Speaking with #BBV, Dr Jagdish Prasad, the Director General of Health Services laments political indifference towards health as an issue. Poor implementation at state level coupled with bureaucratic delays and a medical education system that promotes profiteering is ailing India's healthcare system.
If health is not a national priority for India, blame it on political indifference, says Jagdish Prasad, Director General of Health Services (DGHS). While political apathy has pushed health low on government agenda, bureaucratic tardiness coupled with federal complexities have created a maze where implementation of health schemes more than often goes for a toss. Not surprisingly, even big–ticket health schemes fail to meet stated objectives and goals.
"If there is political will, all problems related to the country’s healthcare system can be resolved. Health is a state subject. The Central government enacts laws, but implementation rests with a state government," said Dr Prasad on Nishane Pe. The show is part of Zee Media’s Bharat Bhagya Vidhata series and guest anchored by film star Ashutosh Rana. Nishane Pe airs on every Friday at 10pm.
While the centre can give direction and grants–in–aid, the onus is on the states to make health a priority and ensure proper implementation.
"State leaders must give high priority to public healthcare. Most states have not properly implemented the National Rural Health Mission (NHRM)," he added.
There is an urgent need to fix the entire medical education system, stressed Dr Prasad.
"High cost of medical education especially in the form of capitation fees charged by private medical colleges and institutes has spoiled the system. After paying capitation fee, a candidate will be more interested in recovering the money than serving the poor."
The process of establishment of medical colleges too needs to be streamlined, said Dr Prasad.
"Profiteering has become the sole objective of many private institutions across the country. If states start implementing the Clinical Establishment Act, these problems won’t occur. But most states are reluctant to implement the Act."
The DGHS also defended doctors not wanting to work in rural areas.
"Doctors currently have no incentive to work in rural areas. Improved facilities in government healthcare centres and comparable salaries will attract more doctors to head to rural areas.
Dr Prasad doesn’t believe the public–private partnership model ideal for improving the country’s health scenario.
"PPP model in health hasn’t produced best results. Private hospitals are more concerned about business. Instead of PPP, we should add and strengthen the existing public health infrastructure."
But, hasn’t the emergence of private hospitals benefitted the people including the poor? Dr Prasad doesn’t seem to agree with it.
"Free or subsidised land was given to many private hospitals on condition that beds will be reserved for the poor and they will receive free treatment. But, is that really happening? If big private hospitals can treat even two percent of such patients, it will be a great service to the nation."
Dr Prasad agreed with Rana that ever rising medical bills is poses huge challenge for the people especially people below poverty line. He stressed that at least in Delhi, efforts have been made to ensure that the poor especially BPL card holders get free treatment at government hospitals.
However, states will have to take greater share of the blame for country’s lack of an efficient healthcare system, Dr Prasad reiterated his earlier stance.
"Statistics suggest that we have just one doctor for 2000 people. This data holds true for urban areas. In rural areas we just don’t have doctors or most of them are absentees. Most states have underutilised funds under the NRHM. For instance, Bihar hasn’t even appointed doctors from the last 10 years."
Currently, the centre and states together spend 3.5 per cent of the gross domestic product, which must increase, if our health objectives are to be met, said Dr Prasad. In addition, Indian corporate houses should come on board to spruce up healthcare infrastructure across the country.
"If Bill Gates is spending on healthcare in India, why can’t our industrial houses follow the same?" asked Dr Prasad.
24 Sep 2013