In an interview with Merinews.com, Dr. VS Mehta, Head neurosurgeon at Paras Hospital, Gurgaon, speaks about neurosurgery, why people have a wrong notion about this kind of surgery, and the lack of specialists in this field.

THE HEALTHCARE sector in India, more specifically in Gurgaon, is a booming. With the emergence of countless corporatized hospitals, there seems to be no dearth of quality life-saving treatments in different fields. However, these treatments cater to only a few segments of the society. This is specially so in the case of neurosurgery.

Deputy Commissioner of Police (Traffic) Bharti Arora reportedly said on Friday that in Gurgaon, along the infamous Delhi-Jaipur highway, 137 people have lost their lives and 210 have been grievously injured in the 263 reported road accidents as on October 31. She also said that in Gurgaon alone the road accident mortality rate has shot to 367.

In fact, the Delhi-Jaipur highway by many is perceived as the ‘Lakshman Rekha’ that divides the two Gurgaons. With the ‘developed Gurgaon’ having quick access to immediate healthcare, the ‘underdeveloped Gurgaon’ even today has to fret for adequate mode of transportation to make it to the hospital having all facilities. 

Why is access to quality healthcare dependant on money power? We roped in Dr. V.S Mehta to elaborate on this great divide. Dr. Mehta is one of India’s top neurosurgeons and is currently serving as the Director and Chief of Neurosciences in Paras Hospital, Gurgaon.

Excerpts from the interview:

In neurosurgery, what are the most common types of problems one faces?

Basically, neurosurgery is a field where there are very few neurosurgeons in the country and the commonest type of problem is trauma. Traffic problems, road conditions and inadequate lighting are some of the factors that contribute to the increasing number of critical cases. Two years ago it was estimated that more than 2,000 people died due to road traffic accident in Delhi alone and more than a one lakh people die in the country. Apart from this, the other problems also include infections, brain tumour and brain haemorrhages. However, trauma or head injury is the primary reason behind road accident mortality.

Gurgaon is slowly transforming into a healthcare hub. What would be the breakthroughs that you wish to see in neurosurgery?

For whom is Gurgaon transforming into a healthcare hub? For the masses at large or only for a few groups of people who can afford costly healthcare? Of course, there are people who can afford and for them it is a good facility but on the contrary, trauma mostly occurs to people who are from the low lying sections of the society. There are no adequate or minimum facilities for them. Surprisingly, in the entire city, there are no government run neurosurgical hospitals. The government has to introduce facilities related to neurosurgery in Gurgaon so that at least the poor people are given timely treatment.

Talking about breakthroughs, it will come only through aggressive researches. Since the sector is yet to be fully understood, research is on. However, In Gurgaon, luckily, the National Brain Research Centre (NBRC), which falls in Manesar, is doing an exemplary research on the brain and its functioning.

Every industry requires research and development so as to cater to the needs of the people in the long run. What are the research and development techniques used in neurosurgery?

Since neurosurgery is a wide spectrum, research is conducted worldwide. The NBRC has initiated a lead and is doing continuous research. However, we still need a lot of inputs from different parts of the country.

With neurosurgery being expensive, do you think with the proper implementation of government aid, the shortcomings can be kept an eye on?

Certainly, neurosurgery is expensive. But cardiac surgery at the same time is an even more expensive process. However, cardiac related surgeries are performed mostly on affluent people as they can afford it. On the contrary, neurosurgery does not specifically have a class as most of the patients are poor and many a times they are stranded as they do not have a place to go owing to the high cost of treatment.

Speaking of government aid, although India has adopted the American way of corporatisation of healthcare, there is no contribution from the government so as to provide facilities for neurosurgery.
With the government expenditure on hospitals gradually diminishing due to private healthcare, the question that finally arises is, where do the poor patients go?

Malpractices are also high in neurosurgery. Taking this into consideration, what is the future of neurosurgery?

Malpractices in neurosurgery is unfortunately rampant. Some of the common reasons are increased corporatisation, advancement of technologies, misuse of technology, decrease in clinical judgement by the clinician, over-investigation and over-treatment, applying literature that suits your ideas and clinicians prescriptions influenced by industries and hospital management.

Since these are some of the basic issues, the other pressing issues are lack of guidelines, absence of an association that pens these guidelines, which has to be on the national level.

In Gurgaon, on an average, do the practitioners face problems with the implementation of clinical governance?

Nothing can be said as there is no clinical governance. There are no associations, which manage the function or issue guidelines for the functioning of neurosurgery. However, there are numerous ‘associations’ but there is no such association, which is recognised by the government. If any is brought into existence, its guidelines will be final. Unfortunately, even the Medical Council of India (MCI) is dormant in this particular regard, leave alone the government. In actuality, it has to be the MCI that has to issue guidelines for the proper functioning of neurosurgery.

What are the common misconceptions people have about neurosurgery?

The commonest of them all is that people believe that in neurosurgery the mortality rate is high. Though the scenario has changed over the years, the results have significantly improved with the availability of facilities and expertise.

Healthcare tourism is one of the most lucrative sectors. What is neurosurgery’s contribution?

Like I said earlier, expertise has improved over the years in neurosurgery and the facilities provided here is comparatively cheaper than most destinations outside. There has been a good increase in the number of patients coming to India for neurosurgery and it will eventually grow.