Fixing healthcare: 

Fixing healthcare: 

Context:

More than 60 per cent of the population cannot afford private healthcare because of the following reasons:

1. Private health service routinely excludes a large poor population, overcharges and reduces many to penury.
2. Private healthcare is often without regulation and even tenuous attempts at implementing the Clinical Establishment Act have not been made.
3. They are confined to cities and urban areas.
4. Comparatively, private hospitals facilitate profit-maximisation with impunity.

What are the problems government hospitals are facing?

Shortfall of doctors

• Lack of accountability, absenteeism, trade unionism and underfunding in government hospitals.
• Health services in government hospitals are quasi-public goods or merit goods.
• Drug supply by the government is not reliable.
• Missing of budget: There is hardly any budget to buy new gadgets and hospital equipment. Most devices are therefore outdated. As soon as they stop working they cannot be replaced by new ones.
• Lack of infrastructure like insufficient laboratory systems, beds, electricity, toilets etc.
• There is a scarcity of skilled manpower. Even if they are they are mostly located in urban areas. A significant portion of doctor are under qualified
• Low public expenditure: Though there has been an improvement in the expenditure still India’s health expenditure is one of the lowest in the world.
• Irregularities like non-availability of medicines and unethical practices by doctors
• Lack of resources: Lack of resources/funds often means diagnostic instruments are not in working condition, forcing doctors to ask patients to get tests done from private laboratories.
• High workload: Acute shortage of manpower hence, they are not able to attend to all the patients, resulting in long queues and delays
• False charges of negligence: People come to the government hospital as a last resort, after trying to get treatment in local nursing homes or doctors, by which time, in most cases, the patient’s condition is critical.

What strategies should be followed to deal with these issues?

• Providing good working environment to the young doctors.
• Providing secure working environment for women doctors and other staffs.
• Increasing funding of health sector
• Improving the public transport in government hospitals.
• Increasing the infrastructure such as more hospital, adequate equipments, adequate staff etc.
• Efficiency is must for public health system but co-existing with private players in the same premises is not the best solution
• Increasing the budget to 3 per cent of GDP will be a welcome step but may be the only one that is required
• Revamping the existing ecosystem to deliver better service.

What are the Government initiatives in the field?

• The Union Government launched Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) to provide free health check-ups to pregnant women at government health centers and hospitals.
• Mission Indradhanush programme aims at reducing maternal and child mortality by reaching out to each and every child under two years of age and all pregnant women who have been left uncovered under routine immunisation programme. Its focus is on improving immunization coverage in select districts and cities to ensure full immunization to more than 90% by December 2018.
• E-Health: In July 2015, the Prime Minister launched his Digital India campaign, and E-Health was one of the initiatives launched with the campaign.