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Has India’s public health system collapsed?

In a hard-hitting op-ed this week in The Hindu, former Health Secretary Sujatha Rao bemoans “the absence of a well thought out policy framework for strengthening the health system.” She accuses her former political masters of “knee-jerk solutions and unintelligent tinkering” and the states of responsibility for ineffective insurance schemes:  “new dimensions of fraudulent and corrupt practices have entered the health sector that continues to register inflation at 30 per cent, with negligible impact on reducing catastrophic expenditures, impoverishing millions in the process.”  As the former head of the bureaucracy in the Ministry of Health and Family Welfare, she should know about these things. It is a provocative and thoughtful piece that is sure to stimulate much discussion

A Union cabinet minister said in November that India’s public health system had collapsed, according to the same paper, The Hindu. Even the venerable Hindu is probably not immune from media hype but their standards are pretty high and Jairam Ramesh did probably say what is reported: “even poorer countries like Bangladesh and Kenya have superior health indicators.”  A bit of this is probably on message: there will be new health initiatives from the UPA government before the next general election but a lot of the speech is very off message if Ramesh did not acknowledge the government’s own perceptions of the success of the National Rural Health Mission. No-one can argue that Ramesh put his finger on the issue of proportion of healthcare delivered by the private sector in India and how unusual that is by world standards. Ramesh has a reputation for independent thinking but this may be a little too independent for the tastes of some of his colleagues.

Is health finally becoming a viable topic of national political debate? Let’s hope so.





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