Records maintained with Radiology Department of JDWNRH reveal that in last two years, the CT Scan machine has broken down 6 times and MRI has broken down 8 times which has contributed to increased waiting time.
The Health Minister Tandin Wangchuk said “I do agree that the breakdowns do happen since both the machines are in its 10th year of operation and are subject to wear and tear.”
He said the machines are very expensive, with the CT scan costing US$ 800,000 for and MRI costing US$ 1.3 Mill for. Both the machines are under comprehensive annual maintenance contract with the principal company at the cost of Nu. 2.5 million For the CT and 2.8 Million for the MRI. He said the machines are repaired in the shortest possible time except when the parts have to be replaced for which it takes longer time than anticipated.
One reason given for the breakdown of machine was that the demands from patients to go for scans though it is not necessarily needed for diagnosis unless the case is severe and requires more precise investigation on diseases.
His inquiry with a senior doctor in JDWNRH stated that earlier when there was only x-ray machine, the people were happy with it and gradually with the advancement in technology and with advanced machines like Ultrasound, CT scan and MRI a decade ago, the demands of the people increased and they are not satisfied unless the MRI and CT scan gets done for their diagnosis.
Regarding the waiting time, he mentioned “as of yesterday there are 184 patients waiting for the MRI for which the appointment has been given until 6 November 2015. As regard to CT scan there are 78 patients waiting for which the appointment is until 8th October 2015, Due to long Tshechu holidays”
According to Lyonpo, the average total waiting time for CT scan is seven to ten days and for MRI is less than a month when the equipment are functional. On an average, 12 regular and 5 emergency CT scan services and 10-12 MRI scans are provided daily. In addition 3 CT scans and 3 MRI scans are done during the special consultation clinics.
He said that as per the international standards, one MRI and one CT scan is estimated to be enough for a one million population whereas the population in Bhutan is not even one million. He said that people need to realize that one CT scan is equivalent to 100 times more than the exposure to x-ray.
He mentioned the comparative charges in various countries likeIn India, most of the private hospitals charge Rs 5,000 to 7,000 for CT scan and 8,000 to 12,000 for MRI and similarly 8,000 Baht and 12,000 baht are charged for CT scan and MRI respectively in Bangkok. In contrast, In Bhutan during the special consultation clinics at JDWNRH, CT scans are minimally charged Nu 1500-2500 depending on the use of contrast and similarly Nu 3,500-4,500 is charged for a MRI scan.
Currently there are only three radiologists who look after CT scan, MRI, Ultra sound and X-ray so,the operational challenges for both the radiological services result from shortages of radiologist but two more radiologist will be supplied soon at the JDWNRH.
Realizing some of the recurrent problems, the health ministry along with JDWNRH has already submitted a grant proposal to the government of Japan for a 64 slice CT machine.
“I am confident that we will be able to get a new one in next 2-3 years. Training of additional radiologist has also been planned in the long term HR plan of the ministry of health” he pointed out.