Ashwini Choubey, a health minister from Bihar, has accused Bihari patients of overcrowding the All India Institute of Medical Sciences (AIIMS) in Delhi – and says doctors should turn them away.
A ‘BJP veteran’ appointed in September, Choubey has been roundly criticised for remarks allegedly made at the launch of Mission Idradhanush, an immunization drive earlier this month. The minister reportedly accused Bihari people of ‘unnecessarily crowding AIIMS…even for minor ailments that could be treated at home.’ Calling AIIMS ‘a premier institute’, Choubey added, ‘I have directed the doctors to send such patients back.’
The BJP have claimed Choubey was misquoted. Mangal Pandey, the state’s health minister, said Choubey “was trying to say that the newly constructed AIIMS in Patna will be developed at par with the AIIMS in Delhi.” As such, ‘there would be no need for the people of Bihar to visit Delhi for treatment.”
‘Insulted and hurt’
This has not been mitigated the upset felt by many over the comments. Among the offended is social activist Tamanna Hashmi, who has filed a complaint with the chief judicial magistrate (CJM). Hashmi reportedly felt ‘insulted and hurt’ after reading Choubey’s remarks as reported in local newspapers. He is seeking a first information report (FIR) charging Choubey with ‘intentional insult with intent to provoke breach of the peace’ and ‘criminal intimidation.’ Both are offences under sections 504 and 506, respectively, of the Indian Penal Code (IPC).
Doctors have also been critical. Shah Alam Khan, an AIIMS professor, wrote an open letter to the minister titled ‘Sorry Minister Saheb, I will continue to treat poor patients from Bihar or anywhere else.’ Khan writes, “as doctors, we cannot (and should not) refuse treatment to any patient based on their region, caste, creed, religion, gender, social status and nationality. It is not only morally incorrect but actually illegal to do this.”
“Overcrowding at AIIMS is not a problem caused by Biharis”, Khan adds. “It is a problem created by the poor infrastructure of healthcare in the country.”
An editorial in the Hindustan Times echoes Khan’s statements. Calling the remarks “callous and uncalled for”, the HT writes “Choubey should focus on improving the healthcare facilities in smaller centres rather than discouraging patients from accessing premier centres like AIIMS Delhi.”
Healthcare in Bihar
Whether Choubey was misquoted or not has yet to be clarified. What the controversy has done is shine a light on public healthcare in Bihar. In particular, it spotlights its accessibility – or lack thereof.
Bihar’s doctor-patient ratio is among the worst in India. The state has just one physician for every 25,000 people. For every 10,000 people, there is just one government hospital bed.
The lack of adequate public healthcare facilities means “Bihar has the highest dependence on private health-care services among Indian states”, as reported by The Telegraph last year. As a result, “an estimated 22 lakh households face “catastrophic” health expenditure.” This is a countrywide problem. As previously reported by Health Issues India, out-of-pocket expenditure on health accounts for two thirds of health spending in India.
The National Family Health Survey (NFHS) for 2015-16, meanwhile, reveals just 12.3 percent of Bihari households have at least one member covered by health insurance. This further limits their ability to access essential treatment.
Professor Khan notes in his letter, “if there are medical setups that are delivering, patients should not be denied entry due to overcrowding. The poor are reasonably intelligent, they flock to places they trust.
“Please let them continue to do so,” he concludes.