Representative image. Photo: Marcelo Leal/Unsplash
The medical fraternity of India is a highly educated and hard-working class of people, but unfortunately, a pall of despair and uncertainty looms over its members. This life-saving profession is often taken for a ride by all ill-behaved patients and their relatives, unintelligent leaders, an oft-inconsiderate judiciary, undue interference by bureaucrats and misguided media narratives.
Medical treatments have also become quite costly, and increasing out-of-pocket expenses have been implicated in increasing poverty. An important part of the problem here is lawmakers. If our governments had spent enough of their budgets on healthcare and improved government hospitals, the poor and the middle class wouldn’t have to turn to private hospitals for medical care. With just about 1% of India’s GDP allocated to healthcare, our leaders have practically left the people’s health to their luck and fate.
Many of the investments that our lawmakers make are also designed to provide returns in the short-term, with no eye on longer term goals. And while bureaucrats may be powerless in this regard, it is surprising that the judiciary has also been silent vis-à-vis meagre allocation towards medical care. And for all of these actors and institutions, private hospitals and doctors have become easy foil for their own inadequacies and failures.
Unfortunately, the medical fraternity has no strong authority in government to press its views, and is set to become even more voiceless under the National Medical Commission Act 2019. In addition, doctors in government service, however qualified and dedicated, have to serve under often less-qualified bureaucrats and with meagre allocations, so it’s not surprising that many of the more talented, entrepreneurial minds of the fraternity have preferred the private sector.
The result is that India has numerous private hospitals providing world-class medical care on par, or even better than those in developed countries, and often at lower prices – even as our government facilities remain far behind. And having demoralised the public health sector, bureaucrats and political leaders turned their focus and ‘efforts’ to the schemes tailored for private facilities, like Ayushman Bharat across India and Aarogyasri in Andhra Pradesh.
Despite the hype and propaganda, the various schemes that offer free corporate healthcare only degrade the government health sector while doing no real good to the poor. If our leaders invested the same funds towards strengthening government hospitals, the poor and the needy will automatically be served better. But ‘corporate healthcare to the poor’ appears to be a more powerful slogan than ‘better care in government hospitals’.
If the government really wants to improve the healthcare standards of the nation, it must first set aside its populist strategies, and endeavour to empower the medical fraternity in matters of healthcare matters, instead of demoralising them. The government should make the National Medical Commission a powerful and autonomous body in healthcare policymaking and administration, and introduce an ‘Indian Medical Service’ – along the lines of the IAS and IPS – for medical professionals, so that they are appointed as members of the council and assist the government.
The government must realise that the people’s health is as important as national security, and must allocate due share of funds for the health sector. The Union health health ministry, strictly following the recommendations of the medical council, must present an annual health budget in Parliament.
These steps together will infuse a measure of discipline and focus in the fraternity, and encourage them to participate in government service. A medical council that is more efficient and genuine with respect to regulating its members, both in private and public sectors, is also an institution capable of effectively mitigating, or even eliminating, medical malpractice and quackery.
As we all know, tens of thousands of students compete every year with each other to enroll in medical colleges, study hard for many years and graduate as doctors in a variety of fields. After all this work, it is a pity that they end up being overseen and administered by a system that is indifferent to their priorities, the priorities of the care-giving enterprise and ultimately to the nation’s health itself. I hope the medical fraternity gets its due soon so that it may dispense its duties to the best of its ability.
Dr Srinivasa Rao Gonuguntla is a practising general and laparoscopic surgeon in Srikrishna Hospital, Narasaraopet, Andhra Pradesh.