Dana Manjhi carried his wife’s body on shoulders as he was denied a mortuary van or ambulance by hospital authorities. (Photo credit: OTV Video Grab)
Dana Manjhi carried his wife’s body on shoulders as he was denied a mortuary van or ambulance by hospital authorities. (Photo credit: OTV Video Grab)

Why are the poor deprived of proper healthcare in India

The plight of these families underscores human apathy and a basic failure — the breakdown of public healthcare in India.
By Sanchita Sharma, New Delhi
UPDATED ON SEP 05, 2016 10:36 AM IST

September 2— A man in Odisha’s Malkangiri district walked 6 km with his seven-year-old daughter’s body as the ambulance transporting them to the hospital left them midway after learning that the girl has died.

August 30 — A man lost his ailing 12-year-old son on his shoulder after the state-run Lala Lajpat Rai Hospital in Kanpur sent him to a children’s hospital, 250 metres away, without providing an ambulance, stretcher or wheelchair.

August 27 — A man was forced off a bus with his five-day-old baby and mother-in-law, after his ailing wife died in the vehicle in MP’s Damoh district.

August 25 — With his sobbing daughter in tow, a tribal man in Odisha’s Kalahandi district carried his dead wife for more than 10km because he had no money for transport and the government hospital, where she died, refused him an ambulance.

The plight of these families underscores human apathy and a basic failure — the breakdown of public healthcare in India.

Successive governments promised to transform the healthcare system, including PM Narendra Modi’s announcement of a Rs 24,000-crore national health protection scheme. But little has changed on the ground. Since health is a state subject, wide disparities exist in delivery and access between states, rural and urban population.

Health allocation has risen marginally or remained stagnant over the past six years across states — average of 4.4% of the annual health spending of India’s 17 largest states.

Delhi remains India’s best performing state, where the average spending is 10.1% of its total spending since 2010-11. The national capital and Rajasthan are the only two states where health outlay has increased by 2% or more of their total spending since 2011.

Most states feel there is no need to allocate more. Bihar health secretary Jitendra Srivastava said increasing health spending from 3.3% in 2011 to 4.1% in 2015-16 considerably improved delivery.

“The average daily patient footfall in the out-patient departments (OPD) of government-run hospitals is 10,408 in 2016 to date, compared to 39 in 2005,” Srivastava said.

The highest OPD footfall across Bihar hospitals was 11,418 in 2013-14, which fell to 9,102 in 2015 after drug availability plummeted in government facilities because of a scam in the purchase of medicines in 2014.

Populism vs rationale

Increasing outlay is not enough if spending is determined by populism and less by need. Dr K SrinathReddy, the president of the Public Health Foundation of India, said: “In the overall process of political prioritisation, health gets the short shrift since needs and grievances are wrongly perceived to be individual.”

The Madhya Pradesh health outlay has shot up from `1,831 crore in 2010-11 to Rs 5,644 crore in 2016-17, but there has been no significant improvement in the delivery.

Cases of medical negligence that end in deaths make national news each month.

In May, two infants were given nitrous oxide instead of oxygen in Indore’s government-run Maharaja Yeshwantrao Hospital died. The previous month, Gwalior police busted a racket of abandoned babies being sold with the help of government-paid ASHA workers.

In March, a tribal woman was found carrying her dead child in a bag in Sagar district because she had no money for transport. The Damoh government hospital made news in June when district collector Srinivas Sharma’s mother died because she couldn’t get timely treatment.

Doctor shortage

India had around 740,000 registered doctors in 2014. But the country of 1.252 billion people has a doctor-population ratio of 1:1,674, against the recommended 1:1,000.

Shortage apart, absenteeism remains high even in facilities where doctors, nurses and health workers are posted.

In Madhya Pradesh, against the sanctioned 7,000 posts for doctors, the total shortfall is 4,000 in 51 district hospitals, 66 civil hospitals, 335 community health centres, 1,170 primary health centres, 9,192 health sub-centres and 49,864 village health centres. “There is severe shortage of doctors in MP, especially in government hospitals. Specialists are not available at all,” state health minister Rustam Singh said. “We are trying to recruit through public service commission, hire doctors on contract and invite homoeopathic and ayurvedic doctors under AYUSH to address the shortage.”

The shortage is increasing out-of-pocket spending, with people seeking care from private clinics and doctors with little or no training. In the absence of regulation to determine accountability and quality standards, quacks run a flourishing trade.

Only one in five doctors in rural India are qualified, says a WHO report on India’s healthcare workforce, highlighting the problem of quackery. The report found close to one-third of those calling themselves allopathic doctors educated only up to class 12. Also, 57% of the practitioners did not have any medical qualification.

Solution

The anonymity of prevention — beneficiaries are faceless and nameless — leads to neglect of public health. “Low visibility of primary healthcare services leads to their neglect by politicians as well as medicos. Yet, these are the basic foundations of a good health system,” said Dr Reddy.

With the private sector providing 80% of outpatient and 60% of inpatient care and patents pushing up the cost of medicines, out-of-pocket spending on health is steadily growing, pushing people into poverty.

Dr Vikram Patel from the Public Health Foundation of India wrote in The Lancet, a medical journal, that as much as increased resources, what is needed is a radically new architecture for India’s healthcare system.

“This system must address acute as well as chronic healthcare needs, offer choice of care that is rational, accessible, and of good quality, support cashless service at point of delivery, and ensure accountability through governance by a robust regulatory framework,” he said.

Everyone talks about the right to health, but with more than 30 million pending cases before courts, ailing people denied healthcare in overcrowded hospitals are unlikely to queue up to get justice.

(With Neeraj Santoshi in Bhopal and Ruchir Kumar in Patna)

SHARE THIS ARTICLE ON
Close
A month ago, Saudi Arabia's interior ministry announced a 'temporary suspension' on flights from India.(Satish Bate/HT Photo)
A month ago, Saudi Arabia's interior ministry announced a 'temporary suspension' on flights from India.(Satish Bate/HT Photo)

On Saudi Arabia flight resumption, Hardeep Puri shares important update

By hindustantimes.com | Edited by Amit Chaturvedi
UPDATED ON MAR 02, 2021 07:38 PM IST
Saudi Arabia has taken a number of steps to check the spread of the coronavirus disease (Covid-19). It has also banned international flights till March 31
Close
Speaker Vipin Parmar had submitted a formal complaint to DGP Sanjay Kundu for registering the FIR. In picture - Himachal Pradesh Congress MLAs holding up copies of the governor Bandaru Dattatreya’s address.(HT Photo )
Speaker Vipin Parmar had submitted a formal complaint to DGP Sanjay Kundu for registering the FIR. In picture - Himachal Pradesh Congress MLAs holding up copies of the governor Bandaru Dattatreya’s address.(HT Photo )

Congress walks out of HP Assembly over MLAs' supension

PTI
PUBLISHED ON MAR 02, 2021 07:03 PM IST
The alleged incident had taken place outside the Speaker's office when the Governor was leaving for the Raj Bhavan after he cut short his address in the House following a ruckus on the opening day of the Budget session.
Close
Urging everyone to take part in the vaccination drive, 64-year-old Shailaja later said the initiative was going on smoothly in the state.(Facebook/@kkshailaja)
Urging everyone to take part in the vaccination drive, 64-year-old Shailaja later said the initiative was going on smoothly in the state.(Facebook/@kkshailaja)

Kerala Health minister, 2 cabinet colleagues take first dose of Covid-19 vaccine

PTI, Thiruvananthapuram
PUBLISHED ON MAR 02, 2021 06:51 PM IST
While Revenue minister E Chandrasekharan received the jab from the vaccination centre at the same hospital,Minister of Ports and Museums Kadannappally Ramachandran got the shot from a hospital in his home district, Kannur.
Close
Odisha had conducted over 75.79 lakh Covid tests of which 79.5 per cent were through Rapid Antigen tests.(PTI)
Odisha had conducted over 75.79 lakh Covid tests of which 79.5 per cent were through Rapid Antigen tests.(PTI)

Faulty rapid antigen kits declared 25 students in Odisha as Covid-19 positive

By Debabrata Mohanty
PUBLISHED ON MAR 02, 2021 06:46 PM IST
  • None of the students had any symptoms of Covid-19 and when their samples were again subjected to RT-PCR tests, the results were negative.
Close
Health secretary Rajesh Bhushan confirmed that the first dose of the vaccine has been administered to 6,704,856 healthcare workers and a second dose has been administered to 2,598,192 of them.(ANI)
Health secretary Rajesh Bhushan confirmed that the first dose of the vaccine has been administered to 6,704,856 healthcare workers and a second dose has been administered to 2,598,192 of them.(ANI)

Over 14 million Covid-19 vaccine doses administered in India: Government

By hindustantimes.com | Written by Srivatsan K C, New Delhi
PUBLISHED ON MAR 02, 2021 06:44 PM IST
“2.08 lakh doses have been given to people who are 45 years to 59 years of age with comorbidities and people above 60 years of age,” Union health secretary Rajesh Bhushan said.
Close
The show is hosted on Facebook page of Kishorechandra Wangkhem, an Imphal-based journalist. (HT Photo)
The show is hosted on Facebook page of Kishorechandra Wangkhem, an Imphal-based journalist. (HT Photo)

Talk show from Manipur gets notice under new digital media laws

UPDATED ON MAR 02, 2021 06:56 PM IST
The publishers were directed to “furnish all relevant documents that ensure compliance of the provisions” of the new media rules.
Close
Brinda Karat asked CJI Bobde to consider the effect such questions will have on the psyche of victims,(PTI File Photo)
Brinda Karat asked CJI Bobde to consider the effect such questions will have on the psyche of victims,(PTI File Photo)

Brinda Karat urges CJI to withdraw remarks made at bail hearing of rape accused

PTI, New Delhi
PUBLISHED ON MAR 02, 2021 06:19 PM IST
  • Karat was referring to remarks made during the hearing of a plea filed by a public servant, who is accused of repeatedly raping a girl, against the Bombay High Court February 5 order which had cancelled his anticipatory bail.
Close
Eish Singhal, the Delhi Police spokesperson, said a slew of efforts in a planned manner helped the police carry out the large number of trace and rescues of missing children.(File Photo. Representative image)
Eish Singhal, the Delhi Police spokesperson, said a slew of efforts in a planned manner helped the police carry out the large number of trace and rescues of missing children.(File Photo. Representative image)

Activist in Goa files anticipatory bail plea fearing arrest in 'toolkit' case

By Gerard de Souza
PUBLISHED ON MAR 02, 2021 06:05 PM IST
  • Shubham Chaudhuri -- a volunteer with global climate activist group 'Extinction Rebellion' told the court that he has nothing to do with the making of the alleged toolkit and has been implicated in the case.
Close
The photo of Karnataka minister BC Patil getting Covid-19 vaccine at home was widely shared on social media.(ANI)
The photo of Karnataka minister BC Patil getting Covid-19 vaccine at home was widely shared on social media.(ANI)

'Not allowed': Centre on Karnataka minister getting Covid-19 jab at home

By hindustantimes.com | Edited by Amit Chaturvedi
UPDATED ON MAR 02, 2021 06:01 PM IST
The Union health ministry on Tuesday said that it has asked for a report from the Karnataka government. Meanwhile, the minister BC Patil, said his decision to take the vaccine at home cannot be considered wrong.
Close
Police said Krishan was a drug addict who even supplied drugs to fund his addiction.(Shutterstock)
Police said Krishan was a drug addict who even supplied drugs to fund his addiction.(Shutterstock)

In Bengal, cache of heroin worth 25 crore seized, one held

PUBLISHED ON MAR 02, 2021 05:56 PM IST
  • A notorious drug dealer, Sunil Howlader, was arrested during the raid. He is a resident of Rasulpur. His SUV was also seized.
Close
Parents have been asked to submit a consent letter to the school head or class teacher before sending their children to schools. (Sunil Ghosh/HT Photo)
Parents have been asked to submit a consent letter to the school head or class teacher before sending their children to schools. (Sunil Ghosh/HT Photo)

54 students test Covid-19 positive at school in Haryana's Karnal

By hindustantimes.com | Written by Meenakshi Ray, New Delhi
UPDATED ON MAR 02, 2021 06:56 PM IST
Haryana had allowed students from Classes 9 to 12 to go to return to schools in December and for those from Classes 3 to 5 from February 24. The government also decided to start regular classes for Classes 1 and 2 from Monday.
Close
Representational Image. (HT archive)
Representational Image. (HT archive)

Tackle terror, prevent persecution of minorities: India tells Pakistan at UNHRC

By HT Correspondent | Edited by Smriti Sinha
PUBLISHED ON MAR 02, 2021 05:42 PM IST
New Delhi’s position was conveyed in response to a speech by Pakistan’s representative at the UN human rights agency following an update on the global human rights situation by UN human rights chief Michelle Bachelet last week
Close
Police with the man from whom they recovered six leopard skins. (HT Photo)
Police with the man from whom they recovered six leopard skins. (HT Photo)

Man arrested with leopard skins, teeth, claws in Uttarakhand

PUBLISHED ON MAR 02, 2021 05:35 PM IST
One person has been arrested while another is on the run.
Close
The pictures of health officials administering the vaccine at the minister's residence flooded social media and television news channels broadcast the story on a loop to highlight the misuse of power by the minister. (SOURCED)
The pictures of health officials administering the vaccine at the minister's residence flooded social media and television news channels broadcast the story on a loop to highlight the misuse of power by the minister. (SOURCED)

Karnataka's agriculture minister gets his Covid-19 vaccine at home, kicks up row

By Sharan Poovanna
PUBLISHED ON MAR 02, 2021 05:30 PM IST
  • The incident has given the opposition parties more fuel to attack the minister and the BS Yediyurappa-led government in the state.
Close
Rajnath Singh being administered Covid-19 vaccine (twitter.com/rajnathsingh)
Rajnath Singh being administered Covid-19 vaccine (twitter.com/rajnathsingh)

‘Bas ho gaya’: Rajnath Singh receives first dose of Covid-19 vaccine

By hindustantimes.com | Written by Karan Manral, New Delhi
UPDATED ON MAR 02, 2021 05:26 PM IST
Rajnath Singh tweeted that he received his first dose of the vaccine at the RR Hospital in Delhi. Tuesday is Day 2 of the second phase of India’s vaccine drive against the Covid-19 pandemic.
Close
SHARE
Story Saved
OPEN APP