Hyderabad: Getting access to quality diagnostic services at government hospitals, especially in the urban primary healthcare facilities and Basthi Dawakhanas, has always been a challenge for the urban poor in Hyderabad.
Till a few years ago, the specialist government doctor at a PHC or a UPHC invariably used to prescribe diagnostic tests and patients were left with no option but to get tested at the nearest private diagnostic laboratory. As a result, diagnostic services have been a major source of out-of-pocket expenditure for patients.
The dependence on private diagnostic facilities and the difficulties that patients in Hyderabad faced were inherited. Lack of planning and decades of apathy towards to the diagnostic needs of the patients by successive government before the Statehood, were the root cause for the situation. Given this, patients used to visit tertiary government hospitals in Hyderabad for treatment.
Recognising these difficulties, the Telangana government launched its prestigious Telangana Diagnostics initiative that aimed to once and for all address the niggling issue of non-availability of diagnostic tests at the government hospitals not only in Hyderabad but across the State.
Apart from deciding to invest on diagnostics in government hospitals, the State also invested heavily in quasi-State-run tertiary health care facility i.e. Nizam’s Institute of Medical Sciences (NIMS), which has now made it possible for poor patients get access to highly advanced diagnostic tests at very affordable rates.
The Telangana Diagnostics initiative is based on the concept of ‘Hub and Spoke’ model wherein a centralised high-end laboratory will be connected to many local urban primary health centres and Basthi Dawakhanas in Hyderabad.
The hub was dubbed as a ‘Centralised Diagnostic Laboratory’ and was connected to PHCs, CHCs, UPHCs, Basthi Dawakhanas, Area and District Hospitals. In Hyderabad, a similar hub worth Rs 1 crore at Institute of Preventive Medicine (IPM) is connected to 16 smaller health care facilities where patient samples are collected for diagnosis.
It was envisaged to incur an expenditure of at least Rs 20 crore to develop 40 diagnostic centres as hubs that would cater to lower-level government health care facilities. The Managing Director, TSMSIDC, had given an estimate of Rs 38 lakh to develop one single hub or a Centralised Diagnostic Laboratory.
The total cost of the Telangana Diagnostic initiative was estimated to be at Rs 7.6 crore for construction of central laboratories of at least 2,400 sft size in 20 different locations with pre-fabricated structures.
Before the Covid-19 pandemic hit Telangana, the State health authorities had already managed to launch several diagnostic hubs across the State. These high-end laboratory facilities are covering almost all the patients visiting public health care institutions in the districts.
Minor diagnostic tests are available at PHCs, CHCs and wellness centres and the high-end diagnostic tests are available at the higher medical establishment. Blood samples of patients collected are transported from PHCs, CHCs to the hub where higher-end tests are conducted and results made available online.
Standalone laboratories at NIMS and Gandhi Hospital
Apart from the IPM facility, in the last few years, the State government has also invested heavily to develop high-end laboratory services at Gandhi Hospital and NIMS. A centralised 24-hour laboratory was established at Gandhi Hospital. At NIMS hospital, the State government had invested over Rs 70 crore to develop laboratory diagnostic services on three floors of the Millennium Block at NIMS that caters to a wide variety of health disciplines and offers expensive diagnostic tests at affordable rates.
Free Covid-19 diagnostics
The first Covid-19 case was detected in March 2 at Gandhi Hospital and in the next six months, the health authorities have managed to establish 18 diagnostic laboratories that are offering only RT-PCR and CBNAAT tests to diagnose Covid-19 for free at government notified Covid treatment centres. Apart from these laboratories, the health department is providing free rapid-antigen tests to detect Covid at over 1000 different Urban Primary Health Centres (UPHCs) and Primary Health Centres (PHCs).