India’s public health care system in need of life support

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Last week, in one of the renowned private hospitals in Delhi, a newborn who was alive was declared dead. While the family was taking the plastic-wrapped body of the child for last rites, the baby made some movement, after which it was admitted to another hospital and is doing well at present. Meanwhile the parents of the child have filed a complaint against the hospital, which is under investigation.

There is no doubt that the medical profession is one of the most humanitarian. We treat doctors as gods on Earth who come to our aid when we are in distress and pain. It is for this reason that every patient has full faith in doctors and the treatments they prescribe.

Since it involves dealing with the lives of people, this profession faces more challenges and requires extra attention to detail. However, in recent times, it has been observed that a few medical professionals have brought a bad name to the fraternity, tarnishing the image of doctors and instilling doubt in the minds of common people.

Instances of medical negligence

One of the first cases that brought Indian medical practitioners under the scanner was the Anuradha Saha judgment, where the National Consumer Disputes Redressal Commission found the AMRI Hospital in Kolkata and its doctors guilty of medical negligence that resulted in death. The NCDRC fixed a compensation amount of 17 million rupees (US$263,800), which was supposed to set a precedent for any such neglect or malpractice.

But that was not the end of things like this making news, such as the case of Rubina. Rubina was admitted to a private hospital in Delhi where she gave birth to a baby girl. Later it was discovered that while conducting the delivery, the doctors left a needle in her uterus, which resulted in profuse bleeding, immense pain and trauma. The Delhi State Consumer Redressal Commission took note of the case, and the hospital admitted fault and paid compensation to the victim.

In a separate ruling, the NCDRC observed that corporate hospitals and specialists were expected to “perform at a higher level than other hospitals/general practitioners.” Responding to the complaint of a couple over the disability and eventual death of their daughter due to “substandard care during labor,” the commission directed Indraprastha Apollo Hospital and a gynecologist associated with it to pay 10 million rupees as compensation.

These are not isolated incidents, as similar reports are heard from all over the country. In spite of the stringent laws that exist to protect the rights of Indian citizens, stories of neglect and overcharging by corporate health-care giants. Many people do not bother to complain because of the lengthy legal processes and the fear of taking on the powerful medical fraternity. But there are a few who have stood against these corporate giants, reminding them of their responsibilities in the long fight to sustain faith in the most respected profession in the world.

State of public health care

The Lancet medical journal in 2015 published a report based on findings from its Global Burden of Disease Study. It stated that India ranked 154th out of 195 countries in terms of access to health care. The neighboring countries of Bangladesh and Nepal, which have per capita incomes slightly more than half of India’s, ranked better.

As per the Economic Survey 2015-16 brought out by the Indian Ministry of Finance, public (federal and state) expenditure on health as a proportion of gross domestic product was 1.3%. The country has a similarly low ranking for life expectancy and neonatal mortality rates, as evident by World Bank data, which definitely show some improvement as compared with the past, but globally the progress is still dismal.

Private hospitals began to boom in India after government hospitals proved unable to tackle the ever increasing population, with their poorly compensated and overworked staff and lack of infrastructure. The deaths of 386 children at a public hospital in the northern city of Gorakhpur in Uttar Pradesh in August has not faded from memory.

Last year, a World Health Organization report revealed that the density of doctors at the national level was 79.7 per 100,000 population. Such figures present a transparent picture of the state of the health sector, which is struggling to accommodate the needs of 1.3 billion Indians. In an effort to find relief from suffering and pain, patients are left with little alternative than to turn to the lavish state-of-the-art private hospitals mushrooming all over the country.

Health care: from service to business

Investment in the Indian health sector has become a lucrative business. Medical tourism is another concept that is gaining strength. Once big players and corporate giants enter the noble profession of health care it is to be expected that revenue generation will be one of the prime motives. But it is not to be overlooked that this profession, which directly affects the lives and well-being of people, has to invest very strongly in ethics and principles.

It is mandatory for any welfare-driven democracy to give a high priority to health care, and a one-sided business model of privatization without adequate quality control and accountability is detrimental to the health of the society. The dwindling budget allocation for the public health sector in one of the fastest-growing populations of the world reflects the misplaced priorities for the Indian government.

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