Delhi HC directs govt to fix ICU bed, IT gaps after surprise audit

Delhi HC directs govt to fix deficiencies in ICU bed management and IT systems in 38 hospitals after an NIC audit. The court also expressed concern over large quantities of unused medical equipment, including ventilators, and sought a report.

The Delhi High Court has directed the Delhi government to take time-bound measures to address deficiencies in ICU bed management and the implementation of the NextGen e-Hospital Management Information System (HMIS) across 38 government hospitals, after a surprise audit by the National Informatics Centre (NIC) found gaps in emergency response and hospital IT infrastructure.

A bench of Justices Prathiba M Singh and Manmeet Pritam Singh Arora examined a detailed NIC audit report carried out between July 13 and 24 following the court's earlier concerns over inconsistencies in the use of the HMIS across Delhi hospitals. The audit examined whether ICU bed availability shown online matched the actual position, whether emergency calls seeking ICU beds were being answered and whether the NextGen HMIS was being implemented uniformly across all 38 hospitals.

NIC Audit Reveals Gaps

ICU Bed Availability and Emergency Response

The audit found that the number of vacant ICU beds displayed on the State Health Data Management Portal matched the actual availability in most cases. However, discrepancies were found at some hospitals, which officials attributed to admissions and transfers taking place after the website was updated. The court was also informed that ICU bed availability is currently updated manually by hospitals, on average three times a day.

The audit further found that emergency calls seeking assistance for ICU beds were properly answered in some cases, while certain hospital numbers were found to be unresponsive. The concerned hospital authorities were informed and advised to take corrective measures.

HMIS Implementation Varies

The implementation of the NextGen HMIS was also found to vary considerably between hospitals. While 18 hospitals were using more than 10 modules of the system, the remaining 20 hospitals were using only five to 10 modules. The NIC suggested that all hospitals should immediately adopt and use the applicable modules.

According to the hospital-wise audit, several deficiencies were linked to shortage of staff and technical manpower, inadequate computer systems and IT infrastructure, and lack of leased-line connectivity.

High Court Issues Directives

The High Court directed the Secretary, Department of Health and Family Welfare, GNCTD, to forward the detailed audit report to all 38 hospitals and obtain their comments. The Secretary has been directed to file a comprehensive report setting out the steps being taken to remove the deficiencies and the timelines for their implementation. The NIC team has also been permitted to conduct another surprise inspection of all 38 hospitals.

Clarity Sought on Common Helpline

The court also sought clarity on the Delhi government's proposal to use the existing Centralised Accident & Trauma Services (CATS) toll-free infrastructure as a common helpline for emergency services, ICU bed availability and hospital speciality information. The court noted that the government report did not clearly specify which CATS number would function as the common helpline or whether the personnel answering the calls would have information about ICU beds and hospital specialities.

The court directed Rajesh Kumar, Deputy Secretary, Health and Family Welfare Department, GNCTD, to file a fresh status report specifying the CATS number proposed for the common helpline and providing details of the Referral Coordinator proposed to coordinate referrals between hospitals. He has also been directed to assist the court during the next hearing.

Court Raises Concern Over Unused Medical Equipment

The court meanwhile expressed serious concern over a large quantity of medical equipment lying unused across 26 Delhi government hospitals. At Guru Teg Bahadur Hospital, 400 ventilators and 910 oxygen concentrators were lying unused in the hospital store. The hospital stated that the equipment had been required and donated during the COVID-19 pandemic but was now surplus.

The court also noted that an ECG machine at GTB Hospital was non-functional and no other ECG machine was mentioned in the report. At the Delhi State Cancer Institute, expensive equipment used for cancer diagnosis and treatment was lying unused, prompting the court to question why such equipment had not been put to use despite substantial investment.

The court also noted that at Deen Dayal Upadhyay Hospital and Ch. Brahm Prakash Ayurved Charak Sansthan, almost all equipment and machines listed in the report were lying unused. The reasons cited included absence of technically qualified manpower and, in some cases, missing parts or accessories.

The Secretary, Health and Family Welfare Department and Secretary, Services, GNCTD, have been directed to hold a joint meeting with the Medical Superintendents/Directors of the 26 hospitals on August 17. They have been asked to examine measures including deployment of technical manpower, removal of unused or condemned equipment, reallocation of equipment to hospitals where it is required, recruitment timelines and procurement of missing accessories or principal equipment.

The matter has been listed for September 18. The court also recorded that the issue concerning patient Kamar Jahan, who had been provided an ICU bed at LNJP Hospital and was receiving treatment there, stood closed. (ANI)

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