Heal the System
The government needs to take innovative measures and overhaul the entire healthcare delivery system in the country to accomplish its Health For All Mission….
By Dr Pranav Ish
The state of healthcare delivery and medical education (complementary to each other) is far from satisfactory in India. We are suffering from a paradox of plenty, our country having an astronomical population of around 1.36 billion. As per WHO guidelines and parameters, a country should have at least one doctor per 1000 persons. Unfortunately, we have a doctor-population ratio of 0.62:1000 only.
Healthcare delivery system is primarily divided into two segments: public and private. The budgeting for healthcare is very inadequate as only 1.3% of GDP is allocated to healthcare as against, globally average of 5%. Even the non-descript countries allocate more funds for the robust health of the people as compared to India.
The medical travel worldwide is to the tune of $97 billion, but India gets only 1% of it notwithstanding that in India cost of healthcare is 1/10 as compared to the US and 5 times of the European zone.
The main cause of this pathetic situation particularly in the govt hospitals is because of the low number of seats created for MBBS/MD/MS/DM while the seats are enormous in the private medical colleges which are deficient in respect of infrastructure, teaching faculty and the patient intake and care.
Students and doctors during under-graduate, post-graduate and super specialization are subjected to enormous pressure because of total mismatch of the number of doctor vs patient ratio hospitals. They live in abject inhuman situations and many a time suffer from various ailments like depression and stress.
Medical education which is long drawn trajectory without any assurance of getting good jobs is the reason the doctors in the course of their studies get frustrated because they are not only subjected to dirty environment, pranks and sarcasms of seniors but quite often are assaulted by the attendants of patients.
Let us rise to the occasion, make medical colleges sufficiently equipped and expand the number of doctors to take care of the precious health of the citizens of the country.
1. Good number of medical colleges can be opened which even may be smaller in size of producing 20/25 doctors thereby needing smaller space and less number of faculty. These mini colleges can be opened at various places including district level hospitals where infrastructure is already present.
2. For secondary and tertiary healthcare, big hospitals should be expanded to allow super specializations. The resources of corporate houses can be taken under their CSR initiatives so that the colossal shortage of doctors and the infrastructure is overcome.
3. The course module of MBBS can be reduced to 4 years instead of 5½ years up to graduation level so that more and more doctors are made available to the society to take care of the big segment of people for primary illness.
4. There should be social audit of the working of all hospitals at timely intervals so that every penny marked for the healthcare is judiciously used and not wasted or plundered.
5. The officials can make surprise inspection in the medical colleges and hospitals so that the staff in these institutions are always on their toes and no procrastination takes place.
It is fervently hoped that the above-mentioned suggestions will be acted upon in the larger interest of the billion-plus nation.
(The author is Assistant Professor, Department of Pulmonary, Critical care & Sleep Medicine, VMMC & Safdarjung Hospital,