A time there was, and that too within living memory, when there were few private corporate hospitals, and those set up and run under the auspices of the Central and State governments were the primary, if not the only, source of healthcare, even for the prominent and affluent sections in various walks of life. Indeed, every State had its own pick of legendary names in the medical profession to conjure with. Even today, public hospitals boast some of the best doctors who are renowned in the disciplines they practise.
The services provided by the State hospitals were mostly free, and at the same time were also of reasonably good standard.
This was attributable not just to the facilities and equipment which were the latest to be had at the time, but mainly to the leadership and commitment of those in charge of them. In the last three or four decades, there has been a proliferation of private corporate hospitals and diagnostic clinics. The private sector stepping into a field of activity of such vital concern to the people is to be welcomed. The findings of surveys held from time to time show that large numbers are taking recourse to private hospitals. To the extent this happens, the public hospitals suffer from apathy at the hands of the governments themselves.
ON THE GROUND
However, the surveys themselves are to be taken with three reservations:
One, they reflect most of the time only the mindset of reasonably better-to-do people living in urban areas; two, the surveys themselves are mostly undertaken and funded by bodies engaged in furthering the interests of private sector medical and healthcare establishments; and three, other than gradings by self-appointed international agencies whose credentials have themselves not been subjected to clinical and critical scrutiny, the quality of services the patients receive from private corporate hospitals have not been brought under social or community audit with the participation of a significant number of patients.
Particularly in the case of private diagnostic clinics, in the absence of an effective enforcement of comprehensive registration, licensing, grading and evaluating system, there is no knowing how many of them conform to the strictest standards of testing methodologies.
The position on the ground is that but for the enormous range and reach of the state medical and public health services, predominant numbers of people all over India, especially the poor and vulnerable sections and rural populations, and more especially those living in far-flung and inaccessible areas, would stand deprived of timely and minimum necessary healthcare.
The Government, on its part, has also been launching missions such as those focused on rural and urban health and on control of particular diseases. But these efforts have been ad hoc and fragmented.
LACK OF TRUST
If the Government sector medical and health services are to measure up to expectations in regard to efficiency and quality, then the first step is for the people to have faith in them, and for those in leadership positions to set an example in this respect by demonstrating their own willingness to patronise them.
Only by doing so can they raise the self-esteem in those running public hospitals and instill in them the needed enthusiasm to improve their functioning.
Undeniably, the lack of trust is one of the main reasons contributing to the low morale of doctors and staff, as also the poor maintenance, of public hospitals.
Unfortunately, the lack of trust of the rich and the famous does not stop with public hospitals; it extends to the entire medical and healthcare sector of India as evidenced by their rushing abroad even for treatment of ailments for which talents, expertise and facilities are available in India itself in ample measure.
I think the time has come for the Government to make a quantum leap in its thinking and embark on an all-encompassing and nation-wide mission to convert all government hospitals into centres of excellence, holding their own with private hospitals and even becoming brands in their own right.
For instance, the mission should result in a vigorous and purposeful drive for making government hospitals institutions of the first resort even for those enamoured of private hospitals.
A country’s mental and intellectual stamina essentially depends on the quality of health, and therefore, of life itself, and a country like India can never ever have enough of attention paid to healthcare.