Healthcare in our country is in a pitiable state. There is only one doctor for more than 1,500 people in the country on average. India lies in the lower half in a ranking of 190 nations in this aspect.
The abysmal state of government healthcare institutions across the country paints a picture of utter neglect. The government has not only been remiss in this aspect but also with regard to the paucity of healthcare institutions and the slow growth in their numbers.
The situation has become so bad that patients of the casualty ward at the Sriram Chandra Bhanj Medical College and Hospital (SCB), Cuttack, are being compelled nowadays to spend a lot of money at private establishments.
This is because the X Ray machine in the department, supposedly, has been lying defunct for more than 15 days. Some private agencies are also taking a huge sum for providing bedside X Rays. Whether there is or isn’t a connivance story behind this episode is impossible to allege either way.
The Superintendent of SCB has said that he opposes such activities inside the hospital and assured to look into it. However, merely making such statements will neither help the patients nor ensure that this immoral practice stops.
It is incomprehensible that the medical authorities are truly and blissfully unaware that such activities are going on inside the hospital. This is more so as some patients and social activists have reportedly tried in vain to take this issue up with the Superintendent.
It is incumbent, under the circumstances, for the hospital authorities to answer why crucial equipment such as the X Ray machine has been lying defunct for more than two weeks in the casualty ward.
They should be also answerable as to why no alternative arrangement was made for the patients in the hospital. They also should spell out why and how private agencies were allowed to operate inside the hospital to provide bedside X Rays. While saying this, we are aware that we all must be grateful for whatever facilities are, indeed, available to the needy patients.
On one hand, while condemning the authorities for allowing the institution to sink to such a desperate level, on the other we must also show gratitude to those who, for pure commercial profit, are offering, albeit illegally, some very essential life saving services.
The SCB story is not unique in this country where the root cause of the ills of this sector is that public health expenditure is very low compared with that in other countries. The latest figures of the WHO National Health Accounts Global Health Expenditure Database show that the government health expenditure in India as a percentage of the budget is a mere 4.55%.
This is pathetic and lower than even Bangladesh, Brazil and Indonesia, where the figures are 7.84, 6.93 and 6.63 respectively. The country also does not do well with respect to government health expenditure as a percentage of GDP. Here the figure for India is 1.28% while it is 4.66% for Brazil and 1.31% for Bangladesh.
These low investments in public health particularly hit the economically weaker states and the weaker sections of society. Sadly, vital and critical sectors like health and education have been chronically neglected by all governments in India.
The planners in this nation, so very busy in urging the populace to use Information Technology (IT) for financial and business issues, have been utterly disregarding the use of this facility’s tremendous potential to do greater public good.
IT is being used for advanced medical assistance across the globe while in India it does not figure even in discussions. Structural weaknesses also hinder some states in using the small funds that are being allocated. However, removing these weaknesses would itself require more resources.
The rural areas are the hardest hit by the lack of adequate funding as the healthcare system is skewed in favour of urban areas. This bias has resulted in more than 15 per cent of the rural population in the country not having access to healthcare facilities.
The infrastructure in rural areas is in a sorry state, with a 40 per cent shortage of community health centres (CHCs), according to a September 2014 India Infrastructure Report. CHCs also face a crippling shortage of medical personnel, including a 70 per cent shortage of specialists.
The government must increase public funding in healthcare and must also prioritise expenditure to ensure that the money is spent in areas where it is most needed. Policymakers must focus on tackling the dearth of infrastructure by creating more facilities and also define the minimum standards to be met.
Remedial measures have to be taken immediately. Otherwise, it would be difficult to revive the country from the already critical situation. While death is the eventual truth for everyone, a good and dependable health care system alleviates pain while alive!
