A Need For Medical Reform In India


In August, nearly 400 children’s deaths were reported at a public hospital in the northern Indian city of Gorakhpur in Uttar Pradesh, one of the poorest regions in India. The unexpected surge of mortality rate placed India’s healthcare system under international scrutiny. Allegations have been made against the hospital, where oxygen supply was suspected to be cut over unpaid bills. While state officials admitted that oxygen supply was disrupted, they claimed the child fatalities were due to different complications and infections. Prime Minister Narendra Modi mentioned the tragic incident in his independence day speech and asked people to stand with the grieving families. An inquiry was also ordered by the state government to investigate the incident.

The Indian Constitution stipulates that the ‘right to life’ is fundamental and obliges the government to ensure the ‘right to health’ for all. In principle, government health service is available to all citizens under the tax-financed public system. Yet, difficulties in accessibility compel households to seek medical service in the private sector, resulting in significantly higher payments. Tracing back in history, India’s Ministry of Health was established with the independence from Britain in 1947. The National Health Policy was then endorsed by the Parliament in 1983 and had aimed to provide universal healthcare services to the public by 2000. Little would have anticipated that healthcare inequality is still a substantial social issue faced by the government in 2017.

Various factors contributed to exacerbating the problem. Some said the severe rural and urban divide was a significant factor. A staggering 70% of the population still lives in rural areas and has limited access to adequate healthcare service. As a result, the rural population relies heavily on alternative remedies or governmental provisions. With the second largest population in the world and an average population growth rate of 1.3%, India faces a pressing need to address its basic health concerns. Despite all this, the Indian government spends only one-third of the country’s total healthcare budget on primary healthcare services. This begs the question, where has the remaining budget gone? A survey released by the Indian office of Transparency International, an International NGO working against corruption, citizens ranked the health sector as the second most corrupted sector, with the police force at the top of the list. Combatting corruption and restructuring the government’s budget plan in effect to divert resources towards rural healthcare is greatly needed in India.

According to surgeon and Indian healthcare author, Atul Gawande, India’s public health system is one of the most complicated in the world. He illustrates the situation by telling a personal story. His grandmother died of malaria before the age of 30 due to the lack of malaria drugs in the village she lived, although his aunt lived into her nineties and his grandfather until 110. “Simple things like clean water, more irrigation, more crops, more affluence added years to people’s lives here. Public health, sanitation and antibiotics also helped,” Gawande claimed. As life expectancy in India increases, the needs of Indian people have become wider. A healthcare system which focuses primarily on infectious diseases will find it difficult to cope with newly emerging illness. Therefore, it is crucial that India invest resources into all areas for a well-rounded healthcare system.

Recently, the Healthcare Federation of India said the country was experiencing a shortfall of nearly two million doctors and four million nurses. The issue is particularly prominent in rural areas where it is estimated that more than 60% of primary care visits made by villagers are to fee-charging unqualified practitioners, known as ‘fake doctors.’ They are not professionally trained and pose a threat to villagers in rural areas. Ridiculously, instead of training real doctors, some organizations have started to provide medical courses to these ‘fake doctors,’ so as to meet the severe shortages of medical officers. However, since they have not undergone proper medical training, they are still very prone to making false diagnoses and over-prescribing medicines. More efforts shall be devoted to safeguarding the prescription of medications in order to avoid further medical complications such as antibiotics resistance.

India’s fragile health care system heaps repeated indignities on its people. Patients have to travel across the country to seek health care, living on sidewalks for weeks while waiting to be seen. Some are left untreated because ambulances refuse to help. Oxygen supplies in hospitals are cut off randomly. All these inhumane practices are happening on a daily basis in India. To truly provide universal health service to the public as promised in the Constitution, politicians should proactively bring debates regarding the issue to parliament and enact suitable laws for medical reform.