Intro: As a symbolic beckon, it is fine to take health a justifiable right, but as citizenry it would be unwise to let the policy debate be taken over by non-issue, or remain pleased by a piece of legislation.
The Draft National Health Policy 2015 (NPH) is revealed by the Government of India for public interpretations. It deserves to be looked at strongly in the context of the affirmed object of the Government and the people of attaining economic growth with equity. For, physical and mental health of the people is a key part of growth in any area of human endeavour. The positive dimension of mental health is stressed in the World Health Organisation’s (WHO) definition of health as contained in its constitution: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.” The description is so wide that Jawaharlal Nehru stated that if we could achieve this, every problem in the world would disappear.
The draft policy has rushed at a time when the time limit (2000-2015) set for aiming at the Millennium Development Goals is fast closing in another eight months. More than couple of goals out of eight goals in this document are concerned with individual and public health and considerably resolve a country’s national health and its global rank in the Human Development Index. Health and Development are inextricably unified each banking on and also supporting the other. Good health is fundamental for productive life; development is needed for maintenance of good health.
The draft policy states its dream: “The Centre shall enact, after due discussion and on the request of three or more states, a National Health Rights Act which will ensure health as a Fundamental Right whose denial will be justiciable. States would gladly opt to approve this by a resolution of their Legislative Assembly…Such a policy formulation/resolution, we feel, would be the right signal to give a push for more public expenditure as well as for the recognition of health as a basic human right and its realisation as goal that the nation must set itself.”
Is India in a position to make health a Fundamental Right? The question is pertinent, but the answer won’t appear quick. We declare with one voice our belief in the right to food. We were brave enough to legislate on the right to education regardless of several known obstacles in the path. But elevation of health as a right appears on the face of it a complicated task. Is health opulence restricted to the well off and those who can meet the expenses of the cost or is it something indispensable to normal living of all citizens? The latter holds a humane approach and hence, we need a policy and programmes, institutional preparations, qualified manpower, and essential equipments – everything within the reach of all to lead a healthy life.
Health is a State subject under the Indian Constitution. It contains public health and sanitation, hospitals and dispensaries. Insanity and mental deficiency including spaces for reception or treatment of lunatics and mental deficients, medical professions, prevention and extension from one State to another of infectious or contagious diseases or pests affecting men, animals, or plants are under the Concurrent List. The Constitutional arrangement is such that the mutual aid of the states is a must for the success of the national health policy.
The goals, placed in the draft policy, are achievement of the highest potential level of good health and well-being. The key principles underlying the policy are to endorse equity, universality, patient-centred and quality care, pluralism in the sense of heartening different medical systems in vogue in India – allopathic and indigenous, subsidiary systems comprising healthcare contributors at different levels, and also some other imperative qualities like responsibility, professionalism, integrity and ethics, learning and adaptive systems, and affordability.
The policy document, like an election manifesto, is undoubtedly venerable and inclusive, but appears to be projecting a fantasy world far detached from the real. The existing healthcare position presents an absolutely different image leaving a stupendous accountability on the executors of the policy to accomplish the goals offered. For sure, we know how much needs to be done. Western industrialised nations have ratified laws granting right to health. In the US, Medicaid is a joint federal-State programme devised originally to persuade States to acquire greater share of the financial saddle for health. National standards are fixed for State programmes.
Like Brazil and Thailand, India has to improve the stipulations of its public hospitals so that public can depend on them. It needs to construct the infrastructure needed to support its vast population. At last, India also has to work out its finances so that this welfare move doesn’t place the country in financial troubles. On the other, the Narendra Modi Government needs to carry out lots of ground work before making health as a Fundamental Right.
Mithun Dey (The writer is a senior columnist)