National Health Policy
I think he National Health The policy is a very welcome step. It was formulated in 2017. But I feel like it should be enforced because we’ve been talking about this stuff a lot, but until it’s enforced, it’s going to stay on paper. And there is a lot of talk. For example, the policy says that we will spend 2.5% of our GDP on health care by the year 2025. But I don’t see that happening. In fact, the health budget has been cut. So do we really need to put our money where the mouth is or do we really need to lead by example as they say. That is why it is important that everything the government commits is enforced. Therefore, it must be made legally enforceable.
Sanitary standards for infrastructure
As for the health standards for the infrastructure, I think they are centralized, which is not the right thing to do because every state is different. And within the state, there are so many differences. So it will be very important, and then also, health is a State issue. Therefore, it is very important that each state calculates for itself how many PHCs it should have, how many sub-centers, how many CHCs, etc. So I would like to see infrastructure standards defined very broadly, and it would be up to states to do this kind of micromanagement on them and decide where to put what infrastructure.Health: Collaboration between states
I think there’s a great need for cross-state collaboration, because some of the southern states, for example, have done very well in health care. Some of their interventions, such as hospital cooperation doing all the procurement, have been adopted by other states like Rajasthan, but we really need to take the best practice from each state and showcase it nationally. Perhaps the Niti Aayog or some other national body could do this. And so that would be a win-win situation and a learning curve for all post-COVID states.
Health Care: Post COVID-19
There has been a lot of introspection and also thinking about how the whole system collapsed during COVID. because the infrastructure simply couldn’t handle the huge load. So I think it will get states to think about how to bolster the infrastructure. Also, I think it will give a big boost to telemedicine. Because we saw that even in places like Delhi, people were communicating with doctors on the phone, making payments over the phone, and getting treatment and diagnosis over the phone, and the way of dealing with COVID was mostly done over the phone. So, I think that’s the way to go for the future.
I think Ayushman Bharat has definitely been a game changer in that he put health insurance in the spotlight and provided health insurance to the poorest of the poor. And the second aspect of this was the wellness centers. But I think the tracking hasn’t been as accurate as it should be, because of the magnitude of the project. There are more than 1.5 lakh centers, sub-centres and PHCs that are to be converted into health and wellness centers. There has to be a very precise type of program in terms of phases, and monitoring the bases to see how it is being done because it is very, very ambitious, I think it is still missing. And of course, the participation of the community has to be there. Many NGOs have also entered the fray and are doing a good job. But overall, I think the supervision aspect needs to be strengthened.
Primary health care has really been neglected by all states, with the result that around 70% of our population actually goes to the private sector. If you look at the big picture, it’s a very sad comment on the state of affairs. This will only improve once the states, as well as the center, commit to that 2.5% of GDP. We are very poorly financed unless financing improves. I do not see that primary health in Primary Health Care has the importance it deserves.
NGO in health
I feel like NGOs in healthcare have a very important role to play because community involvement is something we’ve been trying since the beginning of our planning programs and we haven’t really been that successful. So NGOs can really step in where health systems are weak. For example, I saw a health center run by WISH, where telemedicine is combined with a drug vending machine called Swasth ATM, in one of the remote areas of Rajasthan. They linked up with the Jaipur Medical College. So they were able to show the patients directly via telemedicine to these doctors who are sitting in Jaipur. And as soon as the drug was prescribed, if it was available, it was made available to those patients that same day. So that was a wonderful demonstration of how NGOs can bolster our infrastructure, which is really lacking.
Association with WISH
My association with WISH, which is the Wadhwani Initiative for sustainable health, goes back a few years back when Mr. Sunil Wadhwani first approached me. It’s like a mini-Bill Gates. He made money from it in IT in the United States. And he is investing it again, totally selflessly, in the health of Indians across the country, with the enormous ambition of touching more than a million lives. So, he struck me as someone really committed and genuine, and we find very few people like him these days. And I feel like WISH is doing a great job.