“GOVERNMENT is investing in healthcare and medical education so that the citizens and youth of the Union Territory have the best service and career options they deserve for a better tomorrow”, reads a recent news report. This tiding comes at a time when, according to a report, “Public Health care institutions in Kashmir deliver care to almost 97% of population even though they are severely understaffed. The doctor-patient ratio is one of the lowest in India. The World Health Organization recommends one doctor for every thousand patients; Kashmir has a doctor-patient ratio of 1:2000”. It is true that the valley fares well in disseminating health services and catering to the medical needs of people in comparison to most of the other states but the comparisons must not fool us into believing that all is well. There are sharp deviations from the national average in terms of trained workforce available, accessibility to latest diagnostic techniques and equipments and overwhelming saturation of hospitals. From the jarring inaccessibility of people to quality healthcare to the total absence of healthcare units in far flung areas, the problems posit a spectral diversity, a mammoth size puzzle and a conundrum of infinite dimensions. From the healthcare pangs of nomadic Gujjar and Bakarwal communities to the near absence of dedicated mental health institutions in rural and peripheral areas, everything presents a challenge of odd nature, multiplexing the inequities and violating the right to health of the majoritarian population. Of graver concern, in addition to the issues aforesaid, is the healthcare spectre along the national highway. We are well aware of the vulnerabilities that our highway poses in view of its tough terrain, ending in frequent accidents and vehicle skids, but these vulnerabilities and ensuing loss of life has done little to alarm the administration to establish well equipped emergency response units along highway. The absence of same often leads to the loss of lives for the want of treatment which could have been otherwise rescued with little Medicare.
Easy access to quality healthcare and education has often been defined as the indicators of societies’ level of advancement and prosperity. In a society of ours, we are flooded with reports, on a daily basis reporting mismanagement in healthcare, the unaddressed grievances of patients and inequities in access to healthcare stemming from socio-economic inequalities. The standard medical practice suggests that a doctor ought to check up twenty patients a day and offer at least twenty minutes to each patient. But to our great dismay, doctors in UT are under a humongous burden of checking up to hundred and fifty patients a day, in addition to attending other official responsibilities. And when I speak of giving twenty minutes to each patient I don’t think any of us can recall an experience either at a government hospital or under a private setting having been evaluated so thoroughly. To my poor experience, the average time spent by a doctor with the patient even in private settings doesn’t exceed five minutes. This is something that may not require statistical citation, because we are all a living testimony to this standard practice of under treatment. Maybe there are exceptions to this rule, but I have yet to come across any. The phenomenon aggravates in cases of psychological disorders where the moot point of treatment is listening to the patient and listening thoroughly, but more than often, doctors are seen pressing the prescription button even before the patient has finished his narration. The burden of mistake is not to be placed on doctors, as previously mentioned that our healthcare stands in a supersaturated state and doctors are to be applauded for their heroic services – doing away with isolated misgivings.
Government hospitals are a refuge and shelter to hundreds and thousands of people who can’t afford private treatment, which as a matter of pragmatism fares marginally better than government hospitals. Having underscored the disequilibrium in doctor patient ratio, it becomes incumbent upon the government, as a part of its commitment to be a welfare state to expand the bandwidth of healthcare infrastructure in terms of multiplying hospitals, recruiting healthcare workers and aiming to provide essential medicines at affordable rates. Two developments in this direction under the present regime deserve a special mention. Golden card, to cover the poor, vulnerable and the economically weaker sections of the society and Prandhan Mantri Jan Aushadi outlets, providing medicines at cheaper rates. But both these schemes suffer on ground and implementation. There have been cases where patients with Golden Cards were denied the promised benefits and the entire trajectory of PMJAY stands halted for numerous reasons, doing a great disfavour to those who could have otherwise benefited from it. Both the schemes per se are conducive and well conceived in Indian context and the only thing needed is government and bureaucratic push to make things happen and happen effectively.
A passing reference was made to private healthcare setups and those who are economically well placed prefer these centres both for their supposed efficiency and the social ascent. But there seems to be no or little administrative control on the charges levied by these institutions against the treatments offered and the whims and wishes of those running these units remains the sole factor in deciding the cost of treatment and the protocols followed or broken. By extension, there seems little regulation on the fee that a private health consultant can charge – a fact which is vetted by varying fees charged by various doctors, spread across the scale. The writer had to many a times drop the idea of visiting a doctor for the exorbitant consultation fee that one had to pay and the scene is repetitive from cardiologists to neurologists and others in-between. These are not the things that are beyond the administrative control, but the question we keep asking each other is – who will bell the cat?
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