A recent declaration of the Government of Odisha for free healthcare under a Biju Swasthya Kalyan Yojana definitely is a good step, but this may not be much helpful to the poor people in the interior parts where basic health infrastructure is not available. This will just further help the people already having access to hospitals. There is lack of hospitals along with shortage of doctors, health workers and necessary healthcare apparatus, medicines for delivering quality health service in the state. This persistent situation is by now affecting people much depending on the Government hospitals, but there is no plan and budgetary allocation by the Government to bring the desired positive change in the existing condition. There is regular news about issues of lack of special transport facilities such as ambulance and special medical vehicles in carrying serious patients to hospitals, especially pregnant women and elderly people.
Most of the government hospitals are running with poor quality of health service and lack of minimum facilities and the medical colleges and hospitals are overcrowded with patients from distant places with their caretakers and relatives taking shelter in the medical veranda. These hospitals have no facilities for the attendants. The hospitals are filled with Dalals or middlemen who are exploiting the poor patients from distant places. There is regular conflict among patient’s attendants and the service providers. Besides, the cleanness, discipline, privacy and security issues in the hospitals are not being addressed by the government. It is a fact the doctor-patient ratio in India is less than the WHO prescribed limit, i.e. 1:1000 though every year about 5500 doctors pass out but most of them are not willing to serve in rural and tribal areas due to feeling of professional isolation and discrepancy in living condition and also lack of co-workers especially well- trained supporting medical staff. In case of Odisha, there are only 9.75 doctors per lakh population and less than four beds per 10,000 population.
About 20 percent of the posts in hospitals are vacant and there has been no attempt to fill up these vacancies. The alternative system of medicine, Ayush, Ayurveda and Homoeopathy has not been developed in the State, especially in rural and tribal areas. There is increase in private medical institutions in districts of Cuttack, Khurda, Ganjam and Kalahandi whereas there are districts having very less number of such institutions. In the recent past, the State experienced the death of 34 infants in Sishu Bhawan, Cuttack and hundreds of children died in Malkangiri due to Japanese Encephalitis. Besides, the death of 20 Juanga children in Nagada of Jajpur district, 15 children of Paudi Bhuyan in Sundargarh, Keonjhar, Kashipur of Rayagada due lack of healthcare facilities had shaken the state. The five major diseases, malaria, leprosy, scabies, acute respiratory infection and diarrhea still collectively account for more than 70 percent of the total patients in Odisha. The lack of primary healthcare facilities in the interior tribal parts of the State has been the cause of death of children every day and there is no data about all these deaths.
The tribal people still prefer the traditional method of treatment and have practices of traditional healers. Witch hunting is a regular phenomenon in many parts of the state. Due to absence of primary healthcare facilities, absence of doctors, health workers and other service providers, the situation in the rural India is deplorable. There are good models of quality healthcare facilities by the state governments such as Delhi and Telengana which are being discussed and appreciated internationally by Director General WHO and former Secretary General of UN and Prime Minister of Norway. Especially the Mohalla/Community Clinic of AAP Government of Delhi lunched in 2015 in ensuring free healthcare for the poor people has received appreciations everywhere. The community clinics are catering to about 100 patients every day and substantially reducing the financial burden of the poor in accessing quality health service at door step. This people friendly free of cost clinics are possible with about 4 percent of the total health budget of the Delhi Government spent on them. The Government of Telengana has started medical college in each district along with concept of area hospital, Arogya Laxmi with nutritious diet to mother and child. The pregnant women get Chief Minister KCR Kit for delivering in Government hospital and also with additional amount if delivered baby girl.
The government has also regulated the private hospitals treatment fee by introducing hospital grading system as one of the pioneer initiatives in the country. The government of Odisha should follow such states having exemplary work in health sector, especially for the poor people. Universal access to free and quality basic health services has been one of the major objectives of National Health Policy of Government of India formulated in 2017. The Central Government has come up with Ayushman Bharat Program to build 1.5 lakh health centers closer to home of the people and providing healthcare insurance coverage up to ₹5 lakh to over 10 crore families of the country which is almost half of the population. There is already a budgetary allocation for that. The National Health Policy aims to increase the public health spending up to 2.5 percent of the GDP. Unfortunately, the state government of Odisha has not been implementing a number of Central Government schemes and programs for a number of reasons, including financial limitations, but there has been no financial mobilization from different sources of both private and public sector to address the pressing health issues of the state.
The funds available with corporates under CSR, public sector under takings and under different plans such as DMF, TSP, SCSP and under different Central schemes are not pulled in a planned manner to spend on heath sector. As a backward state having large percentage of poor people, Odisha deserves more finance resources for health sector and it is the duty of the Center to limit regional imbalances in the country, specially by investing more in the development of the backward regions and marginalized sections. Health being a State subject, it’s the primary duty of the State Government to build necessary health infrastructure and develop required healthcare personnel to meet the growing need of the people. There are remote areas with tribal and other marginalized poor population who are deprived of basic healthcare and continue to suffer more in the changing adverse social, environmental and economic situation. The selective service in areas having Government hospitals and the growing dependence on private services and increasing cost of treatment and medicine only lead to further marginalization of the poor people. – Daily Pioneer