The health-care crisis at our doorstep

A little over three months ago, the country watched in horror when news unfolded of the death of a seven-year-old in Delhi from dengue and the subsequent suicide by his young parents.

The harrowing experience of getting a simple thing like a bed in a hospital when you need it was all too familiar. The incident was disturbing as it happened in the national capital under the nose of the Centre and a State government.

In the last three months, more such incidents made mainstream news. Eighteen people lost their life in a hospital in Chennai, during the recent floods due to a power outage.

The year closes on another disturbing incident reported from Madhya Pradesh where close to 52 people who underwent cataract surgery ended up losing their sight.

Healthcare delivery in the country this year has been dismal. Despite pockets of interesting developments — such as the increase in niche service providers bringing healthcare services to your home or hospital-majors like Bengaluru’s Narayana Hrudyalaya hospitals getting successfully listed on the stock exchange – basic healthcare infrastructure continues to groan under the weight of an ever increasing population.

‘Inadequate’ is written large across healthcare delivery and it reveals itself in every part of the country — in the shortage of staff at government hospitals to run basic facilities or in private institutions also short of specialist doctors, intensive care units, nurses, and beds.

The Centre’s health spend as a percentage of GDP is the lowest in the last three decades, health economist at the Public Health Foundation of India, Indranil Mukhopadhyay points out.

This year, there is no progress in the government’s show of urgency in shoring up the public health system, says Amit Sengupta with Jan Swasthya Abhiyan.

Though the Centre has adopted the strategy of giving larger funds to the States, reality is that even the best of States are getting tight-fisted on funding health-care programmes.

Funds are stuck at the State level and are disbursed at their discretion, says Sengupta.

This has a cascading effect as people (doctors, nurses, support and administrative staff) are not paid, facilities are not upgraded, inadequate procurement and medicine stocks occur, and the overall morale is low, he points out. “Everytime the system gets challenged as we saw with dengue in Delhi or the floods in Chennai – there is no long term intent to fix the problem. There is firefighting and results are seen but no long-term shoring up of the system,” observes Sengupta.

On the doctor and para-medical staff shortages, he observes that it has been reduced to merely whether doctors are serving in rural areas, when in fact there is a greater problem of funds, investment and planning.

NH Hospitals founder Devi Shetty underlines the disturbing medical shortages and urges the government to act and strengthen medical education and infrastructure.

Three lakh children die the day they are born and there’s a maternal death at childbirth every 10 minutes. And the worrisome fact is that the 5,000 community health centres responsible for 60 per cent of childbirths have about 80 per cent vacancy even in the southern States, he says.

With 26 million babies born every year and over 5 million needing ceasarians, he says, pointing to the shortages in paediatricians and gynaecologists, among others.

The root of this problem is medical education — “with 50,000 odd under-graduation seats and 14,500 post-graduation seats, we are barely able to replace retiring doctors”, he says.

This is just a tiny insight into why healthcare totters in the country.

The Centre needs to deliver on its promise to up healthcare spending to at least 3 per cent of GDP (from about 1 per cent) and focus its energies on primary healthcare infrastructure and medical education, before the medical crisis at our doorstep flares out of control.

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