By Dr. Arun Mitra
Medicine is a passion not a profession. Preventing disease and treating the patients gives immense pleasure to a doctor. A person dedicated to the cause is beyond the need for praises. However recognition of medical professional’s work from the mouth of the head of the government is a different matter. The Prime Minister very well utilized the art of using words to praise the doctors on July 1 the day dedicated to the memory of Dr B C Roy, a physician, educationist, philanthropist, freedom fighter and statesman who served as the Chief Minister of West Bengal in the Congress government.
After showering praises on the doctors for their role during the pandemic the Prime Minister should have addressed the issue of violence against the doctors which continues unabated despite their role in serving the society during pandemic. He failed to give any concrete assurance. He did not utter that a bill to the effect is pending with the government since December 2019. No steps have been taken to expedite it despite several incidents of violence against the doctors.
He started by blaming the governments before 2014 for not being serious towards healthcare system. Fact of the matter is that immediately after the freedom from the British colonial rule India had been squeezed of all resources. India’s GDP, in absolute numbers in 1947 was mere Rs.2.7 lakh crore. It rose to Rs.57 lakh crore in 2014. Our life expectancy stood at as low as 37 years in 1947 which improved gradually with improvement in healthcare as well as nutrition and it rose to 68 years by 2014.
In the immediate post-independence period our healthcare was developed in the state sector so that it could reach the common man as much as possible. As a result Primary Health Centres were established and rural dispensaries were made in the far flung areas. Not only that India became a hub for producing cheap medicines under the public sector companies in particular. These were supplied not only to developing countries but also the developed countries at cheap rates. We also strengthened our own vaccine making sector
It is in 1952 that the ESIC was established to give comprehensive healthcare to the employees. Hardly any scheme matches this. Even the Ayushman Bharat provides health care for the indoor patients only. In addition there are several conditions to be registered under the scheme. There was effort to break myths in the healthcare and develop it on scientific basis. True, there were several short comings in the planning but to say that nothing was done in those years before 2014 will be injustice and denying the fact.
Coming to the COVID he went on to say that India did better than many western countries in the field of COVID management. He forgets that India’s situation in COVID management has been worse than our neighbouring countries in south Asia even though they have much poor economy. During the second surge there was unprecedented increase in the number of COVID cases in our country. As on 17th May we recorded 2.60 lakh cases or 19 cases per lakh population, Pakistan 3232 cases or 1.4 cases, Bangladesh recorded 698 cases or 0.42 cases, Nepal recorded 9198 cases which is 31 cases, Sri Lanka recorded 2456 cases that is 11 cases per lakh of population. This data from www.worldometers.info indicates a comparison in the proportion of population being taken ill of COVID. As on 17 May 2021 India had nearly 13 time more cases than Pakistan, 44 times more than Bangladesh, 0.60 times of Nepal and 1.6 times of Sri Lanka.
People have not yet forgotten the nightmare they had gone through because of lack of oxygen, lack of a hospital beds, shortage of ventilators and other equipment to save life. He has also forgotten that 23 crore more people have gone below poverty line during this period. Many have been pushed to hunger because of the absence of any aid from the central government. The developed countries, with whom he is comparing our country, paid lakhs of dollars to their people to meet the economic crisis. On the contrary Indian government did not even heed to the economists’ advice of paying Rs.7500 to the poor families. The poor have got only 5 kilogram grain and 1 kg Dal which costs only Rs.225.
Boasting on the increase in the health budget the prime minister said that in this year’s budget the expenditure on health has been increased by more than 2 times. This is completely untrue. The factual increase on the health budget is from Rs.65000 crore to Rs72000 crore. This is a marginal increase of 10 per cent, which is barely enough to meet the inflation in one year. Most worrying factor in this year’s budget was reduction in the spending on Nutrition from 3700 to 2700 crore rupees. This is at a time when India is at 102nd position in hunger index out of 117 countries, worse even than our neighbouring South Asian countries. In fact the public health expenditure on health has been hovering around 1% of the GDP for the last several years and has not increased since 2014 either.
However there has been increase in the corporate sector’s investment on health. With this we have improved in advanced health care but vast section has been excluded. It is only recently that his government took decisions to even privatise the district level hospitals.
Prime Minister’s boasting about vaccination drive in India is far from reality. Whereas on 21 June 80 lakhs people were vaccinated, the number is coming down since then. Number of people vaccinated on 27 June was 17 lakh, on the doctors day it was 42 lakh falling to 14.77 lakh on 4th July. As on today 6.4 crore have been fully vaccinated. With this pace of vaccination it may not be before April 2022 that we will be able to vaccinate our population.
We have recently seen how the data on the number of diseased and deceased has been fudged. This is anti-science because the database gives us knowledge on the strategies to be evolved to manage pandemics in future. It is also well known that most of the decisions being taken during the pandemic had been on the political level rather than the scientific level involving the Public health experts and the epidemiologists. Only an inclusive decision making involving experts can yield results. Our Prime Minister should understand the difference between addressing the medical fraternity and election rally. (IPA Service)