Even after decades of India’s indepen ence, our public health care system is not effective enough to accommodate the needs of 1.37 billion people. Indian politicians are in the process of dividing the standards of healthcare: better care for the wealthy; no care - or the worst form of care - for the poor sections of society.
When we look at the standards of care in our private hospitals, it is not only sickening, but raises serious concerns about the way in which the poor people (particularly in rural areas) have been treated by the state. In every village, you may be able to see a few multi-speciality hospitals, yet I am not sure whether we have a multi-speciality hospital run by the state. When we look at the basic reality of the rural people, those sections of society still rely on the agricultural sector for their living. Therefore, how can they afford to go to these multi-speciality hospitals?
If we were to conduct research on how people use social media to raise funds for their private healthcare, I’m sure you’ll be surprised to see that these people are predominantly based in agrarian society. Some of these stories of inhumane suffering are really heart-breaking, because the system has failed to function in the public care sector.
Is it not the fundamental right of the Constitution of India to access free medical care in order to preserve life; in other words, the fundamental right to life? Is it not the same constitution of India through which our politicians take oath to govern the country, but have they not failed in protecting their people? When the market forces are deciding the quality of medical care, it seems to be predominantly driven by profit-making motives. Should our politicians not be held to account for murdering our public health care system?
Prof. Shah Alam Khan, of AIIMS, New Delhi, wrote about the tragic death of a nine-year-old girl in Rajasthan. This poor girl was diagnosed a tumour on her knee; “a blood sucking leech”.
She was from an agrarian family in Jaipur and was receiving treatments from a private hospital in Jaipur. Her father owned a small piece of land, which he was cultivating, and which was the only source of income for the whole family.
He had no other option than to borrow money from local money lenders. This family had to pledge their only source of income to the money lenders and the money borrowed was pumped into the private hospital. Once treatment had become futile at the private hospital, they referred her to “AIIMS with a small piece of paper which curtly mentioned, referred to a higher center”.
Their stay in Delhi (where AIIMS is located) and other expenses and the exorbitant interests owed to the local money lenders, drove the father to sell his piece of land. Subsequently, the girl’s limb was amputated at AIIMS and chemotherapy was advised. However, this family could not afford to live in Delhi and returned to Jaipur. According to the hospital she “was lost to follow-up, for me, was murdered”.
According to NABARD 2016-17 survey,² “the average net monthly income of Indian rural households was Rs 8,059”. How would these sections of society even think of going to a private hospital for their treatments at a high and disproportionate level of medical fees, when 40% of the abovementioned income is spent just on food? Why are our politicians contemplating equanimity on the fundamental requirement for the existence of the people?
These politicians travel abroad for better medical care, because they don’t even trust the so-called multi-speciality hospitals and they simply catch a flight to more developed countries for better medical care at the expense of these poor people. Do they think the citizens of their country do not require adequate medical care and protection?
It is interesting to note that “public expenditure on health is $43 a year in India, compared to $85 in Sri Lanka, $240 in China and $265 in Thailand”. The Economic Survey of India 2017 reports that India spends only “4 percent of its GDP on health care - less than half of that in Brazil and South Africa”. More sadly, “there was hardly any mention of healthcare in Union Minister of Fina-nce Nirmala Sitharam-an’s maiden budget spe-ech”. The allocation for better rural health infrastructure is alarmingly insufficient and “the government’s own Economic Survey said rural health infra was crying for care”.
Why are our politicians not accountable? Honour-able Jawaharlal Nehru said at the Constituent Assembly: “The first [task] of this assembly is to make India Indepen-dent by a new constitution through which starving people will get complete meal and cloths and each Indian will get the best option that he can progress himself”.
Justice K Ramaswamy states: “Social justice is a dynamic device to mitigate the sufferings of the poor, weak, Dalits, Tribal and deprived sections of the society and to elevate them to the level of equality to live a life with dignity of person. The State should provide facilities and opportunities to them to reach at least minimum standard of health,”.
The Supreme Court held that: “The health and strength of a worker is an integral facet of right to life. Right to health is a fundamental human right to workmen. The maintenance of health is a most imperative constitutional goal.
The apex court held that “the right to life enshrined in the Indian Constitution (Article 21) imposes an obligation on the State. The Court stated that denial of timely medical treatment necessary to preserve human life in government-owned hospitals is a violation of this right”.
Despite all these efforts from the judiciary, along with other constitutional obligations, our politicians are doing everything to murder the public healthcare system without making policies to eliminate inequality in medical care. Should they not face legal action? How long can our politicians pretend or ignore that they know nothing about the lingering death of a system?
Modern politicians are behaving like Sir Cyril Radcliffe, the chairman of the Boundary Commission, who was selected because he knew nothing about India; thus an impartial border could be drawn, but even after decades of marking the boundary, it is still bleeding. If Sir Cyril Radcliffe was only selected because he knew nothing about India, our politicians are only selected because they know everything about their constituency. Yet why can’t they create a free and fair public medication healthcare system?
Dr B.R. Ambedkar said at the Constituent Assembly: “In politics we will have equality and in social and economic life we will have inequality...how long shall we continue to live this life of contradictions?”. Until the nation finds politicians who are committed to “listen to the silent voices of the poor” and in Parliament “put the welfare of the sick in front of every other consideration”, this contradiction will continue.
Whilst the politicians display the highest degree of irresponsibility, it is our duty to protect and safeguard the public health care system for the many. Mr Nani Palkhivala said in his famous budget speech: “The price you pay to be a citizen of a democracy is eternal vigilance, if you are not prepared to have eternal vigilance you are not fit for a citizen of a democracy, you have to fight for it”. Therefore, it is our duty to fight for it, to preserve and to cherish our public health care system for us and for the future generations.
(The author can be reached at firstname.lastname@example.org)...