AILING HEALTHCARE SECTOR IN UTTARAKHAND, STILL SUFFERS FROM GOVT’S APATHY

Mukesh Devrari

India is facing a severe health crisis, not due to coronavirus, but in general due to the neglect of the healthcare sector for generations by the various union and state government since independence in 1947. Over the years, governments’ have given de facto acceptance to the idea that universal healthcare is not possible in India. So, those who cannot afford healthcare should die as human society is also akin to a jungle where only fit has a right to survive. This narrative only shows the medieval mindset prevalent in India.  

BJP and Congress are equally responsible for the terrible situation of the healthcare sector in the state of Uttarakhand. Over the years, neither central nor state governments have allocated adequate funds to the health sector. Not enough hospitals, nursing colleges, pharmaceutical institutions were created in the state.

Health and education are the two most crucial sectors to ensure opportunities for upward mobility. People expect that the government will ensure universal access to healthcare and education, but nothing has been done to achieve these cherished goals. Rather than investing in building new hospitals, the Uttarakhand government preferred to provide healthcare insurance to the people as a panacea for all troubles in the healthcare sector.

Uttarakhand has seen a large-scale corruption due to the public-private partnership model to run hospitals and health clinics. It is one of the great examples of how bureaucrats and politicians abuse the PPP model. They make money by allotting many government hospitals to private companies. Under the PPP model, government hospitals were given to private companies or bids were invited from private companies to run government hospitals in Uttarakhand.

After winning the bids, the private entities paid money to the bureaucrats and politicians to ensure that there will be no scrutiny or audit of their functioning. In some cases, instead of the physicians, these companies appointed dentists in the hospitals to fulfil formalities on paper, most of the patients were turned away on the grounds that there are no medicine and facilities at the hospital, most patients were referred to other hospitals, particularly the large ones still run by the government, who are catering to lot more people than they are capable of, the result to they operate horribly.

The decision-makers (bureaucrats and politicians) have no qualms in playing with the lives of people as no one in government has any sense of care for fellow citizens. Politicians, albeit a few, will prefer such a system as it helps them in approaching the people during the elections, but nothing has been done so far. Due to ruthlessness, rigidity and cruelty of policymakers, people living in remote areas face most of the problems.

Health insurance fraud   

The govt. of Uttarakhand decided to provide insurance to all citizens. The panel of private hospitals was created. People were encouraged to access healthcare and government was supposed to pay directly to the hospitals. The system worked perfectly for some time. More than the patients, private hospitals were happy. Ordinary people also responded positively as they could choose the hospitals based on the level of service it provides.   

Soon, these private hospitals started inflating bills and the govt. officials involved in clearing the bills took the bribe and started clearing those inflated bills. Due to extreme corruption, the system collapsed earlier than expected. Govt. of Uttarakhand had no money to clear the hospital bills. The hospitals also refused to provide healthcare to people on the basis of government-provided health insurance as their pending bills were not cleared on time.   

As private hospitals in India are for-profit businesses, they are not doing any charity. So, the entire plan by govt. not to invest in building hospitals and appointing staff in the existing hospitals but to encourage private healthcare operators to benefit from the universal healthcare scheme collapsed. Although it looks promising on paper to provide healthcare to all citizens. If implemented properly it could have immensely helped the private healthcare service providers as well as people.

So far, there are countless stories of women giving birth to a child on their way to the hospital and dying on roadside or narrow waking lanes which connect villages to motor road. In fact, hospitals are a dream. But pain and the sorrow of economically weaker sections of society never bother our bureaucrats and policymakers.

Way forward

The government must create one hospital in every district with basic facilities. There cannot be any excuse for this. Access to healthcare cannot be ensured by piecemeal measures. There cannot be any short cut for it. The places like Dehradun have five medical colleges in fifty kilometres, but people in Chamoli, Rudraprayag, Pithoragarh, Champawat and other remote districts do not even have the one.

If you will allow me to compare our healthcare system with New Zealand. Kiwis don’t have any concept of paying for health and medicine. If you are ill, old and sick, you will get the best healthcare nation can offer. It does not matter whether you were an engineer or bureaucrat or a labourer all your life. Healthcare facilities are the same for every citizen.

End.