Healthcare System in India & National Health Policy

Healthcare System in India

“Lancet Report on healthcare – India is the poorest performer in BRICS nations”

Challenges faced by Indian Healthcare System

A weak primary health care sector + care provided in these facilities is also not up to the mark.
Unequally distributed skilled human resources & shortfall of specialists across country
Services inequitably distributed – Urban areas command 73% of the public hospital beds, even when 69% of India’s population resides in rural areas
Large unregulated private sector – Private practitioners have become first point of contact in both rural & urban areas – concern lies with Unethical and irrational practices widespread among private hospitals
Low public spending on health – Public health expenditure as a proportion of GDP remains low i.e. 1.15 %
Fragmented health information systems – weak systems for collecting data + non-inclusion of the private sector in data gathering
Poor Health Cover & high out of pocket expenditure – 80 % no health insurance
Weak governance and accountability owing to corruption in health care

There is a greater need of radical restructuring of the healthcare system in India to address challenges including weak primary healthcare and dismally low public spending on health – to assure health for all Indians by 2022. India needs to adopt an integrated national health-care system built around a strong public primary care system with a clearly articulated supportive role for the private and indigenous sectors.

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National Health Policy, 2017

Strengthening role of public sector by increasing public health spending to 5% of GDP by 2025 from current 1.15%
Recognizes need for state intervention to control NCDs as they are reason for more than 60% death in India
Collaborating & regulating the private sector as over 2/3^rd of services are provided by it
Seeks to invest in preventive healthcare viz.

early screening and diagnosis have been made a public responsibility

advocates 2/3rd or more allocation of health budget for Primary Health Care

Affordable quality healthcare for all

Intersectoral approach involving various ministries
Prioritizes addressing primary health care needs of urban population with special focus on poors
Mainstreaming AYUSH systems inline with allopathic professionals

Concerns

It leaves too much to the states on maintaining standards
Would require more human resources and funds
Health care target spending still Much lower than even other developing countries’ spending on health
It does not speak about social determinants of health
Various progressive measures under Draft NHP 2015 such as Right to Health and imposing health cess have been ignored

Thus, to achieve SDG on health, i.e., health and well-being to all by 2030, there would be need for greater and stronger Centre-state coordination and commitment for effective implementation.