NETA, ABHINETA AUR JANTA

Public Healthcare System, COVID-19 and Our Leaders

Punjab Today

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Why public health care system is not trusted by our leaders?

WHILE the government continues to deny coronavirus community transmission, last night the number of cases crossed 18 lakh and deaths crossed 38 thousand. The case load is growing at above 50 thousand a day and above 700 deaths. The last 17 lakh cases have come ever since lockdown 3 ended May 17.

In the past few months of ‘living with COVID-19’, the most high profile case happened yesterday. The Home Minister of India, Amit Shah tested positive. He has been rushed to Medanta, a top private hospital in Gurugram. A few weeks back Amitabh Bachchan was detected positive, he was rushed to a top private hospital Nanavati in Mumbai.

Other top politicians and administrators detected positive in recent days are: Delhi Health Minister, Satyender Jain, taken to Max Hospital, Delhi; Madhya Pradesh Chief Minister, Shivraj Singh Chauhan, Chirayu Hospital, Bhopal; Karnataka CM, B. S. Yediyurappa, Manipal Hospital, Bengaluru; Tamilnadu Governor, Banwarilal Purohit, Kauvery hospital, Chennai.

These are not only high profile leaders but also responsible for the state of affairs of our public health care. Why do they prefer private hospitals and not trust the public health care system of the nation? Is this the kind of example they want to set for the common person?

The coronavirus outbreak has shown us many things but most of all two: a) how our national healthcare system is in shambles, b) how an unscrupulous government can use the opportunity when no one can protest to implement all sorts of draconian policies – opening key sectors to private and foreign investment, agricultural ordinances to let private parties profiteer at the cost of farmers, now the New Education Policy which pushes higher education further out of the reach of underprivileged classes.

On the Public Healthcare System, the normal understanding is that our shift to neo-liberal economic policies in the early 1990s led to erosion of the system. But that is half the story. The core structural issue is the 73rd and 74th amendments to the Constitution in 1993. Generally, it is perceived that these amendments were watershed changes in our democracy because they empowered local bodies—panchayats and urban municipalities. However, they have proven to be a double-edged sword.

Among the twenty-nine developmental activities assigned to local bodies which have a direct and indirect bearing on health are: health and sanitation (covering hospitals, Primary Health Centres, and dispensaries), family welfare, drinking water, women and child development, and the public distribution system.

The period in which these amendments were introduced was also the era of our nation’s move to neo-liberalism which focussed on industrialisation, foreign investment and the creation of an urban middle class. This direction of our economy meant lesser funding for local bodies—which were also dealing with huge issues of corruption—leading to a neglect of key health sectors. This has eroded our nation’s health care system.

Contrast this behaviour of above mentioned leaders with the example of previous prime minister Manmohan Singh. In 2009, Manmohan Singh needed a bypass surgery in which five grafts were done to overcome multiple blockages to heart in an operation that lasted for a little over eleven hours. The operation was conducted at the All India Institute of Medical Sciences (AIIMS), New Delhi.

It was the same with former PM and Bharat Ratna Atal Bihari Vajpayee, who was admitted to AIIMS with a kidney tract infection and chest congestion at AIIMS in June 2018 and passed away at the hospital. Same was the case with former External Affairs minister Sushma Swaraj, former Finance minister Arun Jaitley, both in 2019.

Arjan Singh, the only officer of the IAF to be promoted to five-star rank, equal to a Field Marshal in the Army, also passed away at the Army – and hence government – run Research and Referral Hospital, New Delhi in 2018.

Bureaucrats, public policy experts, doctors and administrators say that even if we were to re-establish our primary health care, it would take decades to earn back people’s trust in them. The coronavirus pandemic gives us a chance to leapfrog across the time gap. Build credibility in the public healthcare system.

Unfortunately for the nation, instead of leading from front, it is the leaders who are setting a contrarian example.

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Punjab Today

Punjab Today

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