Sassoon General Hospital (SGH), one of the largest government hospitals in Pune, is currently experiencing significant strain due to a heavy caseload. In a single week, SGH’s doctors issue approximately 180 disability certificates and handle at least 50 age-determination certificates. This workload is in addition to the 30 postmortems that SGH performs daily.

While there are other government hospitals in Pune authorized to handle these services, issues such as limited infrastructure and bureaucratic hurdles have prevented them from taking on a fair share of the workload. As a result, SGH’s doctors find themselves with barely enough time to attend to patients and engage in medical research.

To address this imbalance, SGH authorities have now reached out to the police and other government hospitals, urging them to distribute the workload more evenly. Dr. Yallapa Jadhav, the medical superintendent of SGH, revealed that they have discussed with Pune police the possibility of "decentralizing" certain medico-legal cases that require police involvement. These cases include fatal accidents, suspected sexual assaults, poisonings, and suicide attempts. “We recently informed the Pune police commissioner that police stations should refer such cases to the closest government hospitals instead of bringing them all to Sassoon,” said Dr. Jadhav. He noted that the situation is partly due to a lack of awareness and Sassoon’s 24/7 operating capabilities, which leads police to rely heavily on SGH.

Several hospitals in Pune are equipped to help alleviate SGH’s burden, including the Armed Forces Medical College (AFMC), Yashwantrao Chavan Memorial (YCM) Hospital in Pimpri, Command Hospital, Sardar Vallabhbhai Patel Hospital (operated by the Pune Cantonment Board), the PMC-run Kamala Nehru Hospital, and the District Hospital in Aundh. These hospitals have the capacity to perform postmortems and issue age and disability certificates. However, they are often hesitant to take on additional work due to infrastructure limitations and a lack of specialized staff.

For example, Dr. Nagnath Yempalle, civil surgeon at the District Hospital in Aundh, explained that their facility conducts five to six postmortems daily and issues age and disability certificates as well. The mortuary at Aundh has six units, though only four are functional at the moment, with the remaining two undergoing repairs. “We provide similar services, but most people are unaware of this,” said Dr. Yempalle. Due to staff limitations, their postmortem facilities are only available during the day, as they have only one forensic specialist. Although any MBBS doctor can perform a postmortem, more complex cases are referred to Sassoon.

YCM Hospital in Pimpri is another facility working to support SGH’s workload. In September alone, YCM issued 82 disability certificates and conducted 352 postmortems, said Dr. Rajendra Wabale, YCM’s dean. Disability and fitness certificates are issued daily, and postmortems are conducted as needed. The hospital also has a cold-storage facility with a capacity for approximately 84 bodies, which helps them manage postmortem cases effectively.

Kamala Nehru Hospital, operated by Pune Municipal Corporation (PMC), also provides certification services. Dr. Prashant Bothe, the medical superintendent, mentioned that they have designated Tuesdays and Thursdays for issuing certificates. However, limited awareness about these services results in most people still going to Sassoon for such needs. Kamala Nehru Hospital, though, is not equipped to conduct postmortems, as it lacks a fully developed forensic department.

Despite SGH’s efforts to share its workload with other hospitals, logistical and structural challenges persist. For instance, AFMC and Command Hospital, both capable of conducting postmortems and other medico-legal tasks, did not respond to requests for comment on their involvement.

SGH continues to advocate for a more distributed approach to medico-legal cases in Pune, emphasizing the importance of utilizing all available healthcare resources. As Dr. Jadhav noted, “Other hospitals can and should step up to help alleviate this burden. Sassoon’s resources are stretched, and sharing responsibilities will benefit the healthcare system as a whole.” The decentralization plan involves assigning cases to hospitals based on proximity, which would help streamline SGH’s operations and improve the quality of care available to all patients.

Pune’s government hospitals are attempting to address the workload imbalance, though some remain limited by structural challenges. Despite these difficulties, SGH is committed to ensuring fair access to medical services while advocating for changes that would lead to a more efficient system. The redistribution of responsibilities, as SGH’s authorities propose, aims to ease the burden on their doctors, who currently struggle to balance treatment, research, and a high volume of certifications and postmortems.

The future of SGH’s proposal to decentralize medico-legal services now depends on how effectively these plans are implemented and whether other hospitals in Pune can overcome their existing limitations. The success of this effort would ultimately mean improved service delivery for patients, more time for research and treatment for doctors, and a more efficient public healthcare system across the city.

(Input from various sources)

(Rehash/Yash Kamble/MSM)