BMC to outsource intensivists for 12 peripheral hospitals, activists highlight risks

BMC plans to outsource intensivists for 153 ICU beds in Mumbai's peripheral hospitals, raising concerns over accountability and quality of care.

MUMBAI: The BMC is set to outsource intensivists to manage 153 ICU beds across 12 peripheral hospitals in the city in order to provide critical care access to residents of the surrounding areas. The intensivists include anaesthesiologists, physicians and post-graduates in general medicine who have received specialised training in handling critical care patients. The appointments are to be made within two months and the contracts will extend for two years.

BMC to outsource intensivists for 12 peripheral hospitals, activists highlight risks

An officer in a BMC-run peripheral hospital said this was being done to increase the service efficiency in the hospitals, as peripheral hospitals lack post-graduate doctors. However, health activists have warned that outsourcing can lead to several problems, including accountability, pointing to previous cases where the practice led to fraudulent doctors being deployed in critical care units.

One such case was reported in 2023 at M T Agarwal Hospital, where a Bachelor of Homeopathic Medicine and Surgery (BHMS) graduate allegedly used the registration number of an MBBS doctor while manning the ICU. Multiple cases were registered against the recruiting agency involved. Similarly, in August, the civic body also suspended payments to an agency after it was found that doctors with fake medical certificates were appointed in the intensive care units at V N Desai Hospital.

In its fresh tenders for hiring contractual staff, the BMC has warned that contractors caught hiring doctors with bogus certificates will be blacklisted. As per the tender, intensivist service providers will be required to ensure 24x7 presence of qualified intensivists in ICUs.

“To ensure quality care and prevent malpractice, the BMC should form a joint committee of civic- and agency-appointed doctors to verify credentials and conduct stringent background checks on recruits,” said health activist Tushar Jagtap. “Outsourcing is not advisable for doctors in particular, as it reduces the accountability of doctors with no stringent overseeing authority to ensure good public health services. The corporation should try to hire internally.”

Activists further warned that outsourcing could result in underqualified doctors managing high-risk patients. “There are reports that contractors don’t verify details thoroughly and often deploy fresh MBBS or even BHMS graduates in ICUs,” said Dr. Abhay Shukla, a public health activist and national co-convenor of the Jan Swasthya Abhiyan. “But medical intensive care units and surgical ICUs deal with extremely complex cases which require MD-qualified doctors and trained intensivists with years of experience. These are highly stressful roles, and given past incidents, one cannot rely on private operators or agencies to supply the right expertise.”

Shukla pointed out that if the BMC itself struggled to recruit good doctors, contractors were even less likely to manage this. “Outsourcing less skilled staff might make some sense but not in roles where a patient’s life depends on the doctor’s training,” he said. “In high skill and leadership roles such as Intensivists and Registrars, where will be the authority to supervise the level of skill of care being provided in the units?”

BMC deputy municipal commissioner Sharad Ughade did not respond to texts or calls from HT. Chandrakant Pawar, the chief medical superintendent of all BMC peripheral hospitals, declined to comment.