13. Health and Family Welfare

583

13.1. Medical Education and Research

nehŒeho nehŒKjš eho mJjâ¡F«

thŒeho thŒ¥g¢ braš

- FwŸ 948

Test disease, its cause and cureAnd apply remedy that is sure

-Thirukkural 948

13.1.1. Introduction

Good health is the basic requirement for determining the quality of life.

A healthy population can contribute productively to the overall economic growth

of the society. Conversely, the economic costs of ill health often push poor

families further down the spiral of reduced income and poverty.

The State has therefore taken the responsibility of providing

comprehensive quality health services, which are easily accessible to all,

especially the vulnerable sections of the population. The public health service

network consists of two related but distinct components – the network of

medical institutions providing curative services at all levels, and the series of

disease specific and health behaviour related campaign based programmes,

targeted towards prevention and control of diseases.

Medical Education and Tertiary health care

On the curative health care side, the tertiary care hospitals provide the

public access to modern medical technologies, which otherwise may not be

affordable to them. These hospitals also serve as the clinical training grounds

for producing medical and para- medical personnel to cater to the health

needs of the State.

The institutions imparting medical and para-medical education under

the Government fold are as follows:

584

Table 13.1.1

The above 40 institutions not only provide medical education but alsotertiary medical care to the public. Besides, there are 4 peripheral hospitalsattached to the Government medical colleges, which provide similar services.All the above 44 institutions provide their services under the overall control ofthe Directorate of Medical Education. These institutions have 4298 doctors,4579 nurses and 4383 para-medical staff. The total bed strength of thesehospitals is 22461, with an average of 22375 inpatients and 72560 outpatientsgetting treatment per day. Besides, the Government medical and para-medicalinstitutions, there has been a growth of self-financing institutions offeringcourses in medicine, dentistry, pharmacy, physiotherapy, nursing, andoccupational therapy.

Tamil Nadu Dr. MGR Medical University

The University was established in July 1988 to promote academicexcellence and to provide for research and advancement of knowledge in thefield of Medical and Para Medical Education. At present, 233 institutionsoffering medical, dental and paramedical education are affiliated to thisuniversity. Besides a well equipped library, the University has the followingdepartments functioning under its fold viz., the Departments of TransfusionMedicine, Curriculum Development, Epidemiology and Experimental Medicine.During the Tenth Plan period, the University has developed a virtual librarywith assistance from Government of India.

13.1.2. Review of Tenth Plan

During the Tenth Plan, it was envisaged to improve the skill levels of themedical and paramedical manpower and to provide effective tertiary carethrough improvement of infrastructure and manpower in the teachinghospitals. This would not only enable the Government medical colleges toconform to Medical Council of India (MCI) norms but would also help to providebetter services to the public.

585

The outlay and expenditure during the Tenth Plan are given below:

Table 13.1.2

One of the major thrust areas during this period was to increase the

number of undergraduate and postgraduate seats available in Government

medical colleges. During the Plan period, three new Government medical

colleges have been opened at Theni, Vellore and Kanyakumari, with an intake

of 100 students each. Additional intake has also been sanctioned in five

Government Medical Colleges during the Tenth Plan period. Accordingly, staff,

equipment and buildings were sanctioned as per MCI norms. The overall

increase of seats in various disciplines at the undergraduate and the

postgraduate level in public institutions is shown in the table below:-

Table 13.1.3

Sl.

586

Creation of additional infrastructure facilities and purchase of diagnostic

equipment in the existing teaching hospitals has been a focus area of the

Plan period. Schemes taken up include construction of the TWIN TOWER

Block at the Government General Hospital, strengthening the Bernard Institute

of Radiology, provision of modern equipment to the Neonatology department

of the Institute of Obstetric & Gynaecology, establishment of a liver transplant

centre and upgradation of facilities at the Government Stanley Hospital.

Mammography units have been established along with vital equipment

in the medical colleges at Tirunelveli, Coimbatore, Thanjavur and Vellore during

the Tenth Plan period. The equipment purchased for the above colleges have

not only been used to train students but also helped to detect breast cancer

at the initial stage itself. Eight Government hospitals were provided with

cobalt therapy units with Government of India assistance to provide more

effective treatment to the cancer patients.

A major initiative during the Plan period has been the opening of nursing

schools attached to 21 Government hospitals at the secondary and tertiary

level. This has been done with a view to provide more educational opportunities

at an affordable cost in the nursing sector, where there is great demand for

skilled personnel, not only within the state but outside also.

As a result of the fire accident at Erwadi, which exposed the inhuman

conditions to which mental patients were subjected to, the state has directed

its efforts towards improving mental health services. Action has also been

taken up to set up the District Mental Health Monitoring Committee to co-

ordinate and supervise mental health related activities at the district level.

The District Mental Health programme has been implemented in eight districts

with GOI assistance. An amount of Rs.1.06 crore was provided during the

Tenth Plan period for the upgradation of facilities at the Institute of Mental

Health in Chennai.

587

13.1.3. Eleventh Five Year Plan

Objectives

The important objectives of the Eleventh Plan are as follows:

� To produce highly skilled medical and para-medical manpower by

providing access to quality medical and para-medical education at

an affordable cost.

� To provide effective tertiary care to all sections of the public by making

available the modern medical techniques and technologies in

Government teaching hospitals.

� To provide research relevant to human development and quality of

life.

Strategies

The above objectives are proposed to be achieved through the following

strategies:

� Opening of fully equipped new medical and paramedical colleges in

uncovered districts in the state.

� Upgrading the infrastructure, manpower, curriculum and teaching

methodologies as well as facilities for students in existing medical

and paramedical colleges, so as to improve the quality of training

imparted.

� Providing infrastructure and modern medical and diagnostic

equipment in existing tertiary hospitals to upgrade the quality of

services to the public.

� Giving specific thrust to medical care for the vulnerable sections

such as geriatric care, mental health care etc.

� Encouraging Centres of Excellence in research activities relating to

areas of present relevance such as virology.

588

Eleventh Plan Outlay and Proposals

The proposed outlay for Medical Education and Research during the

Eleventh Plan is Rs.1058.88 crore, out of which an amount of Rs. 556.02

crore is for ongoing schemes and Rs. 502.86 crore for new schemes.

The major schemes to be implemented in the state during the Eleventh

Five Year Plan are as follows:

Expansion of Medical Education

The state proposes to start Government Medical Colleges in the districts,

where there are no medical colleges. As a first phase, three new Medical

Colleges will be started at a total cost of Rs.300 crore during the Plan period.

Besides, serving as an incentive for students of those districts to study medicine

and come back and serve in the rural areas, the Medical College Hospitals will

also provide high quality tertiary care to the public in the unserved areas. In

addition, an amount of Rs. 190 crore is proposed under ongoing schemes for

construction of buildings in existing tertiary institutions.

Improvement to Medical Colleges

In order to provide quality education, a thrust has been given to improving

infrastructure in the existing medical colleges. The total outlay under this

head is Rs.52.05 crore of which Rs.17.89 crore relate to ongoing schemes. In

addition, an amount of Rs. 33 crore has been provided for curriculum reforms,

improvement of teaching methodology through use of technology such as

e-enabled classrooms as well as funds for computerization of medical case

sheets both for administrative as well as research purposes. Specific provision

has been made for providing staff and infrastructure based on MCI norms at a

cost of Rs. 28 crore.

Besides the above, new schemes which will be taken up include

construction of hostel buildings for men and women at Chengalpattu,

Tirunelveli, Thanjavur, Trichy, Madurai, Kilpauk, Stanley Medical Colleges

and the Dental College, Chennai, construction of administrative block, lecture/

examination hall and operation theatre for the Dental college, Chennai and

purchase of buses for Kilpauk Medical College.

589

It is expected that all these steps will not only contribute to quality of

medical education but will turn out capable and committed doctors who are

willing to work in the rural areas and improve the health of the people.

Improvement to teaching hospitals

The outlay provided under this head is Rs.35.75 crore under ongoing

schemes. Besides existing ongoing works, an amount of Rs.350 crore is

proposed for the improvement of teaching hospitals. The major schemes

proposed for implementation include the provision of modern equipment and

infrastructure facilities to the Institute of Obstetrics and Gynaecology and

Government Hospital for Women and Children and the Kasturba Gandhi

Hospital, construction of multi storeyed buildings, equipment and

infrastructure facilities for Stanley Medical College Hospital, construction of

buildings and provision of equipment to Kilpauk and Chengalpet Medical

College Hospital, construction of five storeyed building for surgery unit at

Royapettah hospital, construction of building and extension works at Rajaji

hospital, Madurai, construction of 300 bedded buildings for Institute of Child

Health, provision of equipment for early detection/ identification to ENT units

of all the Medical colleges and other related activities.

Opening of Geriatric out-patient ward in all Medical College Hospitals

Geriatric Medical outpatient wards will be started in all 14 Medical College

Hospitals with separate fully equipped ward facilities. In addition, provision of

support services such as surgery and insurance coverage and provision of

state of the art ambulances will be made for effective provision of geriatric

care. Follow up of treatment by NGOs and adoption of old age homes by

hospitals will also be provided.

Improving the Para-Medical Education

The state has always been a centre for para-medical education such as

nursing, pharmacy etc. By establishing these institutions, especially in the

public sector, the state is able to provide an effective means to produce and

provide para medical manpower not only for the needs of the state but also for

the rest of India and abroad. Hence, it is proposed to improve the existing

institutions imparting Para Medical Education as well as to open new

institutions and courses.

590

The nursing colleges are proposed to be strengthened at a cost of Rs.9.09

crore through construction of hostel facilities at Chennai, Coimbatore,

Ramanathapuram and Udhagamandalam. It is proposed to start new B.

Pharmacy/ Diploma in Pharmacy in those Medical Colleges where such courses

are not offered. This will be implemented by improving buildings, equipment

and infrastructure and hostel facilities at a total cost of Rs.8 crore during the

Eleventh Plan period.

Apart from the existing different para medical/ diploma courses, 6 new

courses viz. i) Certificate course in Radiological Assistant, ii) Nursing Assistant

course in various departments, iii) Diploma/ Certificate course in

Urogynaecology, iv) Certificate course in Oncology v) Certificate course in speech

therapy and vi) Diploma in Ophthalmic Assistant will be started in all the

Medical Colleges at a total cost of Rs.10 crore which includes manpower for

teaching, provision of equipments and infrastructure facilities etc.

Upgradation of King Institute of Preventive Medicine

In the present day context of growing viral diseases such as dengue,

chikungunya as well as the dreaded menace of HIV/ AIDS, there is a need to

set up a fully functioning virology centre in the state. For this purpose, it is

proposed to upgrade the virology department of the King Institute as a Centre

of Excellence at a proposed outlay of Rs. 30 crore.

Strengthening of Dr. MGR Medical University

The programmes undertaken by the University during the Tenth Plan

will be continued in the Eleventh Plan also. In addition, priority will be given

for introduction of e-governance in the University and strengthening of the

digital/ virtual library attached to it. The University also proposes to establish

a new department of regenerative medicine and stem cell therapy as part of

its work on experimental medicine. Another thrust area will be the setting up

of the Central Organ Registry to streamline organ donation programmes and

facilitate cadaver organ transplants. The resources for these schemes will be

met from the University’s own resources supported by state and central funding.

The Schemewise outlays for the Medical Education and Research during

the Eleventh Five Year Plan (2007-12) are as follows:

591

(Rs. in crore)

Table 13.1.4

592

13.2. Health Care Delivery and Services

c‰wt‹ Ô®¥gh‹ kUªJciH¢ bršth‹v‹W

m¥ghšeh‰ T‰nw kUªJ

- FwŸ 950

Patient, doctor, medicine and attendantAre four-fold codes of treating course

- Thirukkural 950

13.2.1. Introduction

Providing universal access of quality health care to the poor is one of the

major objectives of the Government. In order to achieve this end, the state

provides primary and secondary health care with special focus on maternal

and child health services and continued emphasis on promotion of the family

welfare programme. The major interventions for provision of universal quality

services include improving the manpower and infrastructure in public health

institutions and implementation of innovative programmes to reach vulnerable

unreached sections. The Government also takes steps for the prevention and

control of specific diseases, prevention of food and drug adulteration as well

as dissemination of health promoting information and behaviour. Such efforts

have been quite successful not only in improving health indicators such as

life expectancy, infant mortality rate, maternal mortality rate and total birth

rate but also in improving the quality of life of the people as a whole.

Primary Health Care System

The Primary Health Care and

Preventive Health services in the

State are delivered through the

primary health care methods.

There are 1417 Primary Health

Centres in the state and 8683

Health Sub- Centres attached to

them. The village health nurse

attached to the health sub-centres

is mainly responsible for outreach

services for maternal and child health care such as antenatal care,

immunization, school health services, treatment of minor ailments and health

Public Health and Preventive Medicine

593

education. The doctors in the Primary Health Centres provide first level curative

care along with overall implementation and supervision of community health

programmes such as National Rural Health Mission (NRHM), Varumun Kappom

Thittam, Integrated Disease Surveillance Programme etc.

Secondary Health Care System

Secondary level health care services consist of out-patient and in-patient

care with special focus on maternity and neonatal care, accident and emergency

care and treatment for major diseases including surgical interventions. These

services are rendered through a grid of 28 District Headquarters Hospitals,

155 Taluk Hospitals, 80 Non-Taluk Hospitals, 11 Government Dispensaries,

11 Mobile Medical Units, 2 TB Hospitals, 2 TB Clinics, 7 Leprosy Hospitals /

Centres and 7 Government Women and Children Hospitals. Several speciality

departments have been opened in District headquarters Hospitals and Taluk

Hospitals to offer specialized services to the rural population.

Family Welfare

The Family Welfare programme, launched in 1951, is aimed at promoting

voluntary birth control through contraception. It has been implemented

successfully as a people’s programme in our state involving the active co-

operation of community. This has resulted in a demographic transition as

seen by the declining birth rate and other associated indicators. The

programme is implemented through the primary health care network as well

as 114 post-partum centres situated in the secondary health care system. In

addition, 104 Urban Family Welfare Centres and 193 Urban Health Posts are

functioning under this programme to provide services in the urban areas.

Regulatory functions

The Government also regulates the manufacture and sale of drugs

through the Drugs Control Directorate. The Prevention of Food Adulteration

Act is implemented to ensure that the food products sold in the state are pure

and unadulterated and conform to specification. In addition to these basic

regulatory functions, the provisions of the Human Organ Transplant Act (to

regulate non related organ transplant) and the Pre-Conception, Pre-Natal

Diagnostic Techniques Act to prevent sex selective abortion are also being

implemented with full vigour in our state.

594

Support functions

The Tamil Nadu Medical Services Corporation (TNMSC) has been set up

in order to enable the effective and efficient functioning of the health services

in the state. The activities of the Corporation have expanded from the core

function of procurement and supply of drugs to the medical institutions, to

providing diagnostic facilities such as MRI and CT scan centres as well as

procurement and supply of high value equipments to the health facilities in

the state. The Corporation has received ISO 9001 certification and its quality

services have been appreciated as a role model for other parts of the country.

The State Health Transport Directorate undertakes the function of keeping

the vehicular fleet of the health department in good operating condition.

13.2.2. Objectives and Strategies of the Tenth Plan

The important objectives of the Government in provision of health care

services for the Tenth Plan period included improving quality of curative care

to reach world standard, while at the same time strengthening preventive

services to reduce incidence of diseases and the demand for health care.

The main thrust areas during the Plan period were mainly focused around

improvement in maternal and child health services, with special importance

to neonatal health. In addition, emphasis was placed on provision of speciality

services including accident and trauma care and geriatric care at the secondary

care level itself. Provision of basic amenities to all hospitals, strengthening of

referral services, setting up of urban health services and hospital waste

management were also given importance during this Plan period.

13.2.3. Review of Tenth Plan

The outlay provided for Health Care Services during the Tenth Plan period

was Rs.526.50 crore. The expenditure incurred during the period was

Rs.1085.14 crore. The sub-sectorwise expenditure details are as follows:

595

Table 13.2.1

The increase in expenditure when compared with the Tenth Plan outlay

was due to a combination of factors. The Health Systems Project (HSP) for

upgradation of secondary hospitals was introduced in 2005 and accounted for

an expenditure of Rs.230.79 crore, while the increase under the Directorate

of Medical and Rural Health Services was due to additional infrastructure

facilities provided in secondary hospitals. The hike under Primary Health

Centres was due to the upgradation of PHCs into 30 bedded institutions. The

new scheme for enhanced maternity assistance to pregnant women was

responsible mainly for the increased expenditure under Public Health and

Preventive Medicine.

The demographic indicators and health goals fixed for the Tenth Plan

and the achievements made during the period are as follows:

(Rs. in crore)

596

Table 13.2.2

It may be seen that the state has made good progress towards reaching

the Tenth Plan goals. While targets under Life Expectancy at Birth (LEB)

male & female, Natural Growth Rate, Maternal Mortality Rate and Immunization

coverage have been achieved, there is still some ground to cover in the areas

of Crude Birth Rate and Death Rate, Infant Mortality Rate and under 5

Mortality Rate.

In order to reach the Tenth Plan goals, Government have taken multi-

pronged efforts. As part of the effort to strengthen Government hospitals,

accident and trauma care units have been set up in all district hospitals. To

reduce maternal and infant mortality, a major initiative has been the setting

up of 51 Comprehensive Emergency Obstetric and Newborn Care (CEmONC)

centres to provide emergency obstetric and neonatal care round the clock.

These centres have been selected in such a way that no pregnant woman will

have to travel for more than hour (or 40 km) to reach such a centre.

597

During the Tenth Plan period, with a view to providing at least one 30

bedded institution in each block, 106 PHC’s have been upgraded to 30 beds

and provided with modern equipments like Ultrasonogram, Electrocardiogram,

X-ray machine, etc. This scheme, which will continue in the Eleventh Plan,

plays an important role in making modern medical care more accessible to

the rural people. Construction of Health Sub-Centres, setting up of dental

clinics at the Taluk Hospitals and PHC levels, and setting up of mobile health

units have also been taken up during the Plan period.

Family Welfare

During the Tenth Five Year Plan, the Family Welfare programme continued

to be implemented with full vigour. The performance against the Tenth Plan

target for Crude Birth Rate, IMR & MMR has already been discussed. However,

there is continuing concern that the state continues to record 16.3% (2005) of

higher order births, as against a target of reduction to 10% over the Tenth

Plan period. The unmet need for family welfare services has decreased from

13.0% in 1998-99(NFHS-II) to 8.9% in 2005-06 (NFHS-III). The unmet need

under spacing methods is 4.1% and under permanent methods is 4.8%. The

state has to put in place strategies to see that this unmet demand is catered

to so that population growth is fully stabilized.

Control of Blindness

The state has been a pioneer in the area of blindness control since 1972

when the free eye camp scheme for cataract surgery was first introduced. The

National Programme for Control of Blindness introduced in 1976 was included

in the World Bank Assisted Cataract Blindness Control Project, which ended

in 2002. Currently, the programme is functioning as a 100% Centrally

Sponsored Scheme. The state has reduced the prevalence of total blindness

in the state to 78 per 10000, as against the level of 80 per 10000 prescribed

by the Government of India. As regards cataract related blindness, the

prevalence has come down from the level of 113 per 10000 that prevailed in

1994 to 40 per 10000 in 2002, against the target of 30 per 10000 set by

Government of India. The corresponding figures for total and cataract related

blindness at the all-India level are 110 and 70 respectively per 10,000. Thus

Tamil Nadu’s performance continues to be among the best in the country.

598

The state has consistently achieved more than 100% achievement of target

in carrying out cataract operations with insertion of Intra Ocular Lens (IOL).

It is significant that 112% of this achievement is carried out through NGO’s.

The performance under screening of school children and provision of free

spectacles has also been above target. The total amount released by the

Government of India (GOI) for this scheme during the Plan period works out

to Rs. 42.56 crore.

Tuberculosis Control

The Revised National TB Control Programme (RNTCP) using the Directly

Observed Treatment Short course (DOTS) strategy has been launched in our

state since 26th March, 1997. It has been implemented throughout the state

through 140 TB units (one for every 5 lakh population), 776 Microscopy centres

(one for every one lakh population) and about 11,000 DOTS centres. The

RNTCP Programme also envisages partnership with NGOs and private

practitioners to win the war against tuberculosis. A look at the average

performance during the Plan period shows that the targets set by Government

of India against all the three major parameters, sputum examination (100%),

new sputum positive (70%) and cure rate (85%) have been achieved by the

state. The total assistance received from GOI for the Plan period (upto 31.12.

06) works out to Rs.32.19 crore.

Leprosy Control

The National Leprosy Eradication Programme (NLEP) was launched in

1954-55. With on-set of multi drug therapy in 1983, the prevalence rate of

leprosy has been systematically reduced. During the Tenth Plan period, the

incidence of the disease has further decreased from 4.1/10000 in 2001 to

0.6/10000 in 2006.

Vector Borne Diseases

The malaria problem in Tamil Nadu is mainly confined to urban, coastal

and riverside areas. Nearly 70% of the cases occur in urban centres, with the

main problem area being Chennai. Due to the concerted efforts taken for

mosquito control and prompt treatment of the diseases, the incidence of malaria

has reduced from 43604 to 27431 cases during the Tenth Plan period.

599

The National Filaria Control Programme is being implemented in our

state since 1957. There are 43 urban areas in 13 endemic districts where

filarial control is being carried out since 1997. The single dose mass Di ethyl

Carbomazine (DEC) drug administration programme strategy is being followed

which has been very successful in eliminating new cases of the disease. This

strategy will be continued in the coming Plan period also.

Japanese Encephalitis (JE) has emerged as an important public health

problem in the state during the last few years. The Government have

undertaken prevention and control measures, as a result of which the

occurrence of deaths due to JE have decreased from 36 in 2003 to nil in 2007.

Leptospirosis, Dengue and Chikungunya

These are newly emerging vector borne diseases, which are affecting the

state. To strengthen the surveillance mechanism of these diseases, 7

leptospirosis and 12 dengue clinics have been established in the state.

Chikungunya, a non-life threatening but debilitating disease, erupted in our

state in early summer of 2006 and has become a major public health hazard.

Control measures have been initiated which have been successful in halting

the spread of the disease to a considerable extent.

Varumun Kappom Thittam

The Varumun Kappom scheme has been revived in 2006-07 to facilitate

early detection and treatment of illness. It provides comprehensive health

check-up, treatment and health education to the rural and urban people. It

envisages 9000 medical camps by teams of medical experts all over the state

of which 1070 medical camps have been conducted in the last year of the

Tenth Plan. During the camps, specialist doctors screen the beneficiaries for

communicable and non-communicable diseases. All pregnant women are

examined with ultra sonogram to detect any abnormalities. The referral and

follow-up camps are conducted in the referral institutions. All the morbidity

data have been computerized, so that they can be used for planning purposes.

An amount of Rs. 11.39 crore has been spent for undertaking the above

activities during the Tenth Plan period.

600

Maternity assistance scheme

Dr. Muthulakshmi Reddy Maternity Assistance scheme has been in

operation in our state from1989-90 onwards. However, indicating the priority

given by the Government to maternal and child welfare and realizing the

importance of maternal nutrition, the financial assistance under the scheme

has been increased from the year 2006-07. The present assistance has been

fixed at Rs.6,000/- at the rate of Rs. 1000/- per month for a total period of 6

months covering 3 months in antenatal care and 3 months in post-natal period.

Under this scheme, 2.41 lakh pregnant women have been benefited.

Reproductive and Child Health Project

The Reproductive and

Child Health Project (RCHP), is

a World Bank aided 100%

Centrally Sponsored Scheme.

The first phase of RCHP started

functioning from the year

1997-98 with two components

viz. i) a sub-project covering the

districts of Madurai and Theni,

both urban and rural and ii)

strengthening of infrastructure

facilities in the remaining

districts of Tamil Nadu. The

Phase II of the RCHP was launched during 2005-06 with a project period of

five years (2005-10) at a cost of Rs.426 crore. The main objectives of the project

are reduction of Maternal Morbidity and Mortality, Infant Mortality Rate, under

5-Mortality Rate, promotion of adolescent health and control of reproductive

tract infections and sexually transmitted infections. Efforts that have been

taken during the first two years include creation of outreach through mobile

medical units, providing 24 hour delivery care in PHCs, mainstreaming of ISM

with the health system and implementation of Janani Suraksha Yojana.

State Health Society

The National Rural Health Mission (NRHM) has been launched in Tamil

Nadu with the view to bring architectural correction of the health system to

Health check up programme forpregnant women in rural areas

601

enable it to effectively handle increased allocations and promote policies that

strengthen public health management and service delivery. It aims to improve

the health status of the people, especially those who live in the villages. The

vision is to provide universal access to equitable, affordable and quality health

care services, which is accountable and responsive to the needs of the people.

To achieve the objectives of the mission, the State Health Mission was

constituted and the State Health Society has been registered. The State

Health Society has been constituted merging all the societies working under

the Health sector (except the Tamil Nadu State AIDS Control Society), viz. the

societies for leprosy, tuberculosis and blindness control and the Integrated

Disease Control Programme. All the National Health programmes at the state

and district level have been brought under one umbrella through the State

Health Society, which will function through the individual sub-committees.

This will help to pool all the resources available in implementation of the

programmes. The sub-committees functioning under this society to look

after the specific programmes are: RCHP, Maternal Child Health and Family

Welfare Programme, Vector Borne Disease Control Programme, Tuberculosis

Control Programme, Integrated Disease Control Programme, National

Blindness Control Programme and Indian Systems of Medicine and

Homoeopathy. District Health Missions and District Health Societies have

been formed in all the districts in February 2006.

The major interventions under NRHM include formation of patient welfare

societies at the health facility level, providing untied funds to PHCs and HSCs

to improve their maintenance and to encourage local level health activities.

The routine immunization programme for vaccine preventable diseases has

also been strengthened using NRHM funds.

Tamil Nadu Health System

Project

The Tamil Nadu Health

System Project is an externally

aided project supported by the

World Bank. The project aims

to improve the effectiveness of

the Secondary Health Care

System in Tamil Nadu. The Tamil Nadu AIDS Control Society

602

outlay for the project, extending in three phases from 2005 to 2010 is Rs.482.49

crore.

The major activities completed during the first phase of the project involved

strengthening of hospital infrastructure including provision of ambulances

and mortuary vans. A Pilot project for bio-medical waste management, cervical

cancer screening and prevention of coronary heart disease and hypertension

has also been initiated under the project.

13.2.4. Eleventh Five Year Plan

The overall goal for the Health Care Delivery and Services sector during

the Eleventh Plan is to improve the health outcomes of the people of Tamil

Nadu especially the poor and the disadvantaged. In order to achieve this goal,

the following detailed objectives have been laid down for this sector during

the Plan period.

� Increasing the access to and utilization of health services, particularly

among the unreached and underserved population

� Designing and implementing effective interventions in the area of

Maternal and Child Health to reduce IMR and MMR to the expected

levels

� Making safe and effective means of contraception available on

demand, to increase the Couple Protection Rate and achieve the

targeted reduction in birth rate

� Implementing schemes for prevention and control of communicable

diseases and non-communicable diseases with special focus on newly

emerging vector borne diseases and life style diseases

� Creating awareness and ensuring timely availability of accident and

trauma care services to reduce morbidity and mortality

� Improving the overall quality and effectiveness of public sector health

services

� Promoting a healthy life style among the population

603

Based on the above objectives, the goals fixed for Health Care and Delivery

Services during the Eleventh Five Year Plan are as follows:

Table 13.2.3

Eleventh Plan Outlay and proposals

The proposed outlay for Health Care Delivery and Services is Rs.1503.50

out of which an amount of Rs.1434.95 crore is for ongoing schemes and

Rs.68.55 crore for new schemes. The sub-sector wise break-up of allocation of

funds is discussed in detail below.

Medical and Rural Health Services

The outlay for Medical and Rural Health Services is Rs.519.75 crore, of

which the major proportion of Rs.464.54 crore has been provided for the Tamil

Nadu Health Systems project.

Improvement to District Headquarters Hospitals

In order to facilitate the functioning of District Headquarters Hospitals as

second level referral units, the district hospitals will be well equipped with

modern facilities and equipments which give priority to maternity care, neonatal

care and child healthcare. Simultaneously, the newly upgraded Taluk and

Non-taluk Hospitals functioning as first referral units will also be provided

with minimum basic facilities like operation theatre, air-conditioning facilities

as well as major diagnostic equipments.

604

Tamil Nadu State Illness Assistance Society

The Tamil Nadu State Illness Assistance Society has been constituted in

1998 with an initial outlay of Rs.15 crore shared by the State and Central

Government in the ratio of 2:1. The Society provides financial assistance for

life-saving surgical treatments in specified categories such as open heart

surgery, kidney transplantation, cancer treatment, brain and spinal cord

surgeries etc in notified Government hospitals as well as accredited private

hospitals. The scheme is implemented through the district Collectors for

beneficiaries below poverty line. The scheme will be continued during the

Eleventh Plan with an outlay of Rs.52.50 crore.

Tamil Nadu Health Systems Project (TNHSP)

The major activities of the first phase of the project will be continued

during the second and third phases of the project also. These include provision

of civil works and equipments for upgrading the secondary hospitals, supporting

NGO based activities for improving tribal health, expanding the CEmONC

network as well as projects for bio-medical waste management and control of

cervical cancer and cardiac disease. The total outlay proposed for TNHSP

during the Plan period is Rs.464.54 crore.

The programmes to be implemented under Tamil Nadu Health Systems

Project (TNHSP) during the Eleventh Plan are given below.

Reduction of maternal and neonatal mortality

In order to accelerate the reduction in maternal and infant mortality, the

Government have pioneered the concept of CEmONC centres, where 24 hour

Comprehensive Emergency Obstetrics and Newborn Care is available. During

the first phase, 66 hospitals have been designated as CEmONC Centres. An

additional 32 hospitals will be upgraded as CEmONC centres during the

Eleventh Plan. The Tamil Nadu Health Systems Project will support these

CEmONC centres with additional buildings, equipments and manpower.

During Phase I of the project, 187 well-equipped ambulance services

were operationalised through NGOs in 15 districts to facilitate transport of

emergency cases to the hospitals. During phase II, an additional 198

ambulances will be provided in the remaining 14 districts. This will significantly

contribute to the reduction of maternal and infant mortality and morbidity.

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Tribal Health

The mobile outreach services started in 12 tribal areas in the first phase

will be evaluated and selectively expanded. Health institutions serving the

tribals will be strengthened. A cadre of tribal health volunteers will be developed

to improve the health seeking behavior of the tribals.

Accident prevention and treatment

The project will also provide training and equipment to paramedics in

accident relief so as to take advantage of the “golden hour”. Emergency

transport will be strengthened through partnership with NGOs in which fully

equipped ambulances will be stationed at identified accident prone spots on

all highways.

There are 73 Accident and Emergency Units functioning at the end of

the Tenth Five Year Plan. A provision has been made for setting up of 20

additional Accident and Trauma Care units, under a centrally shared scheme

at a cost of Rs.21.00 crore of which Rs.10.50 crore will be met using state

funds.

Health Management Information System (HMIS)

In order to collect timely information and enable managers to analyze

current situations, identify immediate problems and find appropriate solutions,

the Project has proposed to establish a web based health management

information system covering the 28 District Head Quarters Hospitals, 241

Sub-District Hospitals and their controlling offices in the district and state. It

has also proposed to establish electronic medical records for the patients for

better health care delivery services.

Quality Care

The quality of hospital services will be assessed and measured against

set standards on various dimensions of quality viz., inputs, processes and

outcomes of care using indicators selected by the Tamil Nadu Health Systems

Project. Steps will be taken to improve the quality of care in the hospitals and

to introduce quality rating in all the Government hospitals.

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Strengthening of hospitals

During phase I of the project, civil works have been taken up in the

hospitals in five districts namely, Dharmapuri, Krishnagiri, Kanniyakumari,

Theni and Pudukottai. During Phase II, 24 district Head Quarters Hospitals

and 211 Sub District Hospitals will be covered and additional civil works will

be provided.

Rationalising of equipment

After the completion of an inventory of existing equipments in the

Secondary Care Hospitals, repairs will be undertaken followed by

implementation of a proper maintenance system, through the Tamil Nadu

Medical Services Corporation (TNMSC).

Human Resource Development

In order to improve the quality and effectiveness of hospital services,

regular in-service training is important to the personnel to update clinical

and managerial skills. Training in hospital administration will be provided to

the higher level officials of health services dealing with the Secondary Care

Hospitals.

It is also planned to take up health promotion activities for the population

to follow healthy habits. School-based and workplace-based programmes for

changing knowledge, attitude and practice will be initiated.

The pilot projects on cervical cancer screening, behaviour change for

controlling cardiac disease will be continued and evaluated during the second

phase. The initiatives started in the Dharmapuri and Krishnagiri hospitals

and Bio-Medical Waste Management will be expanded throughout the state

by providing both infrastructure and training.

Public Health and Preventive Medicine

The outlay proposed for Public Health and Preventive Medicine during

the Eleventh Plan is Rs.857.50 crore. This is in addition to the Central funds

that are channelised through the NRHM programme for this sector. The

following are some of the important schemes using the state funds.

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Dr. Muthulakshmi Reddy Maternity Cash Benefit Scheme

This major flagship scheme for improving the nutrition and health status

of pregnant women is bound to have a major impact on the rapid reduction of

MMR and IMR. The proposed outlay for the scheme which will be continued

during the Eleventh Plan period is Rs.776 crore of which an amount of Rs.250

crore is proposed under the Scheduled Caste Sub-Plan.

Varumun Kappom Thittam

The Varumun Kappom Thittam is an innovative and popular scheme to

provide comprehensive health check-up, treatment and health education to

the public. The scheme will be continued in the Eleventh Plan at a cost of

Rs.39.62 crore. Additional resources will also be raised from the NRHM for

this scheme.

Urban Health

With rapid urbanization, accompanied by growth of urban slums, there

is an urgent need to supplement the urban basic health system, especially in

the smaller towns. A comprehensive project proposal for upgrading urban

health infrastructure and outreach services will be sent to the Central

Government for funding, on the same lines as the National Rural Health

Mission.

Construction of Buildings for Health Sub-Centres

An amount of Rs.17.38 crore is proposed (new scheme) for the construction

of buildings for 2173 Health Sub-Centres which are functioning in rented

buildings during the Eleventh Plan.

National Rural Health Mission (NRHM)

The National Rural Health Mission, a fully Centrally sponsored scheme,

which extends upto 2012, will play a major role in achieving the objectives of

the Eleventh Plan. The various sub-committees will continue to function during

the Eleventh Plan. The major focus of NRHM will be on reproductive and

child health, coupled with family welfare, the National Programme for Control

of Blindness and Revised National Tuberculosis Control Programme will also

be implemented through the State Health Society as part of NRHM. There

will also be a thrust towards control of vector borne diseases, especially newly

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emerging ones such as dengue and chikungunya, which have affected the

state in the past few years. The Integrated Disease Surveillance Project will

also be continued during the Eleventh Plan under the NRHM budget. This

will help to detect early warning signals of impending epidemic outbreaks

and initiate an appropriate and timely response. Good quality surveillance

data will also help to monitor disease control programmes and allocate health

resources optimally.

Reproductive and Child Health (RCH)

The continuing activities under this component of NRHM include formation

and strengthening of patient welfare societies at the Primary Health Centres

level, provision of funds for maintenance of PHCs as well as integration of

Indian Systems of Medicine at the field level to make medical care more

accessible, acceptable and affordable to the public.

It is further estimated that 178 new PHCs and 900 HSCs have to be set

up based on the norms as applied to the 2001 Census population. There are

235 blocks where one PHC is yet to be upgraded as a 30 bedded hospital. The

model dental health scheme taken up in PHCs during the Tenth Plan has

also received much response from the public. These schemes will be taken up

in a phased manner using NRHM funds.

In addition, the scheme for providing one dose of rubella vaccination to

adolescent girls in the age group of 10-15 will be implemented during the

Eleventh Plan period. By focusing on this age group, it should be possible to

build a continuous cohort of immunity, thereby reducing rubella among

pregnant women. This programme, to be implemented under NRHM, will

contribute to the reduction of congenital disabilities like deafness and mental

retardation.

Continued emphasis will be placed on improving the Couple Protection

Rate by enabling awareness and availability of effective contraceptives. This

will not only help to bring down the birth rate, but also to increase spacing

between children which will have a positive effect on reducing the IMR and

MMR.

There will be a thrust towards reducing early neonatal mortality by

implementing various focused interventions including emergency ambulance

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services, birth companion programme, training of nurses and infant death

audit in all the hospitals.

An amount of Rs.125 crore has been provided for the implementation of

National Rural Health Mission programmes during the Eleventh Plan. Major

share will be provided to the Reproductive and Child Health (RCH) project

under NRHM.

Drugs Control

The outlay proposed for the Directorate of Drugs Control during the

Eleventh Plan is Rs.0.75 crore which includes schemes for upgradation of

drug testing facilities and streamlining the drug control administration and

monitoring system. In-service training of the personnel in new techniques

and procedures will also be carried out under this provision.

State Health Transport Department

The outlay for the Directorate of State Health Transport during the Eleventh

Plan is Rs.0.50 crore for various schemes to upgrade the existing infrastructure

facilities for maintenance and servicing of motor vehicles attached to the various

Directorates relating to health care.

The Department-wise outlay for Health Care Services is given in the

following table:

Table 13.2.4

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13.3. Indian Medicine and Homoeopathy

Our food should be our medicine and our medicineshould be our food

- Hippocrates

13.3.1. Introduction

Herbal medicinal systems are integral aspects of Indian civilization.Indians had knowledge of herbal medicine for a wide range of diseases evenduring the Vedic period. Due to the undoubted efficacy and minimal sideeffects of herbal medicine, its influence has been increasing among the peopleand has been recognized and appreciated at the world level. It has thereforebeen the objective of Government, both at the State and Central level to revivethe past glory of the various Indian Medicine Systems and to popularize themamong the common people. In Tamil Nadu, special importance has been givento the Siddha system, which is an indigenous medicine system of our statewhich is intertwined with Tamil culture. Both the State and CentralGovernment have taken many efforts to popularize these systems using amulti-pronged approach consisting of education, research and documentationof old documents as well as making these systems of medicine accessible tothe people at the lowest level. The effort of the Government has also focusedon production, standardization, and quality control of herbs and drugs, so asto improve the accessibility of these systems of medicine.

Siddha wings are functioning in 29 District Head Quarters Hospitals,161 Taluk Hospitals, 75 Non-taluk Hospitals, 412 Primary Health Centersand 4 Medical College Hospitals. Besides 42 Government independent Siddhadispensaries are also functioning in the State along with 3 ESI Siddhadispensaries at Salem, Madurai and Vellore. The state has opened 7 Siddhadispensaries in hill areas and one mobile Siddha medical unit in Kolli hillsunder the Tribal Sub- Plan. Ayurveda wings are functioning in 6 District HeadQuarters Hospitals, 1 non-taluk hospital and 22 primary health centers. Thereare 6 Ayurveda dispensaries functioning in the state. Unani wings arefunctioning in 5 District Head Quarters Hospitals, 4 Non-taluk Hospitals and12 Primary Health Centres. Homoeopathy wings are functioning in 27 DistrictHead Quarters Hospitals, 7 Taluk Hospitals, 5 Primary Health Centres alongwith 5 Government Homoeopathy dispensaries. A Yoga and Naturopathy clinicattached with the Yoga and Naturopathy Medical College is functioning in thecampus of Arignar Anna Government Hospital of Indian Medicine, Chennai.

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The Government have started Medical colleges for the Indian System ofMedicine (ISM). Private colleges are also allowed so long as they conform tothe required standards. The student enrolment for the undergraduate coursesin Indian Medicine in Government and private colleges are 236 and 790

respectively. The enrolment in postgraduate courses in ISM is 80. In addition,

Government have taken steps to start a new Government Ayurveda College

and Hospital in Kanniyakumari District. The category-wise intake at these

institutions is given below:

Table 13.3.1

13.3.2. Objectives and strategies of the Tenth Plan

In order to achieve the goals of popularizing ISM and extending its ambit,

the following strategies were proposed during the Tenth Plan:

� Establishment of a National Institute of Siddha Medicine at Chennai

� Conduct of Research Programme and Standardization of drugs

� Expansion of medical education for Indian System of Medicine

� Expansion of Medical aid on a large scale using ISM

� Propagation of the benefits of ISM to the common people

Tenth Plan Outlay

The Tenth Plan (2002-07) approved outlay was Rs.84.63 crore. The actual

expenditure incurred during the period was Rs.76.47 crore which accounts to

91%.

The financial and physical performance under the Indian Medicine and

Homoeopathy during the Tenth Plan period is as follows:

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Financial Performance

Table 13.3.2

The expenditure incurred under Homoeopathy during the Tenth Five

Year Plan was Rs.8.86 crore as against the approved outlay of Rs.3.14 crore.

The major reason for increased expenditure was the opening of 31 Homoeopathy

wings in Primary Health Centres during the Plan period. Regarding Siddha,

the expenditure hike was due to the State contribution towards establishment

of the National Institute of Siddha during the Tenth Plan period and the

setting up of Siddha wings in District, Taluk and Non-taluk hospitals in the

state. In respect of Ayurveda, the major expenditure incurred during the

Tenth Plan period was the setting up of a new Government Ayurveda Medical

College and Hospital at Nagercoil in Kanniyakumari District.

Table 13.3. 3

(Rs. in crore)

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The major activities undertaken during the Tenth Plan period are described

below.

National Institute of Siddha

The National Institute of Siddha established at Tambaram is a joint venture

of the State and Central Government approved at a cost of Rs.47 crore (including

the capital cost of Rs.36 crore) spread over a period of six years from 2001.

The state has transferred the required land of 14.78 acres costing Rs.6.64

crore, which is reckoned towards the State’s share of 40% of the capital cost.

The remaining 60% of the capital cost has been borne by the Government of

India. The recurring cost is being shared in the ratio of 75:25. The main

objective of this Institute is to impart Post Graduate education in the Siddha

System of medicine and ultimately to provide quality medical care through

this system to the suffering humanity. Besides research and teaching, this

premier institution is also engaged in promoting and propagating the science

and art of Siddha.

Tamil Nadu Medicinal Plant Farms and Herbal Medicine Corporation

Ltd. (TAMPCOL)

The Tamil Nadu Medicinal Plant Farms and Herbal Medicine Corporation

Limited (TAMPCOL) is a Government of Tamil Nadu undertaking. The

Corporation manufactures Siddha, Ayurveda and Unani Medicines and

supplies medicines to all the ISM wings functioning in the State. For

undertaking construction works, installation of new machinery and

modernisation in work practices in TAMPCOL, an additional investment of

Rs.1.50 crore was provided during the Tenth Plan period, of which Rs.0.50

crore has been provided by way of additional equity. The equity was obtained

from Government of India for undertaking construction work, purchase of

machinery, renovation and modernization of ISM hospitals during the Tenth

Plan period.

Research and Development

Research areas have been prioritized keeping in view the strength and

contemporary relevance of these systems giving due emphasis to the preventive

and promotive aspects. A memorandum of understanding has also been signed

with Madras University to carry out collaborative research.

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Drug Testing Laboratory

The State Drug Testing Laboratory at Chennai has been well equipped to

test the standard of ISM drugs and quality of ISM drugs. During the Tenth

Plan period, the expenditure incurred under the State budget was Rs.0.25

crore for modernization of the State Drugs Testing Laboratory under a Centrally

shared scheme.

Medicinal Plants Board

During the first year of the Tenth Plan (2002-03), the Government have

constituted the Tamil Nadu Medicinal Plants Board, an autonomous body,

which has been set up to address the issues, connected with sustainable and

equitable development of medicinal Plants. These issues include cultivation,

conservation and processing of medicinal Plants, research and development

towards better varieties as well as increasing the market potential for medicinal

Plants and products in the country and abroad.

Varumun Kappom Thittam

Based on the overwhelming response from the public on the conduct of

preventive health camps under the ‘Varumun Kappom Thittam’ during the

year 1999-2001, the Government have reintroduced the scheme from the

year 2006-07 onwards. The doctors from the ISM wings also play an important

role by participating in the camps along with the Allopathy doctors for treating

the patients. During the camps, 18 types of Siddha drugs manufactured by

TAMPCOL are being distributed to patients.

13.3.3. Eleventh Five Year Plan

The objectives of the Eleventh Plan are as follows:

� To extend medical aid under the Indian Systems of Medicine to cover

the length and breadth of Tamil Nadu

� To upgrade the quality of educational standard in the Indian Systems

of Medicine and Homoeopathy colleges in the State

� To evolve pharmacopoeial specification for drugs used in the Indian

Systems of Medicine so as to standardize their quality

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� To conduct time bound clinical and pharmacological research

especially in identified diseases for which these systems have an

effective treatment

� To draw up schemes for promotion, cultivation and regeneration of

medicinal Plants used in these systems

� To popularize the benefits of these systems among the public, both

within our country and abroad

The outlay for Indian Systems of Medicine and Homoeopathy during the

Eleventh Plan is Rs.167.62 crore, of which an amount of Rs.148.57 crore is

provided for ongoing schemes and Rs.19.05 crore is allotted for new schemes.

The schemes to be implemented during the Eleventh Plan are as follows:

Medical Relief

Opening of Indian Systems of Medicine wings in PHCs

The National Health Policy envisages the integration of the ISM systems

in the overall health care delivery system, especially in the preventive and

promotive aspects of health care. The ongoing schemes viz., functioning of

Siddha and Ayurveda wings and dispensaries in District Headquarters Hospital

(Rs.110.69 crore), homoeopathy wings in District Headquarters Hospitals, Taluk

Hospitals and PHCs (Rs.31.34 crore) and Siddha dispensaries in tribal areas

(Rs.2.19 crore), improving the ISM facilities in Headquarters Hospital (Rs.1.64

crore) and provision of infrastructure for the headquarters staff (Rs.0.74 crore)

will be continued in the Eleventh Plan.

The Government have already decided to open ISM & H wings in all the

PHCs in a phased manner. At present ISM & H wings are functioning in 451

Primary Health Centres. It is proposed to extend this scheme to 220 more

PHCs at a total cost of Rs.19.70 crore which will be met under National Rural

Health Mission (NRHM).

Extension of Medical Aid in Indian Systems of Medicine & Homoeopathy

(ISM & H) System

Steps will be taken to spread the benefit of Indian Systems of Medicine

to the public through schemes such as mobile medical unit which take the

616

treatment to the doorsteps of the people. Special focus will be given for

developing clinics for diseases like rheumatism, diabetes, skin disorders,

infertility, etc., for which the ISM & H system have an effective treatment. In

addition, specialized treatment offered by Indian Systems of Medicine in

gynaecology as well as total body care such as Regimental Therapy, Thokkanam

and Panchakarma will be given importance during the Plan period. The outlay

proposed for such schemes for extension of medical aid through Indian Systems

of Medicine & Homoeopathy system is Rs.1.50 crore during the Plan period.

Medical Education

Upgradation of Infrastructure facilities

The existing colleges of Indian Systems of Medicine & Homoeopathy will

be selectively upgraded as Centres of Excellence during the Plan period. A

pathology and microbiology laboratory will be established in the Siddha

Medical College at Palayamkottai. The infrastructure and staff of various

colleges will be upgraded to reach the norms laid down by the Central Council

of Indian Medicine (CCIM). This includes construction of a separate OP/IP

block to teach clinical cases for the students at Government Homoeopathy

Medical College, Thirumangalam. Audio visual equipment, books and furniture

will also be provided to upgrade the Ambedkar Central library attached to the

Government Siddha Medical College at Chennai. The total outlay earmarked

for these schemes is Rs.5 crore.

Construction of buildings

Construction of building to conduct Diploma Courses

Two new diploma courses in integrated pharmacy and nursing therapy

have been introduced in the Arignar Anna Government Hospital Chennai and

the Government Siddha Medical College at Palayamkottai. An amount of

Rs.2.00 crore is proposed for construction of a separate building for conducting

these new courses.

Students Amenities

In order to improve the performance of the students, it is essential to

provide better hostel facilities. Separate residential quarters will be constructed

for house surgeons in Arignar Anna Hospital for Indian Medicine. Additional

617

floors will be added to the Men’s Hostel for students of the Siddha, Unani,

and Naturopathy College at Chennai.

In addition, separate hostels for men and women as well as a separate

block for post-graduate students are proposed at the Government Homeopathy

College, Thirumangalam. The total outlay proposed for improving hostel

facilities in various ISM&H colleges is Rs.5 crore during the Eleventh Plan

period.

Drug standardization and testing laboratory

A modern drug-testing laboratory has been set up during the Tenth Plan

period using a grant from the Central Government. Its function is to help

enforcement of the quality control provisions relating to the drugs pertaining

to the Indian Systems of Medicine in the state.

It is necessary to provide required infrastructure and staff to enable the

laboratory to discharge its statutory functions and ensure that quality standards

are prescribed both for raw drugs and prepared medicines of the Indian

Systems. It is also proposed to setup a State level licensing authority to oversee

this function and see that drugs are free from impurities and adulteration.

Pharmacies run by the Government will also be upgraded by setting up quality

control laboratories attached to them. These schemes meant for standardization

of quality and testing of drugs pertaining to ISM will be carried out during the

Eleventh Plan at a cost of Rs.2.00 crore.

Medicinal Plants

Establishment of Herbal farms

An amount of Rs.0.55 crore is proposed for establishment of herbal farms

in 25 acres of land available at Government Medical College, Tirunelveli and

100 acres of poromboke land available at Pattanam Perumbudur in Thiruvallur

District, in order to develop and propagate rare varieties of medicinal Plants

for both government use as well as for supply to the other suppliers of ISM

drugs.

618

Modernisation

It is proposed to upgrade the facilities available in the Commissionerate

of Indian Medicine and Homoeopathy, to streamline its functioning. An outlay

of Rs.3.00 crore has been provided for this purpose which includes construction

of a new office building, provision of computers and photocopiers and provision

of Internet and other communication facilities.

The schemewise outlays for ISM & H are given below:

Table 13.3. 4

(Rs. in crore)