PUBLIC HEALTHCARE: INDIA TODAY AND TOMORROW
Dr. Ripudaman Bajwa
Have you ever witnessed a sight where the patient has asked you to remove the I.V. line so that he/she can take his own blood samples for reporting or a CPAP being taken by the nearly moribund child’s father along with a heavy O2 cylinder or a series of unattended ambulance calls because the government one would simply make an excuse to arrive?. If you have answered yes, i can probably comprehend accurately about your working conditions and if you are yet to witness such sad wonders that prevail, the government healthcare in many state sponsored places can any day make you add to the list.
While I was rotating under one of the most respected doctors in a department earlier this month I was lucky enough to start a conversation with the professor. She started by saying “Back in the 90s when I was a postgraduate student, I remember people glowing up with joy that they will receive healthcare from this government hospital. People coming from miles away wanting to get themselves treated”. The pride was visible all over her face sitting gracefully in that dilapidated room. “The bitter truth Ripu today is that only the ones who barely make a living avail the medical healthcare at the very same institution and that joy has now turned into a misery” said the highly disappointed professor. No doubt my meager experience at the place did second her opinion. “200 crores have been allocated to this government institute ‘Doctor Sahib’ in the new state budget for this session” said a representative of a million dollar pharmaceutical company waiting to endorse the medicines not available in the government stock. Silence filled the room and the compounder called in the next patient.
Nothing new about these announcements if you ask me as this was a continuation to aids that the government allocates over years and are utilised* for betterment of healthcare. Sadly today’s article is partly about this asterisk.
With many new schemes and health programs every now and then, the government does benefit certain class of society but yet insufficient considering the humongous needs of this Indian subcontinent. So what should be done? Is this just another article full of criticism and bashing?
So how can the existing healthcare bloom and how modernizations of our healthcare system not stay as a distant dream.
I won’t shy away today by starting from the fact which i have witnessed over time that the major problem today lies in the proper execution and checks on the work by appointed contractors. People easily pay off a 40k earning project supervisor by a tiny part of crores worth tender they won in the auction.
If we talk about some ideas for the future, telemedicine is definitely there to impress. It was introduced to me recently by an enthusiast and some Google searches made me aware about its valuation of 32 million US dollars by 2020. With telemedicine, 67% population of this Indian subcontinent i.e. the rural areas can be extensively boosted by the low cost consultation and diagnosis facilities by the internet connectivity. In recent years, medical research enthusiasts are talking about latest terms like IOT in healthcare, e-health, app based assistance, online ambulance booking and some big data analytics. Medicine is definitely changing and for modernization of government healthcare today , these things will surely come in handy.
I recently got an opportunity to attend an undergraduate medical conclave which made me witness some brilliant ideas that day. Our own idea for that evening of enhancing the organ donation with application based tracking, insurance schemes and voluntary clause inclusion makes me feel proud but somehow down the wire also makes me think if the existing infrastructure could handle it effectively.
In a letter dated on 9th July of last year, creation of ‘All India medical service was given a thumbs up to bridge the gap for Central health service doctors who have never worked in the indigenous states and for improving leadership and management at all levels. Medicine being a state subject would definitely benefit and run towards the goal of modern and efficient healthcare today in ‘2.019’.Reduction in tax levy as a support by the government for making India a healthcare hub or providing infrastructural aid with aims of strengthening the existing system, there could be many options we can look upon.
A pilot project, funded by the Greek Ministry of Health and Welfare and the EC supported the Program ‘INTERREG II’ to establish an advanced and integrated web-based information system that can process and move information in real time, allowing public health authorities to monitor events at hundreds or thousands of public health facilities at once. If this works out maybe it can be a solution for the gaps that exist today. According to the 2014 RUPRI Health Panel report, Access to Rural Health Care – A Literature Review and New Synthesis, barriers to healthcare result in unmet healthcare needs, including a lack of preventive and screening services and treatment of illnesses.Creating healthier rural communities is one of the most important aspects to improve healthcare at the primary level and with engagement of a variety of stakeholders this may not be a distant dream. Some brave steps, open challenges, good approaches and you may watch someone else writing about how progressive our system got over years.
With the globe set to witness the world’s largest democracy undergo it’s another exercise this year, the budget of whooping 7 billion dollar (50,000 crores) could have done wonders for so many things besides only promoting promises.
‘Together we can do, WHATEVER IT TAKES’.