When you think civic hospitals do you think over crowded, unhygienic surroundings? The Brihanmumbai Municipal Corporation (BMC) agrees.

The BMC has admitted that poor conditions in civic hospitals prevent the urban populace from using them, something the Human Development Report (HDR) also pointed out.

“Most urban patients choose private hospitals due to hygiene and other infrastructural issues but we have the best quality doctors,” said Additional Municipal Commissioner, Manisha Mhaiskar. “People trusted our expertise during the swine flu epidemic.”

Civic hospitals treat about 21,000 out patients every day that adds to the burden, officials said. The BMC has said it would work on the recommendations of the HDR, which it commissioned.

The report, a first, was prepared by the All India Institute of Local Self Government and supported by the United Nations Development Programme.

The report says that lack of access and infrastructure has led to a shift of patients towards the private healthcare industry.

The reports says patient overload causes hospital employees — from surgeons to ward boys — to be overworked and appear unfriendly. “This also leads to difficulties in the doctors giving undivided attention to the cases,” it says.

The report has recommended the setting up of better dispensaries so that patients are not unnecessarily referred to hospitals. Infrastructure, location (most of the civic hospitals are in the island city), access and timeliness of services in civic hospitals need to be improved, the report says.

“We will soon have a meeting with the deans of the hospitals and work on the recommendations in the report,” said Mhaiskar.

Three-fourths of the 50 city hospitals were in the public sector in the 1950s but now there are more private hospitals. There are 1,500 private hospitals and nursing homes in Mumbai.