During
the 2011 budget, when the IndianGDP
is estimated to increase by 37% from 2009-10 to 2011-12 the allocation for the
health ministry for the various public health oriented national disease control
and prevention programmes has gone down by 14%.The Indian ruling class
regardless of the political parties they represent are only concerned in their
vested interests which could retain them in power. The vast majority national
and regional political parties have always achieved unity in their diversities
in ignoring the interests of the people who elected them and further exploiting
them to be in power and enjoy the privileges of power.
The
very notion of Universal healthcare in India is a cruel laugh at the vast majority
of its people, where the so called free and universal health infrastructure
provided by the government is underfunded, understaffed, undersupplied with
medicines and surgical equipments. The hospital beds to patient ratio, doctors
to patient ratio, hospitals to patient ratio and the government funding to the
extent of our population are all far less from the minimum standards set up by
the international regulating bodies.The inadequacy of our government health
care system is appalling and forcing even those who cannot afford to pay for
their healthcare at the doors of the private health care providers. The average
spending by ordinary people for procuring medical care in hospitals is already
a large percentage of their earnings when compared toseveral other parts of the
world and continuously increasing and is worse in rural areas. The irony of the
more poverty stricken and impoverished people in the remote villages and rural
areas to pay more for their healthcare as there is a general lack of government
healthcare provisioning system and the private healthcare provides are obviously
located in well affluent urban areas is a classic example of inverse care law,
characterised by health inequalities which is a direct outcome of socio
economic inequalities.
Public
health care plays a very important role especially in the circumstances of
prevailing health inequalities and this drastically inadequate health care
provisioning system. Although public health care which is about prevention and
control of disease, increasing quantity and quality of life and promoting
health is definitely not a replacement for provisioning health care in the
following levels:
-
Primary level by the
general medical doctor and general dentist and other health care professionals,
who not only act as a first point of consultation for all patients within the
existing health care systems, like the primary health care centres and private
medical clinics etc., but also provide routine check-up, diagnosis and also
provide early consultation thus contributing to the prevention of disease or
disease progression.
-
Secondary level of healthcare provided by the medical
specialists like cardiologists, dermatologists etc., who do not have first
contact with the patients. The secondary care also involves acute care and
emergency care.
-
Tertiary care is again specialised health care dealing with
long time inpatient treatment of chronic diseases like cancer. It also involves
rehabilitation and restoration of the functions hampered by the disease
progression.
Nevertheless
Public health plays an important part in enhancing the quantity and quality of
life by emphasising prevention and promoting health. During the First
International Conference on Health Promotion, organized by the World Health
Organization (WHO) and held in Ottawa, Canada, in November 1986,Ottawa Charter
for Health Promotion was signed as an international agreement which apart from
setting up sweeping goals to achieve “Health For All”. Itis about the World
Health Organization's foremost health care approach to promote health and
enhance the quality of human life. Ottawa Charter clearly identifies important
areas for health promotion which are:
- - Building healthy public policy
- - Create supportive environments
- - Strengthening community action
- - Developing personal skills
- - Re-orientating health care services toward prevention of illness and promotion of health.
To
frame a healthy public policy, to create supportive environments like public
parks, fitness and sports centres etc., to engage in communities to identify
their health priorities subsequently enable and empower them to fulfil their
health needs, to educate individuals to fulfil their health requirements and
finally diverting more resources into prevention and disease control, all of
these needs heavy investments. A radical budget allocation into public health
care is vital. The recent budget allocations for healthcare particularly public
healthcare, which is a meagre 1.4% of India’s GDP, itself, prove that the
government have no serious intentions to reverse the present health care system
of India. The low budgetary spending in public health care would also ensure
the continuation of substandard delivery along with increasing inadequacy to
meet the healthcare demands of a growing population. At the same time it also enables
the exploitative private health sector to establish itself. The health care services in the second
largest populated country are already in the radar of global business corporations
as an industry worth 40 billion US dollars and projected to grow exponentially.
Apart
from Kerala, majority of the regional governments have so far consistently
smeared the already abused pages of the Indian constitution which declares that
"raising of the level of nutrition and the standard of living of its
people and the improvement of public health as among its primary duties". The
insensitivity of the government policies regarding public health care is not
only due to the lack of political will but it is how a vast majority of ruling
governments operate throughout the world until they face a mass resistance from
ordinary working people and youth. This could possibly be demonstrated in the
states of India itself. Organised working people and educated, socially aware
young people and also their political consciousness are all reasons for the
high human development index and life expectancy seen in Kerala.
It
is important to identify and consider the fact that the past and present
governments have been consistently considering social spending as an
unnecessary burden but vital tool for electoral politics. We expect a radical
approach from the government towards public health care. We need an independent and democratic fact
finding commission to precisely estimate the amount of funding required
fulfilling the health care demand of our people and the government should at
once initiate the allocation of funding according to the health care needs of
the people. Sadly the mainstream political parties and the big businesses have
different plans. Hence the need is a political, socio economic alternative and
a true working class alternative.
