“I should have been here at 8am,” said Thankamma, a resident of Palakkad’s Kalleppully. TNM met the 63-year-old at the Palakkad District Hospital on January 3 as she joined a long queue at 10 in the morning to obtain an outpatient (OP) ticket. She finally received the ticket at 12.15 pm. However, the physiotherapy department’s doctor will only attend to 50 patients a day. “I have to do physiotherapy here every day, for a few weeks. I can do physiotherapy, but cannot see the doctor. I will have to come back early tomorrow morning,” she said.
Hospital authorities attribute the long queues to the process of issuing Unique Health Identification (UHID) cards, which started recently but patients and bystandersTNM spoke to said it is not a new issue. The hospital’s ticket counters have people queuing up from five in the morning despite the fact they open only at 7.30 am. The average time a person needs to stand in the queue is three hours.
“If we need to leave the hospital after a checkup and collecting the medicines around 2 or 3 pm, we have to stand in line as early as 5 in the morning. Both my father and mother have experienced this," said Ashwini M, a native of Chittur.
Palakkad district hospital has a daily footfall of around 1,300 to 1,500 patients. The hospital has five counters for OP tickets. While two counters are for the general public, there is one for senior citizens, one for differently abled individuals and another for people who hold a UHID card, designed to document a patient's medical history. The card system was launched in the general hospital on December 1.
To receive the UHID card, the patients need to submit their Aadhar card number along with their mobile number for OTP verification. Patients with UHID would be able to skip the queue by booking the OP tickets online, which would make queues redundant. Palakkad General Hospital began the online booking facility from January 1.
Dr Jayasree, the medical superintendent of the hospital, said the long queues are a recent development and are happening because of the health card issuing process. “Most patients do not have a health card. Now cards are being made and that is why the wait time is a little long. The outpatient counter now opens at 7 am instead of 7.30 am to help patients,” she said. Some departments have only one doctor and they are available only on specific days of the week, Dr Jayasree said. “The patients who seek treatment from these specific departments arrive early in the morning to secure the tickets,” she said.
The departments of Cardiology, Nephrology, Urology and Neurology have only one doctor each and they are available only on specific days.
Ashwini said her parents had consulted a general physician and dermatologist in the hospital in 2023 and had to reach the hospital at around 5 am to ensure OP tickets.
Raji Mol, a resident of Vadassery, said she had visited the hospital with her mother in September 2024 and found it hard to get OP tickets. “We got tired of standing in the queue. This long wait was not only for the OP ticket, but also for the pharmacy and insurance formalities,” she said.
Febin Rahman, vice president of Keralassery panchayat, said hospital’s casualty also experiences heavy rush. “I visited the hospital on December 27, to help an accident victim who sustained a head injury. Many fever patients and those seeking vaccination were waiting. They only allowed people with severe injuries to enter the casualty. The casualty system must improve,” he said.
The overcrowding in government hospitals is not only an issue in Palakkad but also can be observed in all districts.
Kerala Government Medical Officer’s Association (KGMOA) state president Dr GN Suresh said doctor-patient ratio in the state’s public sector is skewed. “According to the World Health Organisation (WHO) the doctor patient ratio should be 1:1000. The overall state ratio is much better than this. But if we exclude the private sector the ratio would be approximately 1:6000. A doctor in the public sector needed to attend to more than 150 patients a day. It is a human right violation of both the patient and the doctor,” he said.
The issue is not the shortage of sanctioned strength of the doctors, but the numbers have not gone up considering the patient load “The number of people who depend on the public health sector has gone up in recent years due to the improvement in infrastructure and since private healthcare has become unaffordable. The number of doctors has not increased accordingly,” he added.
Patients need to share beds
Ashwini said most people like her depend upon the government hospitals because they cannot afford private healthcare. Her family’s experience at the hospital wasn’t pleasant. “My father was admitted here for four days in September 2024 due to breathing difficulty. There were no bedsheets and patients needed to share beds, nurses were rude and we couldn’t use the washrooms due to poor maintenance,” Ashwini said. She filed a formal complaint but is yet to receive a reply. .
Raji Mol said she found that patients were forced to share the bed while her mother was admitted to the hospital in September 2024. “Three years ago while my grandmother was admitted the situation was the same. Even though one patient was in a serious condition they did not provide a separate bed for them. We never know the condition or the disease of other patients. What if it is a contagious disease?” asks Raji Mol.
TNM asked the hospital’s Public Relations Officer (PRO) Ajith for a response regarding the allegations. The report will be updated once TNM receives a response.
Binumol K, the president of Palakkad district panchayat said the number of beds have not gone up with the number of patients. “Most patients are from economically weaker sections and are being asked to adjust to avoid going to private hospitals,” she said. Construction of a new block started in 2024 and once it is complete, the issue of bed shortage can be addressed, she said. The Rs 127.15 crore project, utilising the Kerala Infrastructure Investment Fund Board (KIIFB) funds, was sanctioned in 2020.