NAGAR PANCHAYAT HOSPITAL

Introduction:

The case discusses the issues of autonomyand

accountability in the healthcare divisionof a local self-
government. It highlights theunderlying tension between
the elected representatives'need to control the
divisionand the executive's need for basic functionaland
financial autonomy in developing and maintaining the
division as a useful andresponsive facility to the public. It
raises questions as to the concept of cost
andresponsibility centres in local self-governmentsand
what happens when one of theresponsibility centres
starts generating revenue and becomes a truly profit
centre.Since the basic nature of the service is more of a
responsibility — do the surpluses generated by the new
profit centre get ploughed back to the same facility or
should it get into the general pool of the Panchayat? If
the argument is that it should be ploughed back to the
responsibility centre to improve the overall facilities of
the division, then should the objectives of the division be
redefined and what should be the most appropriate
institutional mechanism to grant autonomy for a division
that is doing well? How would these mechanisms work in
the long run? The case tries to sensitize the discussants
to the issues and tensions that emerge in a well-managed
division of a local-self-government. It also raises the
 larger issue of autonomy and accountability in democratic
institutions.

Problem:

The main problem faced by nagar panchayat was the lack

in payment for the employees selected on a ad hoc basis i.e
unplanned ,was to be given by the panchayat. And there was
serious l ack of inventory management mechanisms at the
pharmacy division and dependency on private labs for
tests.,the main problem is that there was no direct
executionary power to the CMO, and the panchayt do not
invest more in buying equipments rather they did spend on
other resources which are not related to health care
facilities or to the hospital.The main core problem in this
case is about the donation, where watever money comes
under the name of hospital goes to panchayat ,there is no
proper sufficient dunds supplies to the hospital and also as
mentioned in the case that there is only 9staff working in
the hospital, there is lacl in doctors and as Mr.balu only the
physian it takes longer waiting time for the patient to do
their checking.final problem was that whether the hosptal
will remain or sustain in the future when there is absence of
the present CMO.

Solutions :

It is better to meke the hospital autonomy to l increase

the value of the hospital.and they can Appoint qualified people
in the hospitalto reach the objective of the hospital, through
Effective communication between the CMO and the panchayat
people, can make the issue understandable nad try to sole
the issue and also they can see to that they can Maintain
separate doc’s specialized in their fields to the patients,

Implementations::

As said in the problem s that they should revenue generate

from the hospital should be used only for the health care
services. And they should Create a formal hierarchy in the
hospital right from superior to lower level inorder to have a
proper suppl of information and in mean to run the hospital
very smoothly.