PRECARIOUS HEALTHCARE

Source: The Hitavada      Date: 27 Aug 2017 09:45:38


Seventy years after Independence, we are still grappling with the problem of setting our healthcare sector in order. Private healthcare is beyond the reach of a majority of Indians, who still depend on government facilities. 

THE nerve-racking incident of children’s deaths in Gorakhpur, that too due to alleged disruption in oxygen supply, has not only made national news but also drawn the attention of international media and it raises concerns about the condition of our precarious Government healthcare facilities.

This is not an isolated incident. Close on the heels of Gorakhpur incident, another such incidents of death, possibly due to the same reason was reported from Raipur’s Ambedkar hospital. According to information, three children died in the State run medical college hospital after the oxygen supply was allegedly disrupted for half an hour because of which the incident occurred.

Though the hospital management earlier denied any such mishap, sources informed that the cylinder operator identified as Ravi Chandra in an inebriated condition slept during duty, thus disrupting the oxygen supply to the emergency ward.

Earlier, not many weeks before, an incident of disruption in oxygen supply leading to the death of a few patients was also reported from Indore’s M Y Hospital. Incidents of death due to negligence or whatever reason, especially in Government hospitals, and especially of children, is common across the country.

Not many months ago, West Bengal reported several baby deaths in a Government hospital. Earlier too, there have been incidents of baby deaths in the State. How or what happens is not exactly clear but it is surprising that despite repeated instances of such deaths, nothing much changes on the ground.

Seventy years after Independence, we are still grappling with the problem of setting our healthcare sector in order. Private healthcare is beyond the reach of a majority of Indians, who still depend on Government facilities. With the Government healthcare system in a shambles in number of States, majority Indians are thus always at a grave risk since the Government hospitals are not reliable. Public spending on healthcare is still much on the lower side that could be one reason for the lapses and lacunae as most hospitals are not that well resourced or equipped. Also, since it is a Government system, procurement and implementation of things are neither smooth nor fast.

These things hit the Government hospitals. Also, it must be factored in that most Government hospitals are overcrowded and doctors shorter in number than required or prescribed, which again leads to inefficiency and negligence, even if we ignore for once factors like corruption and relative unaccountability. The Gorakhpur incident, grave as it is by any measure, is not only a clarion call for all hospitals but also reflects a reality that plagues almost all Government hospitals which are nothing more than ticking bombs.

The problems which the Gorakhpur Hospital would be facing are general for almost all hospitals and unfortunately, for decades, they remain unaddressed due to systemic hindrances. The number of doctors vis-à-vis our growing population is already dismal which doesn’t in any way help the cause of health. The remote and rural areas are still largely underserved.

Lack of proper roads and power supply make life perilous for over 60 per cent of our population. Added to that, there is lack of probity— incidents are attempted to be hushed up and investigations are often botched, which leave reports inconclusive and thus reform measures are not taken. Unless we accept the truth and own up to our shortcomings, how could we go for a course correction?

Even in the Raipur, Gorakhpur and Indore or Bengal incidents, we would hardly ever know what exactly happened or who was actually guilty and whether or not the errant staffers have been adequately punished or the loophole plugged for good. There is no guarantee that such an incident won’t take place again because history shows we hardly learn from our mistakes and nor do we care.

Those being treated at Government hospitals are mostly from the lower middle or lower financial class and hence they are for all practical purposes a ‘voiceless’ groups, who could be neglected or ignored. It is a sin to accept or allow the smallest lapse in the supply of the life giving oxygen gas.

There are several ways this can be ensured and most hospitals have several backup plans so that if one system fails the other instantly takes over. There can be layers of checks and balances to streamline the process and make it flawless but understandably hospitals hardly adopt all the right practices and procedures, mostly because of lack of accountability, delayed Government approvals and inquiries, legal loopholes and underhand practices that always save the guilty.

The Government seriously needs to sit up and take control of the sector with iron hands. Health and education are basics of any society and unless the basic underpinnings are right, no society can progress. No wonder then that despite being an economic superpower of tomorrow, we are laggards when it comes to human development index.

No amount of military might or economic prowess ultimately matters if a nation’s health, education and infrastructure are in the doldrums. To be able to be counted in the rank and file of the developed and the greatest nations, we urgently need to spruce up the healthcare system.

Even sub-Saharan African countries and neighbours like Bangladesh and Sri Lanka have progressed by leaps and bounds in improving their health care status but it is an area in which we are woefully dubious for our lapses and preventable deaths. We lead in all parameters like infant mortality, maternal mortality, under-5 deaths, deaths due to TB, malaria and dengue and deaths due to road accidents. This simply points towards our yawning gap in demand and supply of adequate hospitals, doctors, equipment and communication network.

The process of lessening this gap, even if started today in all earnest, will take at least two decades to bear fruits. The Government must wake up to this stark reality and spend its resources effectively to modernise and streamline the management of Government hospitals so that these facilities stand out as dependable, most preferred, state-of-the-art, one-stop solutions to all classes and sections of people. The perception has to change.

The Government needs to open more medical colleges to boost the supply of doctors, mandate/incentivise doctors for serving in rural areas for at least some part of their career, enhance Government spend on healthcare by boosting infrastructure, equipment and communication network in rural and remote towns and villages, and instantly punish the guilty by fixing accountability and expediting the process of probe and reporting, that will pave the way for weeding out corruption too. By the way, a slew of measures need to be taken in tandem and the ‘mission’ mode must not stop unless visible improvement is seen on the ground.