It is imperative to define ‘essential health care,’ which should be made available to all citizens to facilitate inclusivity in health care. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. At one end of the spectrum are private hospitals with world class facilities and personnel offering services, which are competitively priced, compared to similar services abroad, but remain beyond the capacity of most Indians. At the other end, there is an unregulated private sector which is more affordable, but offer services of varying quality, often by under-qualified practitioners. Both urban and rural Indian households tend to use the private medical sector more frequently than the public sector.
All Indian citizens can get free outpatient and inpatient care at government facilities. Under India’s decentralized approach to health care delivery, the states are primarily responsible for organizing health services. Because of severe shortages of staff and supplies at government facilities, many households seek care from private providers and pay out-of-pocket. In India, since the last 10 years considerable work has been undertaken related to health and hospital sector reforms, which has involved various government, worldwide multilateral agencies and other stakeholders. Delivering affordable health care to India’s billion plus people presents enormous challenges and opportunities for the medical community. The practice of medicine is becoming increasingly complex and time consuming.
India currently has fundamental rights in various other areas, such as the ‘right to education’ and the ‘right to information’, but a right to health has been conspicuously absent. However, various legal precedents dictate that the government is responsible for citizens’ healthcare. The right to health has been an old demand from India’s public health community, who believe that a legislatively guaranteed right will bring better health access and accountability.
In a development which should bring cheer to public health activists in India, a committee set up by the government has recommended that India have a fundamental right to health.
The committee has also recommended that health, which is currently a state subject, be put on the concurrent list so that both the Centre and states can have a role in policy implementation and changes.
The Right to Universal and free Healthcare Act was passed in 2019 which extends to whole of India. According to this Act, every individual shall have a right to free and compulsory health care facilities and services in any hospital in geographical proximity. No individual shall be liable to pay any kind of charges or expenses which may prevent him or her from availing healthcare services. Where in a hospital, there is a lack of healthcare and medical facilities, an individual shall have a right to seek transfer or refer to any other hospital. Where an individual is required to move from one hospital to another, either within a State or outside, for any reason whatsoever, such individual shall have a right seek transfer to any other hospital, for getting medical treatment. Every individual shall have the right to basic necessities of life affecting the health conditions. Every individual shall also have the right to opportunity to enjoy the highest attainable level of health. Every individual shall have a right to universal health in and around his or her surroundings, which may include “underlying determinants of health”. Failing to provide the “underlying determinants of health” to an individual without sufficient and reasonable cause, the appropriate Government shall provide compensation to the individual as per provisions of this Act.
Clause 3 of the Bill provides for Right to Free and Compulsory Healthcare facilities and services. Clause 7 provides for the establishment of hospitals, within such areas or limits of neighbourhood, where it is not so established, within three years from the commencement of this Act. Clause 13 provides for the establishment of hospital management committees. The Bill, if enacted, will involve expenditure from the Consolidated Fund of India. It is not possible at present to quantify the funds that may be involved.
Right to health and education are the founding pillars of any welfare state. India, after entitling the Right to Education, looks forward towards a legislation entitling Right to Health. Every nation-state is obliged to support the right to health through the allocation of meximum available resources. A rights-based approach to health requires that health programmes and schemes must prioritize the needs of those furthest behind first towards greater equity, a principle that has been echoed. The Bill would also ensure free and universal healthcare facilities to every individual of India. The binding right to health would enable the last man standing to get healthcare facilities at no cost. The binding right to health would also enable the Centre and the State to allocate greater funds towards the healthcare, strengthening the healthcare system of India.
I have always been against Glorifying Over Work and therefore, in the year 2021, I have decided to launch this campaign “Balancing Life”and talk about this wrong practice, that we have been following since last few years. I will be talking to and interviewing around 1 lakh people in the coming 2021 and publish their interview regarding their opinion on glamourising Over Work.
If you are interested in participating in the same, do let me know.
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