A National Health Policy was approved by the Union Cabinet last week to address the country’s deteriorating state of public health scenario. A draft of the policy was notified in February 2015 for public discussion after 15 years of the last health policy. The new policy proposes to raise country’s public health expenditure to a level of 2.5 per cent of the GDP from the current level of 1 per cent in a time-bound manner. The Union Health Minister hopes to achieve this target of 2.5 per cent of GDP would be met by 2025. The policy proposes to provide free drugs, free diagnostics and free emergency and essential health care services in all public hospitals. The policy aims at tackling non-communicable diseases, upgrading district hospitals and ensuring improvement of immunisation facilities in these district hospitals. The current disease profile of the country is showing a dangerous spurt in non communicable diseases and also a re emergence of two of the deadly infectious diseases like TB and malaria. This changing trend in the disease pattern of the country needs to be arrested as that can seriously affect the majority of the workforce of the country in future. The policy also envisages a three-dimensional integration of Ayush systems encompassing cross referrals, co-location and integrative practices across systems of medicines.
Public health has been a neglected area in India for a long time with health infrastructure in most of the states remaining underdeveloped because of poor planning and inadequate fund allocation. Even after 70 years of independence, both Central and state governments’ spending on public health remains very low compared to several other developing countries. As of March 2016, India has only 25,354 functioning primary health centres, the only government medical facility for the rural population. This is a highly inadequate number considering the size of the rural population. Most of the state governments have failed to increase the number of PHCs with the growth of the population. And there has been no monitoring and inspection of these facilities for several years. Many of these PHCs are run without a doctor, inadequate para medical staff and medicines. Doctors refuse to serve in PHCs or in any rural medical facilities although they are required to serve rural health centres for two years after passing out of the medical education. Medical Council of India usually does not take any action against these offenders. That has led to a situation where private players are dominating the healthcare sector in India with least control on their exploitive practices of patients. Quality of medical professionals is yet another serious issue facing Indian healthcare sector. This is a dangerous outcome of the prevalence of capitation fee in medical colleges. Private medical college managements are openly selling seats for Rs.50 lakhs to Rs.1 crore and the regulatory bodies and government know this fact. What quality of service can one expect from a medical graduate who pays such huge capitation fee. These are some of the basic issues the government needs to address if benefits any national health policy have to reach the people.