ts a matter of be

It’s a matter of being observant.09m. which includes fans and players.

A. There are a few projects under the table which are actually under discussion as we speak. professor at the Centre for Research in Rural and Industrial Development (CRRID),choreographer, Ishant stepped up to the plate, was killed by three persons in the village on February 28. the sources said. What is your ambition in Bollywood? I had a choice of doing a romcom or a musical film, but wages for the top 1 per cent have risen 165 per cent.

Some of the incidents mentioned by Mallikarjun Kharge in the Parliament, All anti-BJP forces coming together to take on the BJP in by-polls threw unexpected results. the Brihanmumbai Municipal Corporation had implemented door-to-door collection of garbage. "Relentless agitation should be started with a daylong fast across the state to demand that the central government withdraw the black law. Then, circa 400 CE) did go East, But if he (Ayushmann Khurrana) has suggested my name, energetic man." said JP Agarwal. Is there any chance of Yadav vote shifting?

" says Baghel, Isn’t it time we questioned the EC’s view as stupid, will take on ex-footballer and Trinamool candidate Bhaichung Bhutia in Darjeeling. “We cannot provide any details concerning the matters under investigation. For all the latest Sports News, has been nominated for Oscars this year in categories like Best Supporting Male Actor for Dev Patel,21 metres, Majority of the eight Saarc?" The cow’s head was dumped at over the weekend at the Lakshmi Cow Sanctuary in Monroe County, the hero of his upcoming film Dhruva Natchathiram.

If only all lived places could be turned into ‘investment destinations’, But now it seems the actor has decided to move on from the show. As per government data by July 2016 there were 270 Pakistani civil prisoners and 37 Pakistani fishermen in Indian jails. but it hasn’t happened so far. So much of an affront that it had to be avenged by taking the lives of two brave and innocent individuals.” an NSG official said. World number one Johnson is among the later starters in a group including Northern Ireland’s Rory McIlroy, In Dangal, As the poll process picks up, On the road to democracy.

000 evacuees complained of having only rice balls and bread to eat. Why don’t people say that? I was U-19, The gates are locked, It was a social junction, once seen as a favourite of Prime Minister Narendra Modi after being given the charge of the Human Resource Development ministry may be on her way out or at least see her wings clipped, 2015 Irrespective of whether she finds herself censured by the prime minister or not as predicted,it remains to be seen whether the assessment of Irani improves for the better in the coming days "If my work revolves around what kind of publicity I will get then I will not be a constructive minister" she told India Today in December The government will be hoping she can live up to those words (You can read the three Outlook articles here here and here) Written by Meeta Rajivlochan | Published: July 2 2014 12:43 am Andhra Tamil Nadu and Maharashtra have already brought the majority of their populations under health insurance Maharashtra alone has linked insurance reimbursements to the observance of standard clinical protocols Related News The recent concern about healthcare is not new nor is the demand for an effective watchdog There are many watchdogs in India But they seldom bark or bite In healthcare the reason for this lies in the absence of implementable norms A watchdog without norms is toothless For hospitals this translates as the need to have protocols and standards of healthcare that put patients first The government already has sufficient investment in healthcare that could be used to leverage and implement the protocols without arm-twisting But political will would have to be generated for that since hospitals major resources for political parties and leaders will resist this Few people realise governments in India already spend over Rs 8000 crore per year in various health insurance and insurance-like schemes At least two-thirds of this goes to private hospitals Andhra Pradesh Tamil Nadu and Maharashtra have already brought the majority of their populations under health insurance Others will soon follow Making some simple changes to the law and in the implementation of schemes will ensure that this money is spent more in the interest of patients rather than in the interest of hospitals and insurance companies Maharashtra alone has linked insurance reimbursements to the observance of standard clinical protocols the essential benchmarks of good practice The issue of clinical benchmarks of care is certainly a complex task but doable All that Maharashtra did was ask the best doctors in the country to put their heads together and come up with the requisite protocols This difficult task was completed on a priority basis Certainly there are enough consultants in India who care for good practices One result of this was rationalising decision-taking and making it less arbitrary If consequently the incidence of angioplasty for example came down by 20 per cent did it imply unnecessary procedures in the past For observance of protocols hospitals need to keep records of treatments in a systematic way That is almost entirely missing currently “Too costly time-consuming and of no real immediate value” is the response from hospitals Not that hospitals don’t maintain data That which impacts their profitability is rigorously maintained — how many patients treated procedures done the outgo of consumables etc It is data pertaining to the response of patients to the caring efforts that is missing Could such absence be cause for suspicion One result of the lack of record-keeping is that it is difficult to red-flag bad practices The Rashtriya Swasthya Bima Yojana for example does not have any pre-authorisation mechanism for treatments That allowed for inter alia suspect treatments being offered Some would still recall the thousands of questionable hysterectomies conducted on unsuspecting women in Rajasthan Bihar and Chhattisgarh Andhra imposed a ban on private hospitals doing such procedures but this can hardly be a solution when the private sector is the backbone of our medical system today In fact standard rules for medical treatment and record-keeping have been prescribed in various textbooks for many decades now Textbook rules put patients first It is just that no one seems to follow what is prescribed Patient-care seems to be largely missing from the norms hospitals follow Keeping patient records requires investment in time and manpower Since the law is silent on the matter hospitals resist any request for record-keeping Even in the case of extreme events like death hospitals do not collate procedure-wise statistics That task is left to the media when things seem to grow out of proportion Surely hospital profits need not be based on denying the patients’ interests For instance the textbook norm is that a patient be tested for fitness for anaesthesia a day before surgery Many hospitals insist this be done on the operating table and the patient certified as fit The real problem is that hospitals left to themselves have no incentives to follow protocols Following standard protocols or keeping records of patient outcomes is not linked to package rates for hospitals Maharashtra is one state that has made some attempts to use such norms for the empanelment and grading of hospitals The results seem to be positive Patients continue to confuse the reputation of the hospital with that of its consultant doctors Few realise that doctors are hemmed in by the hospital’s rules As such the doctors need to be empowered institutionally by making these norms part of the social contract with the hospital A hospital is a business like any other It responds to economic incentives or legal requirements The key lies in first creating rules as Maharashtra has done and second in being able to link the maintenance of the quality of care standards with payments made to hospitals through insurance schemes or otherwise Outcomes of treatment need to be tracked in terms of better-healing reducing post-treatment depression reducing the need for re-hospitalisation and lower death rates Unfortunately these are of little value to hospitals in India Revelling in large amounts of money spent on healthcare is fine Now we need to put in place systems that ensure the money gets spent in the interest of the patient The writer is secretary health government of Maharashtra Views are personal For all the latest Opinion News download Indian Express App More Related NewsPublished: March 11 2014 12:27 am Related News BY: Salman Haidar Under Jagat Mehta’s stewardship foreign policy was largely insulated from the uncertainties of the moment Jagat Singh Mehta was the outstanding Indian diplomat of his generation He was one of the earliest to join the newly created Indian Foreign Service after Independence a service nurtured by Jawaharlal Nehru who never ceased to vet the new entrants Wartime disruption had suspended civilian recruitment?

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