Clear Instructions from Health Secretary Dr. R. Rajesh Kumar: Specialist Services Now to Be Provided at District Level
Dehradun : On the instructions of Chief Minister Pushkar Singh Dhami, the Uttarakhand government has started enforcing strict measures to curb unnecessary referrals of patients from government hospitals. Health Secretary Dr. R. Rajesh Kumar clarified that no patient will now be referred from district and sub-district hospitals to higher institutions like medical colleges or larger hospitals without valid medical reasons. He stated that, following the Chief Minister’s directives, it is being ensured that every patient receives primary treatment and specialist consultation at the district level itself. Unnecessary referrals not only strain resources but also deprive patients of timely and appropriate treatment.
Dr. R. Rajesh Kumar further informed that the Health Department has issued a comprehensive Standard Operating Procedure (SOP) aimed at ensuring transparency, accountability, and medical justification in the referral system. The SOP emphasizes the following key points:
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Referral Only in Case of Specialist Unavailability: A patient will be referred to a higher institution only if the necessary specialist is not available at the hospital.
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Decision by Senior On-Duty Doctor: The on-duty doctor will personally examine the patient and decide on the referral. Referrals based on information received via phone or email will no longer be valid.
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Immediate Decisions Permitted in Emergencies: In critical cases, the on-duty specialist can make life-saving decisions via WhatsApp or phone calls, but such decisions must later be documented.
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Written Justification Mandatory: The referral form must clearly mention the reason for the referral, such as the unavailability of specialists or necessary resources.
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Senior Officials to Be Held Accountable: In cases of unjustified or unnecessary referrals, the concerned Chief Medical Officer (CMO) or Chief Medical Superintendent (CMS) will be held accountable.
Special Focus on Ambulance Management
Dr. R. Rajesh Kumar mentioned that, as per CM Dhami’s instructions, clear guidelines have been issued regarding the use of ambulance services to ensure transparency in patient transfers. The 108 ambulance service will be used strictly under Inter Facility Transfer (IFT). Departmental ambulances will be deployed in a planned manner, and their technical condition will be reviewed to ensure operational fitness.
District-Wise Status of Ambulances and Mortuary Vans
Currently, the state has a total of 272 “108 ambulances”, 244 departmental ambulances, and only 10 mortuary vans. Certain districts—such as Almora, Bageshwar, Champawat, Pauri, and Nainital—do not have mortuary vans. CMOs of these districts have been instructed to ensure immediate alternative arrangements. Dr. Kumar added that older vehicles, whose registration age has completed 10 or 12 years, can be deployed as mortuary vans as per regulations. Regional operational expenses for these have also been fixed.
