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Tamil Nadu govt drafting ‘Right to Health Bill’
Tamil Nadu is drafting a ‘Right to Health’ Bill to offer universal health coverage and create a redressal mechanism in the state, health secretary J Radhakrishnan said on Wednesday
Tamil Nadu is drafting a ‘Right to Health’ Bill to offer universal health coverage and create a redressal mechanism in the state, health secretary J Radhakrishnan said on Wednesday.
The first step towards the Bill was a consultative meeting held last week between economist Jean Dreze (part of the CM’s economic advisory council), public health experts and state officials.
The Bill seeks to cover all age groups and include people with disabilities and mental illnesses. “These are baby steps, but Tamil Nadu has taken the lead in starting this discussion,” said Radhakrishnan. “Our aim is that when we present the Bill, it should encompass the wishes of all people including the personnel who will be providing services with a public centric focus and ensure means of funding.”
“Through this Bill our aim is to put together disparate systems within our healthcare and make it organised,” said an official of the National Health Mission (NHM).
“We don’t want people to be denied healthcare dur to lack of drugs or service. We are looking at several models from across the world and this will be a rights-based approach.”
Officials said that Jean Dreze pointed out about how other factors such as clean drinking water, sanitation, housing, clean air were social determinants of health. But in Tamil Nadu those functions come under the local municipal bodies.
An official in the know of the matter said a section in the government hopes to push the Bill during the state assembly session.
“The implementation of the Bill is not easy,” said the official, who attended the first meeting and didn’t wish to be named.
“The Right to Health Act is present in 79 countries. We have to look into how this Act worked in these countries. I’m saying it is required, but it has to be vastly debated with every stakeholder,” the official said.
“How are we going to tackle rare diseases? Finally, for ensuring the right to health, what is the kind of staffing we need? Will it be 1:8 or 1:12 nurses, and are we proportionally paying them? Only because we strengthened our manpower, we were able to do better service during Covid-19.”
The additional staff will now be removed from the workforce after Covid cases drastically declined, said officials. Though Tamil Nadu does not have ASHA workers, health work here is dependent on women health volunteers, social health workers, activists and staff, who are on a contract.
Private sector hospitals are yet to be involved in the process, and discussion on matters like insurance is likely to take place in the next meeting. Officials said they want to model it along the lines of Thailand, which gave universal healthcare to all its citizens in the 1990s.
Tamil Nadu has been a forerunner in education and health infrastructure with a doctor for every 253 people, a ratio which is higher than other states and better than standards laid down by World Health Organisation (WHO), according to government data.
Experts said that years of strengthening the public healthcare system yielded results during the outbreak of the coronavirus. Tamil Nadu was able to rapidly scale up RT-PCR testing, one of the highest across the country.
A turning point in the health sector was the swine flu outbreak in 2009 when laboratories with RT-PCR facilities were increased across the state. This existing infrastructure, knowledge of testing and trained manpower resulted in approvals for Tamil Nadu’s government and private labs, experts said.
“Many Indian states are thinking about a Right to Health Bill. It is an uphill task, and it is welcome that Tamil Nadu has initiated it. This brings health high on the political agenda,” said public health expert Dr Prabhdeep Kaur.
“This will also ensure resource allocation. The Bill is intent that it is the government’s responsibility to ensure that each citizen has access to a core set of healthcare services. A Bill does not mean the government will provide everything. But it sets a platform for a discussion for a role that the private sector and the government will play. The government may provide all services or it may facilitate them. The best example from a developed country is the UK’s NHS, and for a low-income country Thailand is a good example.”
Thailand, she said, has built an infrastructure and resource for every village, and peripheral area where they are given preventive services by a team of doctors, nurses and paediatrics and there is a referral pathway for a higher level of healthcare. “But the idea is citizens enter the healthcare system from a single point which we don’t have here,” she concluded.
