How can health infra be upgraded and how can it be made affordable to all?
Awareness regarding schemes needed
The healthcare allocation in the Union Budget 2020-2021 was Rs67,484-cr which looks like a big amount but it is only about 1per cent of the GDP. With the next Budget just around the corner, this number must be increased to tackle any future pandemics. The government has introduced very good schemes like ‘Ayushman Bharat’ which provides an insurance cover of Rs5 lakh per family every year. But such schemes fail due to lack of proper implementation and awareness among people. Such issues need to be addressed on priority to ensure good healthcare for all as healthy citizens lead to a healthy nation.
Jatinderpal Singh Batth
Right time to revive medical services
Till the 1970s, the healthcare system in Punjab was healthy enough to provide diagnostic services to the community. Hospitals and dispensaries were adequately manned and functioned almost religiously. The wing expected to provide preventive medical service was visibly active in the field whether rural or urban. School kids were regularly examined for any ailments. Vaccination against seasonal pandemics was a routine thing and the medical and paramedical staff enjoyed genuine respect in society. Pharmacies were there but only to assist the government-run hospitals. No one could imagine drugs being pilfered or stolen. All pre-natal and post-natal requirements were satisfactorily met by government gynaecologists and obstetricians. Caesarian section deliveries were very rare. It may look far-fetched, but ultimately, the same services that the community enjoyed earlier have to be made available now with the positive difference that now the number of hospitals is much more, taking into consideration the privately-run clinics and dispensaries. The only requirement is organising what already exists. And that’s where the rub lies. Who will bell the cat? A genuine political will, a genuine earmarking of funds and judicious allocation to cities and villages can get the results. Health and education should not be run on business lines. They need funds. Mobile connectivity is there to help. Now, the public is ready to cooperate if the results are available. The Covid can prove to be a game-changer.
Prof Mohan Singh
Quarantine centres lacked amenities
Health infrastructure must be upgraded in Covid-19 and other emergencies because in the pandemic period most of the people complained about poor quarantine centres. So firstly, the government should improve quarantine centres. Ward and patient area should have much space, light and an all-round comfortable atmosphere. Wherever possible to promote patient-friendly and healing environment, separate access routes for staff, patients and the public to wards and services should be there. A range of amenities such as choice of food, telephone to improve patient and staff coordination must be there. Environment should be configured a certain degree of cleanliness sufficiently flexible to secure all patients. All of this will help patients to decrease fears in their mind and make them mentally stable in such situations.
Dr Rohan Mehra
Effective execution of govt schemes a must
To upgrade the health infrastructure, firstly mental health and psycho-social support should be made available to all workers. To upgrade the health emergencies there must be community preparedness, medical material management, distribution system, emergency public information system, non-pharmaceuticals interventions and fatality management systems. Importantly, neither patients nor services should be constrained by a physical environment, but the environment should be configured to be fit the purpose with a high degree of cleanliness. There must be effective implementation of government schemes, allocation of funds, provision of basic health facilities should be a part of fundamental right, working on the ESIC needs streamlining, increase investments in health sectors, build more affordable government hospitals, encourage mobile clinics, organise free regular check-up camps, make them aware of healthcare policies, affordability in treatment specially in medicines, educate on health insurance schemes, setting up healthcare access task force with local hospitals and other community. Awareness seminars with the help of different NGO’s and healthcare workers could do the needful.
Set aside budget for research purposes
The first step to improve infrastructure is to increase the budget allotment for medical research so that more hospitals and research centres can be opened. Measures should be taken to ensure the allotted sum is used in a transparent manner. The government hospitals need to be made more clean and hygienic and all viable precautions should be installed and made full use of. Eco-friendly sanitisation tunnels should be introduced.
A new category of hospitals required
I think government should increase health budget and make treatment affordable to everyone and to upgrade health infrastructure. The government should open mohalla clinic in every ward of the councillor ensuring each and every person gets free health check-up and treatment. The government should increase salaries of medical officers and specialist doctors so that more doctors prefer working in government nursing homes as compared to private hospitals. The government should construct a separate category of hospitals under special category like ‘infectious diseases hospitals’ which only deals with controlling and treating communicable viral and bacterial diseases. Every citizen of India must have a compulsory free health insurance minimum up to Rs3 lakh connected to their bank account.
Dr Naqsh Thakur
Pvt, govt hospitals must work in tandem
The private sector plays a significant role in delivering healthcare services to people in developing countries. By some estimates, more than one-half of all healthcare – even to the poorest people – is provided by private doctors, other health workers and other non-state actors. The government needs to find ways to work with the private sector to accelerate progress toward high-priority health objectives. Household decision-makers in developing countries often choose private providers because they respond more to patients’ needs or preferences. People value the convenience, flexible payment plans, and ease of access to healthcare providers and drugs at private health homes. They also value the closer locations and more responsive services. India’s public expenditure on health as a percentage of the GDP is far lower than countries classified as the ‘poorest’ in the world. India’s public expenditure on health now stands at 1.28 per cent of the GDP, but even then, it is way lower than the average expenditure of poor countries. The viral diseases are going to define how medical and surgical sciences are going to be practised in future. Since the explosion HIV, HCV, HBV, swine flu and now Covid, the habitat flora of surgical patients is changing. We will need to develop dedicated and specialised viral units in hospitals which will exclusively cater to these patients in a perfect isolation. The human resource department for such dedicated units will also need to be developed. This way a normal patient who is not infected with deadly viruses will be able to avail treatment. Remember it’s this latter subset of patients which suffered the most because the whole attention as well as the resource was diverted to Covid.
Dr Rakesh Sharma
Form Disaster mgmt health services
With health emergencies occurring repeatedly in recent times, the present healthcare infrastructure structure needs updation. Since the present infrastructure is inadequate in handling, a separate disaster management health services be formed. It should have a nodal headquarter manned by personnel drawn from Army Medical Corps. It should have stocks of life saving drugs and equipment to handle the situation. State units should enrol volunteers of NGOs, private hospitals to assist and work under the nodal headquarter in case of need.
Hear the wailing of govt hospitals
It is needless to mention that the health system in our nation is not upgraded and people do encounter various afflictions in health sector. The administration should make some strategies to facilitate the masses. I am falling short of words to articulate my thoughts. Honestly, government hospitals are in deplorable condition and maintenance is the crying need of the hour. On the contrary, private hospitals are in an excellent condition since they are too costly. Therefore, a commoner cannot afford the expenses of private hospitals. In this age, people succumb to a few maladies and government agencies should pay proper heed to this.
Right policies will strengthen it
It has been rightly said that the health of people is the foundation upon which all their happiness and powers as a state depend. We have the health infrastructure and the services but the only problem is that they are not functioning in an optimal manner. Because of this, a healthy future cannot be achieved without putting the health and the well-being of the people at the forefront of the lifecycle unless the existing health infrastructure is upgraded drastically to cope with the Covid-19 and Avian flu like emergencies. Since good health is essentially beneficial to economies and societies, it is pertinent to see how the system across the country is struggling to maximise the health of people. The need of the hour is to address on priority basis the stresses and shortcomings of our health system to make people healthier and resilient to future. Hence, investment in public and private health infrastructure is of paramount importance if significant health and economic dividends are to be reaped. With right policies health infrastructure can be strengthened to wake it from the deep slumber into which it has slipped. ‘Health for all’ has so far remained a mere slogan. If it has to transpire the government and community will have to work in tandem on various fronts to make healthcare accessible to all without any discrimination. Research infrastructure in the departments of community medicine in various institutes should be strengthened. Gaps in enforcement, monitoring and evaluation should be plugged. Training facilities for public health specialists should be provided overcoming the lack of financial and material resources. The Health Ministry should embark on innovating schemes through public-private partnerships to revitalise the health infrastructure. The health system should be equipped with both reserve capacity and agility to provide high quality universal health coverage. Besides, population stabilisation is a must for ensuring a qualitative life for all the citizens along with the upgradation of the health infrastructure the government should provide minimum amenities to encounter the future emergencies like good housing, proper sanitation, access to affordable healthcare, access to potable water, proper drainage and sewerage, monitoring the functioning of the gigantic medical centre network and generation of awareness by all possible means.
Tarsem S Bumrah
More govt medical colleges needed
Central and state governments took all the necessary steps to control the spread of coronavirus in the country. But these were short-term measures and now it is time to make a long term strategy to tackle avian flu like diseases in future. Before we go for healthcare we must put a glance at medical education in the state. The first government medical college in the state was established in 1864 at Lahore and shifted to Amritsar in 1920, second government medical institution started at Patiala in 1953 and third and last in 1973 at Faridkot. Just imagine no government medical college in the state was established since almost half a century! Whereas number of medical colleges in private sector have come up charging a hefty tuition fee and making it a money-making business instead of missionary work to serve the poor. So, the first step should be to increase seats in existing government medical colleges and also establish more institutions in public sector. In the pre- Independence days we were having an exclusive hospital for infectious diseases named ‘Infectious Diseases Hospital’, located near present bus stand at IDH Market named after it. Here is a time to revive such exclusive hospital for infectious diseases as per the pattern of exclusive eye, ENT, TB, cancer, mental hospital already in existence in the city as government undertakings. All most all over the world healthcare system is in public sector, whereas we are opening this sector to private entrepreneurs, whose only aim is to make money. I wish to quote Adam Smith: ‘Businessmen seldom meet together, even for merriment, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices’. So, strengthening the government healthcare system is the only solution to the problem.
Harsh N Johar
It is all about the budget
Emergencies such as Covid need strategies to build emergency medicine and critical care infrastructure across the country in public health system by creating sufficient dedicated, fully equipped manpower in different zones of a state. This will require significant increase in health Budget, especially for emergency and critical care infrastructure so as to improve public health system and social health making it affordable to all sections of society. India spends meager amount of GDP on health (1.5 per cent) in contrast to above 10 per cent by developed nations. Critical care medicine has a crucial role in emergencies which can be utilised maximally in pandemics by phone triage, home testing , telemedicine OPD, thus decreasing visits to hospitals leading onto early identification of disease thereby preventing further spread. This requires training in emergency medicines, critical care, pulmonology, infection control, safe testing and isolation protocols which helps in creating better teams to tackle such situations. These training be made part of basic nursing and medical courses, making mandatory time-bound clinical postings in emergency/CCM centres which will produce a well-trained manpower. These centres may be made autonomous bodies to make a healthy working environment which will retain trained, experienced manpower.
Dr Monika Gupta
Complete overhaul of system required
Training of paramedics and interventionists, their life-saving equipment handling capability as well as compatibility in bulk surpassing the routine shortage is a prerequisite to deal with any life-threatening situation. Coordination of a collective dedicated body of doctors, administration, social, political and religious heads for preventive discipline and mobilising the funds in a short notice is the need of the hour. The availability of duty and tax-free subsidised equipment and kits to the hospitals should be a priority. Mass insurance of the masses (calamity insurance) should be made mandatory with a compulsory peanut contribution clubbed with electricity/house tax bill. Last but not the least, personal, institutional and financial security to hospitals to deal with the situation without fear since mortality and its repercussions by the society are not affordable to the sensitive psych and morale of the health providers!
Dr Gurkirat S Aulakh
Practical not paper work required
Virus infections, bacterial infections, microbial infections, etc are our future challenges. I think we should take it positively. But with this, it’s necessary to find developments in research. As we know our county is a growing one and we are better than others but still more research fellowship, research projects in universities should be carried out, both at national and state level. We need more awareness for every type of situation in future. As we all know that people in remote areas are oblivious of knowledge of such things, so government should begin awareness lectures through Health Department with the help of sarpanch. Research scholars should also be appointed for awareness camps. Our government should need practical work more as compared to paper work.
Jatinder Vir Singh
Now that the Covid vaccination drive has started and fresh cases are on the decline, should parents send their children to school as the Punjab Government has allowed resumption of classes from Class V onwards?
Suggestions in not more than 200 words can be sent to [email protected] by Thursday (January 28).