?MEDICAL AND RURAL HEALTH SERVICES

??????????? The Director of Medical and Rural Health Services is incharge of planning and execution of all programmes of Medical Services. He is responsible for rendering medical care services, through the grid of 26 District Headquarters Hospitals, 160 Taluk Hospitals, 79 Non Taluk Hospitals, 12 Dispensaries, 11 Mobile Medical Units, 7 Women and Children Hospitals, 2 TB Hospitals/Sanatorium, 2 TB Clinics and 1 Leprosy Rehabilitation Promotion Unit.

??????????? The State has been divided into Twenty Nine Revenue Districts for the implementation of the Medical Services.

??????????? The Joint Directors of Health Services in Districts are the overall controlling officers of all the Medical Institutions for the Implementation of medical services including family Welfare and supervising authority for all health programmes. The Deputy Directors of Medical Services (Thoracic Medicine) in every District look after the T B Control programme. Specialists in the rank of Civil Surgeons are also provided in the district Headquarters Hospitals. The Deputy Directors of Medical Services (Leprosy) in every District look after the Leprosy Eradication Programme. The Leprosy Programme has been integrated with the Department of Public Health in order to involve Leprosy Field staff in Public Health work and the Health Inspectors in Leprosy work.

???????????? Improvements to District, Taluk, Non Taluk Hospitals and Dispensaries constitute an important development of plan of activities in the shape of expanded medical facilities, specialised services such as Medicine, Surgery, Obstetrics and Gynaecology, ophthalmology, ENT, Venerology, Orthopaedic Surgery, Anaesthesiology, Child Health, Dental, Psychiatric Clinics, Ambulatory services, Pathological Laboratory Services, Leprosy, T B, Diabetic Clinics, Cardiology, Nephrology and most of other improvements. Accident and Emergency service to meet the accident hazards is being implemented in a phased manner. The Maternity and Child Health and Family Welfare activities are undertaken effectively through non-teaching Medical Institutions under Family Welfare Post Partum Programme.

??????????? In other Health Medical Programmes, such as Control of Blindness, medical facilities under Hill Area Development Programme and Adi Dravidar and Tribal Welfare Schemes, etc., the Medical Services Department is coordinating and implementing the Programmes through the Government Medical Institutions under this Department.

Direction, Supervision and Policy Formulation:

The Strength of various categories of staff is given below:

Sl No

Staff Position

No. of Posts

2003-2004

1.

Director

1

2.

Additional Directors of Medical and Rural Health Services

6

3

Additional Directors of Medical and Rural Health Services (Admn)

1

4.

Joint Director of Medical and Rural Health Services

3

5

Joint Director of Medical and Rural Health Services (Admn)

1

6.

Deputy Directors of Medical Services (Leprosy)

3

7

Deputy? Director of Medical and Rural Services(Admn)

1

8

Financial Advisor? & Chief Accounts Officer

1

9

Other?? A & B Group? Staff

39

10

Ministerial Staff

153

11

Office Assistants and Others

89

?

Total

298

Hospital and Dispensaries:

??????????? Each District has a District Headquarters Hospital, Taluk Headquarters Hospitals, Non-Taluk Hospitals and Dispensaries.? The District level Administrative Control of the Medical Institutions including Family Welfare Programme is vested with the Joint Director of Health Services.

The Strength of staff under District level Administration is given below:

Sl. No

Name of the Post

No. of Posts

1

Joint Director of Health Services

28

2

Hospital Superintendent( in the cadre of Senior Civil Surgeon)

30

3

Deputy Director of Medical and Rural Health Services ( in the cadre of Senior Civil Surgeon)

24

4

Senior Civil Surgeons

165

5

Senior Civil Surgeon Specialist

176

6

District Leprosy Officer (now Deputy Director of Medical Services (Leprosy))

25

7

District T.B. Officer ( including one post of Superintendent, TB Hospital)

22

8

Assistant? Surgeon / Sr,Asst Surgeons? / Civil Surgeons? (including Dental)

1942

?

9

Nursing Staff

4759

10

Ministerial Staff

2228

11

Paramedical Staff

3516

12

Other Staff

4192

?

Total

17107

?

DIRECTOR OF MEDICAL AND RURAL HEALTH SERVICES (MEDICAL WING)

OBJECTWISE CLASSIFICATION??????? ??????????????????????? ??????????????????????? ??????????????????????? ??? (Rs.in lakhs)

Sl

Object

?

Accounts

2002-03

Budget Estimate??

2003-04

Revised Estimate?

?2003-04

1

Salaries

10713.63

11467.20

11021.39

2

Wages

0.03

0.05

27.36

3

Dearness Allowance

4568.98

6317.40

5311.12

4

Travel Expenses

52.76

66.04

61.58

5

Office Expenses

599.14

610.78

670.18

6

R.R.T.

16.78

27.19

42.88

7

Publicity

?

?

-

8

Advertisement

1.29

7.00

7.00

9

Grants

37.52

37.59

37.59

10

Contribution

2.22

-

-

11

Subsides

?

-

-

12

Hospitality

?

-

-

13

Major works

?

-

-

14

Minor works

?

-

-

15

Maintenance

1.72

1.54

1.54

16

Machinery & Equipment

213.57

165.52

216.98

17

Motor Vehicle

85.49

8.43

9.15

18

Materials and Supplies

?

?

?

19

Depreciation

?

?

-

20

Inter Transfer Accounts

?

?

?

21

P P S S

1.12

0.48

0.43

22

Investments

826.00

783.00

783.00

23

Other Charges

?

0.02

0.02

24

Rewards

?

?

?

25

Service Commit charge

?

?

?

26

Ration Charges

?

?

?

27

Petrol, Oil, Lubricant

60.65

73.08

63.68

28

Clothing

46.91

117.15

113.87

29

Stores and Equipments

416.08

468.87

465.81

30

Foreign Allowance

?

?

?

31

Festival Advance

97.87

136.73

133.52

32

Compensation

1.20

?

53.24

33

Conducted Tour Expdr

?

?

?

34

Prizes and Awards

0.38

1.46

2.01

35

T A for non Officials

?

?

?

36

Lands

?

?

?

37

Buildings

?

?

?

38

Medicines

4090.51

4100.66

4100.63

39

Diet

585.28

635.40

658.50

40

Books

?

?

?

41

Procurement of Agri Inputs

?

?

?

42

Computer & Accessories

1.67

0.30

4.80

43

Training

?

4.00

6.00

44

Deduct Recoveries (-)

-116.15

-136.73

-133.52

DISTRICTWISE INSTITUTIONS-2003-2004

(ABSTRACT)

Sl.No

District

H.Qrs

Taluk

Non-Taluk

Others

Total

1

Kancheepuram

1

6

1

1

9

2

Vellore

-

6

4

-

10

3

Tiruvannamalai

1

5

1

-

7

4

Cuddalore

1

5

2

1

9

5

Dharmapuri

1

4

-

2

7

6

Salem

1

6

2

1

10

7

Erode

1

6

3

1

11

8

Coimbatore

1

6

8

2

17

9

The Nilgiris

1

5

-

6

12

10

Trichy

-

7

2

1

10

11

Pudukottai

1

8

3

1

13

12

Dindigul

1

6

5

2

14

13

Madurai

1

4

1

1

7

14

Virudhunagar

1

7

1

1

10

15

Sivaganga

1

5

4

7

17

16

Ramanathapuram

1

6

3

-

10

17

Tirunelveli

1

6

6

1

14

18

Tuticorin

1

6

2

-

9

19

Kanniyakumari

-

4

5

-

9

20

Nagapattinam

1

7

4

1

13

21

Thanjavur

1

6

6

-

13

22

Villupuram

1

7

2

3

13

23

Karur

1

3

2

-

6

24

Perambalur

1

5

1

-

7

25

Tiruvallur

1

7

3

1

12

26

Tiruvarur

1

6

1

1

9

27

Theni

1

4

2

-

7

28

Namakkal

1

3

4

-

8

29

Krishnagiri

1

4

1

1

7

?

Total

26

160

79

35

300

Hill Area Development Programme:

??????????? The following Schemes are now functioning? under Hill Area Development Programme in the State.

Forty bedded ward at Government Headquarters Hospital, Udhagamandalam.

Forty bedded ward at Government Hospital, Gudalur.

Government Dispensary at Gudalur Bazaar.

Tribal Development Programme:

??????????? Government have established the following Dispensaries to provide medical facilities to the Tribal Population especially living in remote areas.

Thoradipattu, Kalrayan Hills in Villupuram District.

Melnivalur, Kalrayan Hills, Villupuram District.

Mobile Medical Unit at Valliamalai, (Kalvarayan Hills) Villupuram District.

Kariyakoil, Kalrayan Hills, Salem District.

Sempulichempatti, Trichy District.

T.B. CONTROL PROGRAMME:

??????????? There are about 2 lakh TB patients in Tamil Nadu. Among them, 0.7 lakh are infectious. There are 10 TB Hospitals (2 Government Institutions under the control of Director of Medical and Rural Health Services, 6 Government Institutions under the control of Director of Medical Education and 2 Private Institutions) in the State. In all, there are 3,654 beds in the State exclusively for inpatient treatment of the acutely-ill TB patients, all the TB patients are on domiciliary (home) treatment in the nearest Medical or Health facility. As per RNTCP DOTS Programme Officer in the rank of Additional Director is at the State- level to co-ordinate and supervise the TB Control Programme activities. At the District-level, each District TB Centre is headed by a Deputy Director of Medical Services (TB). Central Assistance under the External Assistance Component is provided meeting 100% requirement of anti-TB drugs and the establishment cost of 29 Districts Societies. State Government meets the entire expenditure on running the TB institutions (towards staff, maintenance of TB Institutions, drugs, vehicles etc). In 2002-2003 about eighty thousand cases were diagnosed and fully cured.

??????????? The Revised National Tuberculosis Control Programme (RNTCP) is implemented in all Districts now. 138 TB Units one for every 5 Lakh population, 627? Microscopy Centes one for every lakh population were created .Thus the Programme is completely decentralized upto the village level. With full coverage of the State under Revised National Tuberculosis Control Programme the incidence of Tuberculosis would be brought under control. NGOs, Private Practitioners, SHGs are being involved in RNTCP in a phased manner. Tamil Nadu will be is one of the best states in the country in implementing RNTCP.

Achievement under the Revised National Tuberculosis Control Programme

Year

New Sputum Positive TB Patients diagnosed

Chest Symptomatics for whom sputum examination was done

Cure-rate

Target

Achievement

%

Target

Achievement

%

Target

Achievement

2000-2001

30890

24533

79

308880

384506

124

85%

37%

2001-2002

31055

23589

76

310550

380747

123

85%

81%

2002-2003

31055

24346

78

310550

376037

121

85%

84%

2003-2004

31055

36153

116

310550

596367

192

88%

192%

?

EXPENDITURE DETAILS UNDER TB CONTROL PROGRAMME??????????????????????? ??????????????????????? ??????????????????????? ??????????????????????????????????????????????????????????????????? ??????????? (Rupees in Lakhs)

YEAR

CENTRE

2000-2001

281.88

2001-2002

755.59

2002-2003

485.54

2003-2004

568.57

FINANCIAL REQUIREMENTS

DIRECTORATE OF MEDICAL AND RURAL HEALTH SERVICES

?????? ??????????????????????? ??????????????????????? ???????????????????????? ??????????????????????? ??????????????????????? ??????????? ??????????? (RUPEES IN LAKHS)

Sl No

Programme Activity Classification

Accounts 2002-2003

Budget Estimate 2003-04

Revised Estimate 2003-04

Plan

Non Plan

Total

Plan

Non Plan

Total

Plan

Non Plan

Total

1. a

Direction, Supervision

?

?

?

6.50

?

6.50

6.50

?

6.50

????? b

Policy Formulation

?

?

?

?

?

?

?

?

?

???? c

Direction at Headquarters level

?

283.51

283.51

?

348.87

348.87

?

311.28

311.28

???? d

Direction at District level

?

553.48

553.48

?

667.51

667.51

?

596.29

596.29

?

Total

?

836.99

836.99

6.50

1016.38

1022.88

6.50

907.57

914.07

2.

Training Programme Training for Para Medical workers for Leprosy etc

?

?

?

?

?

?

?

?

?

?

?

Total

?

?

?

?

?

?

?

?

?

?

?

?

?

?

?

?

?

?

?

?

3.a

Hospital?? & Dispensaries??????

26.67

18535.85

18562.52

134.66

2240.91

20375.57

161.33

19516.82

19678.15

?? b.?

Previnciliation???? of?? Panchayat??? Union Dispensaries.

?

?

?

?

?

?

?

?

?

?? c.

Ambulance and Mortuary van

?

43.58

43.58

?

51.73

51.73

?

48.58

48.58

?? d.

Mobile Medical Unit

?

22.46

22.46

?

24.18

24.18

?

22.45

22.45

?

Total

?

?

?

?

?

?

?

?

?

4.

Contract

?

?

?

?

?

?

?

?

?

a.

Leprosy control

52.00

906.54

958.54

81.79

1256.38

1338.17

69.19

1071.86

1141.05

b.

T.B.Control

11.94

613.61

625.55

15.14

870.76

885.90

13.60

677.97

691.57

c.

AIDS

3.67

?

3.67

4.18

?

4.18

3.89

?

3.89

d

Illness Assistance Society

?

?

?

0.01

?

0.01

0.01

?

0.01

?

Total

?

?

?

?

?

?

?

?

?

5.

Grants

?

37.58

37.58

?

37.58

37.58

?

37.58

37.58

6.

Laboratory Services

?

65.89

65.89

?

80.74

80.74

?

74.01

74.01

7.

Control of Blindness

?

153.83

153.83

?

259.05

259.05

?

241.67

241.67

8.

Mental Health

24.87

?

24.87

34.66

?

34.66

56.44

?

56.44

9.

Regional Diagnostic Centres

826.00

?

826.00

783.01

?

783.01

783.01

?

783.01

?

PERFORMANCE REPORT FOR THE YEAR 2003-2004? (DISTRICT WISE)

SL NO

NAME OF THE DISTRICTS

BEDS

TOT.OP

AVG.OP

TOT.IP

AVG.IP

MAJOR Operations

MINOR Operations

EMER. CASES

1.?????? ?

Kancheepuram

793

3944367

10777

253898

694

5276

36269

125749

2.?????? ?

Vellore

972

2977849

8136

316382

864

14031

29579

61263

3.?????? ?

Tiruvannamalai

705

2530571

6914

241637

660

15424

46566

50114

4.?????? ?

Cuddalore

964

3533623

9655

331215

905

15280

33774

21302

5.?????? ?

Dharmapuri

926

2546417

6957

343072

937

7761

12884

30301

6.?????? ?

Salem

531

2113287

5774

167370

457

4652

15543

23874

7.?????? ?

Erode

1145

3569222

9752

418902

1145

10773

21557

53690

8.?????? ?

Coimbatore

1187

4097325

11195

373404

1020

10381

10902

39952

9.?????? ?

The Nilgris

795

918638

2510

90871

248

1849

4529

5259

10.?? ?

Trichy

437

1859571

5081

146233

400

5073

28851

44290

11.?? ?

Pudukkottai

937

2406954

6576

267189

730

7809

26084

21871

12.?? ?

Dindigul

860

3358278

9176

215295

588

5902

45476

18300

13.?? ?

Madurai

436

1852589

5062

131183

358

357

34124

10064

14.?? ?

Virudhunagar

1030

2798966

7647

291727

797

7172

13746

10668

15.?? ?

Sivaganga

706

1948393

5323

174784

478

7551

11325

24261

16.?? ?

Ramanathapuram

938

2452967

6702

214541

586

7254

9448

7501

17.?? ?

Tirunelveli

778

2925260

7993

218464

597

9572

10233

7533

18.?? ?

Thoothukudi

495

1513723

4136

178855

489

2652

16683

21910

19.?? ?

Kanyakumari

339

1648594

4504

118124

323

2686

18154

6675

20.?? ?

Nagapattinam

963

1963967

5366

184519

504

7621

12626

116296

21.?? ?

Thanjavur

831

2593414

7086

192336

526

2527

33780

17743

22.?? ?

Villupuram

792

2720187

7432

385024

1052

4437

58392

94495

23.?? ?

Karur

339

1179439

3223

106358

291

2760

3495

3672

24.?? ?

Perambalur

368

1943130

5309

104049

284

4672

29896

12867

25.?? ?

Tiruvallur

416

2310153

6312

79786

218

5903

2382

23684

26.?? ?

Thiruvarur

591

1903254

5200

222454

608

1347

72379

53143

27.?? ?

Theni

618

2234823

6106

218509

597

1352

10763

26629

28.?? ?

Namakkal

659

2650075

7241

174033

476

4511

11430

58458

?

TOTAL

20551

68495036

187145

6160214

16832

176585

660870

991564

?

PERFORMANCE REPORT FOR THE YEAR? 2002-2003 (DISTRICT WISE)

SL NO

NAME OF THE DISTRICTS

MLC

PM

LAB TESTS

X-RAY

ACCIDENT

DELIVERIES

CEASAREANS

OTHER

MATY

AVG. BIRTH.

1

Kancheepuram

13003

1190

597369

15465

10089

11129

1435

27149

30

2

Vellore

19667

1703

985389

10367

2590

15723

1181

2994

43

3

Tiruvannamalai

12204

604

1813626

9711

2643

8515

405

14554

23

4

Cuddalore

11969

1951

732582

20116

4224

11237

1296

14053

31

5

Dharmapuri

15512

967

648743

16909

4924

10932

927

271

30

6

Salem

7797

357

459481

7076

1719

4460

402

3979

12

7

Erode

10389

1284

1567019

20675

3586

12036

2166

1189

33

8

Coimbatore

10282

1342

1070493

14822

4856

14313

2405

13770

39

9

The Nilgris

3044

359

215876

8154

999

3469

253

1275

9

10

Trichy

4221

309

487249

8016

1107

4388

252

0

12

11

Pudukkottai

7780

341

488842

20143

3454

13153

1340

1476

36

12

Dindigul

9212

1025

1296958

13653

2234

8078

729

1487

22

13

Madurai

3199

257

205106

9030

2449

4563

351

0

12

14

Virudhunagar

5761

560

607964

23010

3912

7800

1277

8991

21

15

Sivaganga

5176

334

313797

13673

1042

6383

1143

1494

17

16

Ramanathapuram

3915

1422

669995

17743

2036

5631

1029

5520

15

17

Tirunelveli

3919

957

732105

13242

1429

8002

854

764

22

18

Thoothukudi

3249

426

287663

6702

1986

6096

1070

5026

17

19

Kanyakumari

3274

371

385628

11350

1405

1950

185

0

5

20

Nagapattinam

9096

441

909622

12327

2685

8174

760

1946

22

21

Thanjavur

8862

498

398464

13076

1795

10745

1502

2175

29

22

Villupuram

18233

757

584213

14761

5930

11645

431

5007

32

23

Karur

2537

417

192160

7978

1214

3541

469

806

10

24

Perambalur

6174

284

374657

5588

1527

3833

46

0

10

25

Tiruvallur

6675

365

181716

7322

2598

5716

672

686

16

26

Thiruvarur

5015

194

442408

12847

1863

6237

491

86

17

27

Theni

6428

433

330616

11842

1972

5119

1407

122

14

28

Namakkal

5253

437

831797

14064

1048

3493

481

406

10

?

TOTAL

221846

19585

17811538

359662

77316

216361

24959

115226

589

?