 96,388 insured service recipients have sought services from the hospital. The hospital has stated that about Rs. 300 million that it should have received from the health insurance is yet to be paid.
