Wake up call for health care

There are two sectors, which are vital for India's development –health and education – and both sectors demand more focus. For example, the country has not had a single Health Minister who was interested in their ministry since Raj Kumari Amrit Kaur. Most of the politicians who have been put in charge of the ministry simply bide their time as the system is also not conducive to their work. In such a situation it is not surprising that incidents like the Gorakhpur tragedy occur. It is indeed shocking to hear that these children died because of lack of oxygen supply and the Chief Minister has ordered an enquiry by the Chief Secretary (who is right under him) to investigate. It is anybody's guess what the report is likely to be. UP is important for BJP. Prime Minister Narendra Modi deputed his Health Minister JP Nadda to visit the hospital and get a first-hand report, also promising all help from the Centre. After all UP had given a massive mandate recently in the Assembly polls to the BJP, which in turn boosted their image. The bigger question is why is India not able to improve its health care? No doubt it is difficult as even the affluent countries like the United States of America and the United Kingdom are struggling with their health care system.

India ranks 154 out of 195 countries in terms of access to healthcare. Despite making huge steps it continues to be at the bottom as it has failed to achieve most of the healthcare goals. It has performed worse than expected in tuberculosis, diabetes, rheumatic heart diseases, and chronic kidney diseases. With the country's health needs undergoing a dramatic transition, in the recent years, chronic diseases claim more than 50 per cent of deaths. The budgetary policies in India have evidently failed to keep pace with the changing disease demographics and health care needs.

In India, there is one doctor for every 1,700 people against WHO recommendation of 1 for 1000 people. The Health Minister told the Lok Sabha recently that India has a doctor-patient ratio of 0.62:1000, meaning there's one doctor serving almost 1,613 people. "Assuming 80 per cent availability, it is estimated that around 8.18 lakh doctors (are) available for active service (in the country)," MoS Health Anupriya Patel has said. Moreover, only 48 per cent of the 1.35 million beds are functional and about 65 per cent of these are located in top 20 cities indicating the deficit in medical professionals, and inadequacies of the health system today. Calling for a mandatory shift to generic drugs, even the Economic Survey 2016-2017 points out that the country faces health care challenges, including a decline in the role of public delivery of health services, and accessibility and affordability of medical care.

On the other hand, health care has become the largest sector both in terms of employment as well as revenue. The Indian Medicare market is worth about $100 billion and it is growing fast. The revenue of health care in 2017-19 is also expected to grow at 15 per cent. Medical tourism alone is expected to double from the present $3 billion to $6 billion by 2018. The Indian pharmaceutical sector is also growing fast. All these would push up the health sector delivery. If India proposes to make use of the demographic dividend, health and education sectors need to be given more focus.

Innovative measures are needed both in government and private sector health care systems. For this rationalisation and prioritisation of the limited resources, along with raising new public and private resources to augment the funds are required. Above all, the health care delivery to the doorstep needs to be enhanced. India should take advantage of the range of insurance offerings. The government of India has approved the National Health Policy 2017, which will provide the policy framework for achieving universal health coverage but the problem lies in implementation. Every citizen has a right to health care and the Gorakhpur tragedy should thus be a wake-up call for health care reforms.IPA