R D Singh Bandral
For a wealthy Nation, Health of it’s citizen is indispensable.
One of the prime sectors fighting tooth and nail against the present pandemic is the health sector; though, the same is not equipped with enough facilities and infrastructure, like their counterparts in European and other developed nations. But still kudos to our health workers, who are into their services, day in and day out, since the outbreak of Corona pandemic in India. Just one day back, it was reported in the news that around 600 health workers in India, which includes Doctors, Nurses and paramedics were found to be infected from corona virus while being in the service of infected patients. Once a health worker gets infected, then unknowingly he becomes a carrier of infection for his family also and the draconian chain continues.
The Government has left no stone unturned to fight against this painstaking situation, but still we are not in a situation to take a sigh of relief, when day by day the number of infected persons are increasing. The only thought, which bring goose bump is; “will we be able to tackle the situation if it worsens like; Italy, Spain or USA?” . It is a known fact that, the hereinbefore mentioned countries are world superpowers and have a very robust health care system, with all latest facilities and good infrastructure in their hospitals, but still they were brought on their knees, as hospitals were found to ran out of beds and ventilators, when the number of patients increased. Whereas, in India the Doctors were found to be struggling for PPE(Personal Protection Equipment) kits and other accessories to tackle this gruesome situation. Many doctors and hospitals came up with inventive ideas also, like; one doctor at some far flung hospital was found to be checking patients through a transparent sheet barrier, with patient standing on other side of transparent curtain and in another case, our own GMC Jammu, has developed two covid-19 dedicated stretcher, which are covered from above with transparent plastic sheet. But, this “jugadu” technology is not going to help us forever and time has come to strengthen the health sector and invest in the same, to face the tough times in near future.
LOOPHOLES;
Nevertheless, WHO recommends 5% of GDP investment over Health sector, at present only 1.4 % of the our GDP is invested for health sector, which is not proportional to the population of our country. As a result, the health sector is in shambles, which needs a serious relook and proper investments over the infrastructure and medical equipments of hospitals. The hospitals do not only lack in proper infrastructure, patient beds, medical equipments; but also have deficiency of health workers, among which the less ratio of doctors against the proportionate ratio of population makes situation quite grim. As per WHO report, there shall be 1 doctor for a population of 1000 people, whereas, in capital itself the ratio is; 1 Doctor for 2028 people and the worst case is in Bihar, where ratio is; 1 Doctor for 43,788 people. Due to which, there is too much burden over the doctors in government hospitals and even the salary is not handsome. So, most of the young doctors after completing their studies prefer to be in private sector, rather than being in Government sector, ignoring their “Hyppocratic Oath”, which in-fact has nothing to do with the word, “Hypocrisy” and was coined in the name of great Greek Physician; “Hypocrates”, who wrote an oath for doctors that, they will serve the society to the best of their ability, resulting this profession to be called as a noble profession.
In J&K also, the situation is no different; as most of the health centres in far flung regions, either have less doctor or no doctor at all. As, most of the young doctors after getting into Government services, either seek study leave for pursuing further studies or they get themselves attached at some roadside hospital, preferably somewhere in Jammu District. In a PIL with number PIL No. 16/ 2018, pending before the High Court of J&K, Jammu, a shocking revelation was made in the pleadings that, the most of Primary Health Centres in far flung places and even in some district hospitals of Jammu division, there are no doctors or not enough as per vacancy available and in Jammu district alone there are 103 surplus doctors attached at the behest of some influential persons. Doctors get appointed in government services under RBA categories, but when comes to service, they usually prefer to be posted in cities.
Moreover, lack in infrastructure can be seen in most of the Government hospitals and situation is no different with the medical equipments, as either the machinery is in poor condition or defunct. In the prevalent situation, ventilators are indispensable, but the government hospitals across India do not have enough ventilators to meet out the needs, if the curve of COVID-19 patients does not flatten. Like, in all J&k hospitals there are only 210 ventilators, where the number of covid-19 patients has crossed 800 mark and the population of Union Territory is around 1.5 crores. Moreover, there are not enough beds in hospitals to deal with the situation, thus, the Government has made arrangements in other places like; hotels, schools buildings etc.
Though, many new Govt. Medical College (GMC’s) Hospitals are opened in various districts of J&K, but they are still running in District Hospital buildings, with most staff of district hospital. Condition of Government hospitals can be seen from the aspect that, whenever some influential person gets unhealthy, he prefers to be admitted at AIIMS or in some reputed private hospital, rather than some routine Government hospital.
Due to all these factors, India with 7% of total world population carries 20% of world diseases burden, ranking India at serial number 143/188 as per Global burden of Diseases report. Countries like, Sri-lanka and Syria are at better positions, ranking at serial no. 79 and 117.
LEGISLATION:
Though, there are private hospitals also with good facilities, but they are not in the reach of every person, especially in our country where the BPL category constitutes 42% of the total India’s population. Thus, in order to deal with this complex situation and due to booming private hospital industry, the Government in the year 2017 has come up with a New Health Policy, with the name; “Ayushman Bharat”, under National Health Protection Mission. The scheme of ‘Ayushman Bharat’ is basically based on health insurance cover upto 5 lacs/per family, which will cover around 10 crore families, which means around 50 crore people in India. Under the scheme of ‘Ayushman Bharat’, no premium is to be given, as the same will be borne by the government. Most of the poor people will be covered under this scheme and there will be socio-economic caste census to do the needful for the implementation of scheme. The scheme of ‘Ayushman Bharat’ is on the lines of Obama Care enacted in USA.
One of the peculiar things about this scheme is that, under ‘Ayushman Bharat’, an insured family will be able to get treatment not only in Government hospitals, but also in private hospitals empanelled under the said scheme and many reputed private hospitals are also empanelled under this policy. The said scheme can be seen as a initiative measure taken by government under the Sustainable Development Goals, 2015; vow of which is taken at international forum by various nations to fight against the new problems of health, faced by human kind on this planet.
Being a promising scheme, it shall not be forgotten that, most of the India resides in rural areas, easy access to which are only the Government hospitals. Moreover, the procedure for treatment under said scheme in private hospitals is quite tedious. Therefore, the Government hospitals and research institutions are still the most reliable and dependent centres, upon which the most of population depends and they need keen relook.
(The author is a practising Advocate
at High Court of J&K)
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