Assam Health Minister Himanta Biswa Sarma was spot on when he said this week that healthcare must be seen as a “right” of the people rather than the “charity” of the State. Equally heartening to note was the Assam government’s decision to walk the talk: on Thursday, the Congress-led government tabled the Assam Public Health Bill, 2010, in the assembly. Assam is the first state in India to come up with such a Bill that proposes to provide free treatment to poor patients and make it mandatory for all hospitals and health institutions (both government and private) to provide free healthcare services to patients admitted in the emergency wards for the first 24 hours. The Bill will be put to vote on March 31. Health is on the State list of the Constitution.
The importance of health in a nation’s development cannot be undermined and India as a country does not have a glowing track record. The National Rural Health Mission’s (NHRM) says that the curative services favour the rich: for every Re 1 spent on the poorest 20 per cent population, Rs 3 is spent on the richest section. Moreover, only 10 per cent Indians have some form of health insurance and over 25 per cent hospitalised Indians fall below the poverty line thanks to medical expenses. In the face of such figures, Assam’s move must be applauded and other states should seriously think of taking a similar step. Assam was one of the states that was identified by the NHRM for special focus because its medical care system was paralysed due to lack of funds and personnel. Taking structural and financial help under NHRM, the state is reversing this trend. Take for example, Chirang district. In 2001, its immunisation level was less that 5 per cent but today it’s around 70 per cent. The local public health units are well-staffed with three medical practitioners including an ayurvedic doctor. However, a recent Comptroller and Auditor General report has also pulled up the government for financial irregularities and procurement of substandard medicines.
The challenge for Assam will be when the NHRM exits in 2012. As of now, it is the NHRM and not the state system that is delivering. The Bill cannot be just ornamental; it must have the capacity to nurse back its own parent system to health. Nevertheless, a good start has been made and expectations will be running high. The Assam government’s challenge now is to ensure that the Bill treats the symptoms and administers the cure in time.