The inadequacies of the state as a mere enabler (riding on insurance, Ayushman Bharat and PPPs) rather than as a direct provider of public health lie cruelly exposed in the face of Covid-19 — typically, the frontline staff. The latest proposal to provide insurance cover of ₹50 lakh per person to frontline health workers including nurses, anganwadi workers, ASHA workers as well as private hospital staff and some other specified categories, on closer scrutiny, suggests a sheer lack of respect and empathy for providers of essential services.

The Pradhan Mantri Garib Kalyan Package Insurance Scheme for Health Workers Fighting Covid-19 was announced as a major sop for an estimated 22 lakh health workers. However, the fine-print revealed in the FAQs ( BusinessLine , April 8) clarifies that this is a life insurance only in the case of an accident/death due to Covid-19. It does not cover expenses related to treatment or quarantine and requires submission of eight documents to prove “loss of life due to Covid-19”, including a laboratory report certifying positive test for Covid-19 and a certificate by the concerned healthcare institution that the deceased was deployed for care and came in direct contact with a Covid-19 patient. There is something seriously amiss if no provision is made even for hospitalisation and treatment of frontline health workers when they are performing a national duty at grave risk — braving exposure to the virus, aggressive behaviour in public spaces and alienation from their families. Instances of nurses, ASHA workers and other hospital staff getting infected, as 40 of them did earlier this week at the Wockhardt hospital in South Mumbai, are becoming frequent; as are episodes of them being assaulted in the course of their duties. Nurses looking after Covid-19 patients in Delhi are on duty for 14 days with 12-13 hour shifts without any proper provision for rest and refreshment. They cannot go home for 14 days and are taken to gurudwaras to sleep and use the toilets. As for anganwadi workers and ASHA staff, who are conducting door-to-door surveys to track contact histories of Covid-19 patients, they are being physically attacked besides not getting even the minimum wage for the additional duties.

The immediate task, therefore, is to provide instant financial and infrastructural support to these health workers. The time for half-measures such as insurance and over-reliance on the private sector is truly over. The state must emerge as the primary provider of healthcare.

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