Covid-19 is a wake-up call. Govts need to invest in healthcare | Opinion
Covid-19 holds a crucial message for the government in India and abroad. That Covid-19 basic amenities such as healthcare and education cannot be completely subcontracted to the private sectorUpdated: Mar 24, 2020 08:04 IST
As we head into a time of uncertainty and a possible crisis in healthcare, social unrest and economic and financial havoc initiated with the pandemic of Covid-19 worldwide, there has been an unprecedented shutdown in India. Central and state governments, state-run institutions and the private sector, all have acted with speed to ensure their shutdown is effective and the spread of this dreaded and sometimes fatal disease is contained.
While this clamp down is a welcome step to cope with the emergent need to contain the transmission of the virus, we also need to comprehensively study the serious life-threatening implications for our elderly population or those who are immunocompromised due to diseases. The situation is evolving every instant and we can only guess how it develops in the future. And it is not getting over soon with medical professionals estimating that it may last for at least 2-6 months. If we are lucky.
That governments and their institutions are acting at the ground level and not just tweeting or posting on social media is reflected by the effectiveness of official orders of closedown of schools, colleges and other places where people congregate. While it may have seemed alarmist to begin with, we Indians must realize that a failure to have acted in time would have led to horrendous consequences as in Italy or China. The coming days will show whether the Government was alert or alarmist.
The criminal law, specifically the Indian Penal Code, has provisions such as sections 269 and 270 to punish those who unlawfully, negligently or maliciously commit acts that spread infectious diseases dangerous to life. Government can give directions for quarantine of vessels (ships) and failure to comply leads to criminal prosecution. There are provisions under the Code of Criminal Procedure, or CrPc, empowering executive magistrates to act against activities injurious to health. Failure to comply with these directives can lead to criminal prosecution. However, these measures are mainly reactive to a deteriorating situation.
In India, successive administrations have for decades ignored public healthcare systems, which has led to a situation where we have promoted privatization of healthcare and ignored the state’s duty to protect the right to life of individuals. Primary and secondary healthcare centres at a local level lie abandoned or unmanned. General medical practitioners, who formed the backbone of private healthcare have all, but disappeared.
There are no credible government medical testing labs, except in large towns and district headquarters. In most states at the block-level, government healthcare presence is either non-existent or ineffective. In some states, primary healthcare has been taken away from municipal bodies and is back with the state government, with no benefit to the ailing.
India’s failure to ensure access to clean air, clean water, healthcare – preventive and treatment, among others is a breach of the right to life. Not only is healthcare a fundamental right but also recorded in our Directive Principles.
We lose Indians to infectious diseases that are treatable and preventable on a daily basis. Yet, during the 12th five year plan, 2012-2017, we reduced public spending on healthcare substantially. Public-private partnerships have been a way of promoting qualitatively superior healthcare to make India a destination of health tourism, which is evident from our prominent city hospitals in the metros. A visit to government hospitals outside the metros shows the woeful absence of infrastructure, doctors and health professionals. Healthcare has been fighting for funding along with education, environment, urban development etc. and has been at the losing end for long with governments propounding the theory of “minimum government maximum governance”. But what about the right to life? The State’s duty to provide healthcare was recognised in 1989 in Parmanand Katara’s case. Treatment cannot be sacrificed on the altar of governments committed to market economy unmindful of human cost. The abrogation of the government’s responsibility to provide healthcare at the village, block, tehsil and district levels has thrown up a challenge to policymakers, which is not just limited to healthcare but has far-reaching economic, political and governance implications.
Covid-19 is a wake-up call for governments worldwide, centre or state, at every level, not only in India but internationally, that basic amenities such as healthcare and education cannot be completely subcontracted to the private sector. This is necessary to bring about a state where a citizen who pays his taxes (and even the ones who do not), is owed a duty by the State as part of our social contract, not to be left to seek access to inadequate state healthcare facilities, which fails to protect our lives and health.
(Sidharth Luthra is a former Additional Solicitor General and senior advocate, Supreme Court. The views expressed are personal)