Surrounding healthcare
Beginning with the first step, higher education is a priority area for any long-term development and catering to this sector so that it thrives better cannot be a pursuit in isolation. In order to sustain the structure of higher education, the series of interconnected aspects of which higher education is a very conspicuous link must be developed and strengthened for there to be any substantial and qualitative impact of these investments. In a more specific sense, the development of higher education in a field like medical sciences without upgrading and enhancing primary and secondary education will have little chances of bearing optimum fruits. The education, as a result, will suffer from problems of falling standards and quality, poor infrastructure and maintenance services, inadequate support systems, capacity overload, and inadequate manpower and good faculty—all of which happen to be the reality of India's higher education sector in general. Substandard products of a weakened system in the job market will have little scope in the long run. In order to be able to absorb fresh graduates of impactful professional courses like medicine, a suitable domestic market is a basic necessity. As far as the healthcare scenario in India is concerned, the situation is less than favourable on many levels. It is widely demanded that the government increase health budget. As the year draws to a close, an annual round up and some comparison is warranted. The previous year, 2018 saw the launch of the government's flagship health scheme Ayushman Bharat, and in 2019, the government initiated a major reform in the medical education sector with the National Medical Commission Act, 2019, passed in Parliament which marks the process of replacing the tainted Medical Council of India. With this Act come the provision for four autonomous boards to regulate medical education and ethics, as well as conduct a national exit exam for MBBS students which will double up as an entrance test for PG courses. The National Medical Commission (NMC) is thus authorised to regulate the fee structure for private medical colleges in India. This legislation too caused its share of stir as sections of the medical fraternity and students went up in arms against the law, arguing particularly against the NMC's fee regulation for only 50 per cent of the seats, and the common exit exam. Protests against the law settled after negotiations, and 'assurances' were given by Union Health Minister himself. But, as a matter of pragmatic concern, conducting a common exam inclusive of both theoretical and practical aspects for nearly 70,000 students across the country is nothing short of a challenging task.
As much as it is a toiling task to become a doctor in this country, the job of a medical professional is one that is far from any respite in terms of work conditions and work load. This year also saw the compounded situation of violence against doctors—despite this being a recurring phenomenon and a cause of serious concern, the scale of agitation and mobilisation was unprecedented this year. Beginning with a violent attack on a junior doctor in Kolkata's NRS hospital, the matter snowballed into a nationwide agitation to the extent that doctors demanded that the Centre pass a law to specifically deal with the issue of violence against health professionals. The fact is that states do have such a law in place: The Protection of Medical Service Persons and Medical Service Institutions (Prevention of Violence and Damage or Loss of Property) Act, 2017, exist—to the oblivion of many health professionals. However, those who are in fact aware of this contended that the implementation of the law was faulty and the punishment not suitable enough to deter patients and their attendants from attacking doctors. Hence came the Union Health Ministry's promise of a fresh law but as matters stand, the draft law is reportedly caught in a tussle between the Health Ministry and the Union Home Ministry. At the bottom of it all lies the still unaddressed issue of the doctor-patient relationship, the unfortunate state of healthcare in government hospitals in general that often instigate the patients' ire being directed at the medical professionals. WHO recommends one doctor per one thousand of population. About 8 lakh doctors are actively available at one time in India, which means that the doctor-population ratio in India is 0.62 doctors per one thousand populations. While nearly 70 per cent of India's population lives in rural areas, rural India has just about one-fourth the doctors as compared to urban areas. This clearly means the dire shortage of doctors. Events and occurrences apart, the key concern remains that the government increase the health budget, which at present stands at around 1 per cent of the GDP. While the ambition of setting up AIIMS in different cities across the country and increasing the number of medical colleges seem to be taking off well, the persisting state of healthcare, particularly beyond the metro cities, is bleak and remains a cause of concern. The death of over a 100 children in an outbreak of encephalitis in Bihar's Muzaffarpur district stands testimony to this as doctors, researchers, and governments at both the state and the Central levels failed to zero in on the cause of sudden deaths—containing the spread of the disease and planning a preventive strategy for subsequent years remained a far cry. With the proposal of Universal Health Coverage, the government is set to face the tough task of balancing its priorities—which are many.
