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Reforming Healthcare Systems

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July 21, 2017

What is the issue?

  • The West Bengal Clinical Establishment Regulatory Commission has fined Apollo hospital chain Rs 30 lakh over the death of a 4-month-old.
  • The commission was set up in response to widespread public protests over mistreatment and overcharging.

What did the WHO recommend?

  • WHO representative in India had sought regulation of the private healthcare sector.
  • It also asked the government to consider tax based financing of universal health coverage.
  • This, along with a degree of regulation of private delivery can achieve something meaningful.

What is the present state of healthcare?

  • There is a massive shortfall in state delivery of affordable healthcare.
  • Therefore, people are forced to turn to private deliverers and becoming prone to overcharge and underserve.
  • Over 80% of what Indians spend on healthcare is out of pocket.
  • In 2016-17 state and central governments spent 1.4% of GDP on health compared to a global average of 5.99%.
  • The far greater challenge is to improve the quality of management of the public health service.
  • So that the enhanced state funding translates into at least somewhat acceptable delivery.

What are the problems?

  • Lack of functioning primary health centres across the country which have doctors, paramedics and a stock of essential medicines to distribute.
  • Over concentration of new super speciality hospitals.
  • A lot of investment has been made in equipment but there is often an issue with staff being posted to run them.
  • The national doctor patient ratio is poor compared to international benchmarks, but the ratio for rural areas is even worse.
  • This is because doctors are reluctant to move out of urban areas.

What might be an effective solution?

  • Make district hospitals into teaching hospitals where a preference is given to local students.
  • This increases the hances of them working in areas where they come from.
  • Rural areas also face a severe shortage of paramedics.
  • Have more nursing colleges and train the students to become ‘nurse practitioners’, who can deliver basic diagnosis and prescribe essential treatment.
  • Two-year courses for nurse practitioners in critical care have been started.

 

Source: Business Line

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