[Answered] Give an account of recent steps taken by the government to improve Indian healthcare system.

Healthcare in India remains one of the largest sectors in terms of both employment and revenue generation. It has reported a compounded annual growth rate of 16.5%, and likely to be worth $280 billion by 2020. However, the health care system in India has some issues and is not affordable to all. The ground reality is that healthcare in India pushes families into deep debt even after one episode of illness, particularly crushing low-income groups.

Inadequacies in India’s Healthcare System:

1. Paucity of Resources: Doctors work in extreme conditions ranging from overcrowded out-patient departments, inadequate staff, medicines and infrastructure.
2. Doctor-Patient Ratio: India has only 10 lakh registered doctors to cater to 1.3 billion citizens. While urban areas have 58% qualified doctors, in rural areas the number is as low as 18.8%. There is one government doctor for every 10,189 people according to WHO against the recommended ratio of 1:1,000.
3. Unaffordable Treatments: More than 17% of Indian population spends at least 10% of household budgets for health services. Competition Commission of India report on affordability stated that 50 to 65% of Indians did not have regular access to essential medicines.
4. Doctor-Patient Relation: The highlighting of errors by doctors, medical staff, and hospitals, as well as corruption among doctors, has further eroded the trust patients have in the medical facilities. Trust deficit between doctors and patients is also gradually becoming a concern, with rising violence against doctors.
5. Risk of epidemic: India suffers from lack of doctors and clinics, especially in rural areas and in case of epidemics and diseases like tuberculosis. Thus patients are either never diagnosed or diagnosed too late.
6. Ineffective Implementation of Laws: Despite laws in place that envisage imprisonment besides recovery of compensation from perpetrators for loss or damage to Medical professionals and property, states are lacking in its effective implementation. For example, West Bengal has also enacted a law for protection of doctors but due to its poor implementation it has failed to curb the ongoing doctor-patient crisis.
7. Quacks: The shortage of trained doctors has led to a proliferation of unqualified quacks. Just 19% of people in rural India who call themselves doctors actually have a medical degree. These quacks are usually trained in alternative remedies, such as homeopathy, but advertise themselves as qualified medical professionals to patients desperately seeking help.

Recent steps taken by the government to improve Indian healthcare system:

1. National Health Mission: National Health Mission (NHM) encompasses its two sub-missions, the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM). The main programmatic components include- Health System Strengthening in rural and urban areas, Reproductive-Maternal Neonatal-Child and Adolescent Health (RMNCH+A) and Communicable and Non-Communicable diseases.
2. Ayushman Bharat: It has two component- a) Health and Wellness Centre which will provide Comprehensive health care and will be responsible for providing free essential Drug and diagnostics Services, and b) National Health Protection Mission which will subsume the on-going centrally sponsored schemes– Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme.
3. Jan Aushadhi: Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana Kendra has been set up to provide generic drugs, which are available at lesser prices but are equivalent in quality and efficacy as expensive branded drugs. This will help to reduce out of pocket expenditure.
4. National Medical Commission Bill: Replace the medical commission of India with the national medical Commission as the top regulator of Medical Education. AYUSH practitioners are allowed to practice allopathy after completing the bridge course.
5. Support to states: Support is provided to States under NRHM, to strengthen the health system including establishment and renovation of health infrastructure, engagement of Nurses, doctors and specialists on contractual basis.
6. Financial assistance: Financial assistance is provided to the States/UTs for selection and training of Accredited Social Health Activists (ASHA), who act as a link between community and healthcare facilities.

There is a need to increase public spending on health care for communities and better health outcomes.  Efforts must be made to make healthcare more affordable and accessible. India must invest more in Increasing state’s capacities to make healthcare better.