[op-ed snap] Unhealthy Binaries


Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: National Health Protection Scheme

Mains level: Healthcare infrastructure in India


Misleading beliefs related to the healthcare sector

  1. The first, most deep-rooted misleading belief, is that private practitioners are less suited to deliver healthcare services than public healthcare professionals
  2. The second is that health outcomes of patients are immaterial, that there is no need to track patients or maintain records, spending more money on healthcare is enough

Institutional infrastructure to track health outcomes

  1. Tracking health status means that patient outcomes like disease, death, infection and so on, be regularly ascertained, reported and monitored
  2. In some countries, it is routine to set up such reporting systems
  3. They even set up disease-specific registers in which a variety of hospitals and physicians participate

Status of such infrastructure in India

  1. In India, till date, there has been no institutional framework fixing such key indicators
  2. There isn’t any general rule mandating that these should be reported regularly, whether in the public or private sector
  3. The need to track patient status is not given the importance it deserves

Optimal performance not possible

  1. In the absence of system-wide requirements, it is merely ideology and individual conscience that determines the quality of care available to patients
  2. Systems that are driven only by ideology and individual conscience can hardly perform optimally

Patient tracking

  1. It can be done by setting up a simple user-friendly software application
  2. This could be used to record patient data on a few key parameters
  3. Many state governments like Maharashtra, Andhra Pradesh, and Tamil Nadu use such software applications for secondary and tertiary care programmes
  4. These applications could be modified for patient tracking

Way forward

  1. India is moving towards creating structures for universal healthcare with the National Health Protection Scheme
  2. To successfully put care and quality back into healthcare, it is important to set up this kind of system to track the health status of patients
  3. Tracking health status will matter and effectiveness of resource use has little to do with the size of resources made available
Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.
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