REPORT ON FEASIBILITY OF UPGRADATION OF THE ESIC HOSPITAL

In the meeting chaired by the Hon’ble Member of Parliament, Sh. Sanjeev Arora Ji on 02.06.2023,
it was suggested to prepare a feasibility report on the extension/upgradation of the existing ESIC
Hospital in Ludhiana from the present bedded strength of 300 to a total bedded strength of 500. In
pursuance of the direction, a brief study was made of the operational guidelines pertaining to the
hospital, its human and physical resources and other factors, with a view to analyse the need of
upgradation of the total bed capacity, and is presented for your perusal

A) CURRENT RESOURCE ENDOWMENTS OF THE HOSPITAL

The hospital stands on land that has been taken over from State Government by ESIC in 2004.
There are 4 main buildings in the hospital premises (Old Building, New Building, Staff Quarters
and ESIS Dispensary). All the buildings are more than 25 years old and to ascertain feasibility of
upgradation, a structural audit has been assigned to CPWD. Hon’ble MP in the meeting suggested
that one of the buildings be shifted out to make space available of the extension of the hospital.
As far as human resources are concerned (as of 20.06.2023), the following is the status of doctors at
the hospital:

Cadre Sanction In Position (Regu- In Position (Con-

lar) tractual)
Super Specialist 06 - 02
Specialist 28 16 03
GDMO 52 27+1* 06
SR - 3 57 - 26
ESIC JR on bond - - 13
service (UG)
ESIC SR on bond - - 2**
service (PG)

* One GDMO diverted from ESIC DCBO Barnala

** 2 ESIC SR unauthorized absent

As can be seen, there is a serious shortfall of staff, against the sanctioned strength, which will need
to be resolved as well, for the upgraded capacity to be optimally utilised.
B) BED OCCUPANCY STATISTICS
The total registered IP Facilities are at present around 4,30,000/- and the bed capacity is at 300 (in-
creased to this figure from 262 in July 2021). The Bed Occupancy Trend of the hospital is as fol-
lows:

As it can be seen, two phenomena seem to have taken place consecutively. In 2020, beds were ex-
panded to cope with the increased pressure of COVID. ESIC, by mandate is a hospital that provides
care for families of migrant labourers, workers of establishments with < 10 workers and private
school teachers with < 21000 salaries. These norms were relaxed during COVID, but they kicked in
once the disease burden abated. This was met with the aftermath of massive out-migration by
labourers (the key patient pool of the hospital). This shows in the huge fall in bed occupancy to
56.7% in Dec 2020.
Another factor which has contributed to the bed occupancy not picking up (as claimed by the hospi-
tal) is that post-COVID, workers have not returned with their families to the city. They have chosen
to avail the benefits of the family Pehchan card which helps the family avail health services at ESIC
hospitals in their native places. Workers themselves choose to avoid being bedridden as it means a
dip in their daily earnings. They seek OPD treatment when they can help it.
A juxtaposition with respect to patient footfall and care (on Daily Average of Admission and Total
Number of bed days) is as follows

The largely overlapping trends of these two parameters suggests the strength of the underlying phe-
nomenon pulling them (COVID here). Both parameters have picked up post COVID but have not
reached the pre-COVID levels of patient engagement buttressing the claim of the hospital about
out-migration of families. Comparing this with the bed occupancy, what can be inferred is that the
average duration of time spent by patients in beds must have come down again corroborating the
claim that labourers when living alone would opt for OPD services if they can help it.

RECOMMENDATIONS
· As per letter numbered U-13/14/ATR/ESIC/38/14 Med-1 Vol1, dated 11.07.2022 1 from
ESIC to ESIC Hospitals, those hospitals with minimum number of IPs (Insured persons) of
4,00,000 can have 500 beds. Current bed capacity is 300 and IPs are about 4,30,000. As
Ludhiana is a major industrial hub of Punjab, the incoming patient number is likely to rise as
the Industrial production picks up pace after slowdown due to COVID, and the Govt’s push
towards more industrialisation, it is highly recommended that the capacity be upgraded to a
500 bedded hospital
· Currently, serious ailments (secondary and tertiary care) are referred to empanelled hospi-
tals. Capacity building through placement of specialists and super specialists, (oncologists,
cardiologists especially) would help optimally utilise the infrastructure of the Hospital.
· More awareness about the facilities available can be provided to the beneficiaries of the hos-
pital. There are also 12 dispensaries in Ludhiana (out of 27 in Punjab). Awareness regarding
medical facilities and medicines available can boost the patient numbers at the hospital.
· The absence of private wards may be a dissuading factor for female patients. Expanding bed
facilities with semi-private/private arrangements can help them seek the right kind of medi-
cal attention.
· Keeping in view, the potential demand in the immediate future, and the time it would require
to expand the infrastructure in terms of both quantity and quality, it is highly recommended
that the hospital be upgraded to a 500 bedded hospital with provisioning for private wards,
for it to be able to cater to natural exigencies (like COVID) as well as regular burden of pa-
tients.
· Additionally, it is recommended that a satellite centre/Additional facility be created at the
Industrial Focal Point, Ludhiana to provide medical facilities in the vicinity of maximum
clientele as well as provide emergency facilities closer to the workplac

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