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HEALTH CARE SECTOR IN INDIA: ISSUES AND CHALLENGES
BY: DR. T.K. JAIN AFTERSCHO☺OL

Health, education, and security are the three most important issues that people face. It is one of the fundamental responsibilities of the government to provide these three important facilities. These are as good as fundamental rights. If the government doesn’t have budget for these issues, that it should not have budget for other things also. There should not be any excuse, when we talk about these fundamental issues. It is and will remain an important responsibility of the government to provide health care facilities to the masses. India’s population is increasing at a very fast pace and diseases and problems are increasing at even faster rate. Both private and government sector must collaborate for achieving good health care. This must be treated as a fundamental national priority. For many years, government sector has performed exceedingly well. Private sector has come up now and will continue to grow, but when we talk about rural areas, or when we talk about far off places, the government sector still remain the only choice. We have to strengthen the government sector and use latest technologies like audio-visual aids, video

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conferencing, etc. so that the government sector is able to meet the requirements of the masses. There are two aspects – one regarding treatment and the other regarding management of institutions engaged in health care. The government sector still has excellent group of doctors. But unfortunately, the management of govt. sector hospitals is very poor. It needs professional management. It needs autonomy and it needs to be freed up from political interference. It can give excellent support to the poor people – as it is still very competent to hand the masses from India. We should also look at initiatives of non-profit hospitals like Narayan Sewa Sansthan, Arvind eye hospital, Mahavir Cancer centre, Heart care foundation etc. These are doing pioneering work. They need to be encouraged, and given full support. They can help us in providing low cost health care treatment. They can also give us model of hospital – which is both efficient and well managed. They are providing better treatment at lower cost in comparison to government sector hospitals. They need to be recognized, supported and appreciated. Health care needs professional management. We still have a few management intuitions in this sector. We have for example IIHMR, and some other institutions. Management components must be added and training and re-training programmes on behavioral management must be introduced. The health care sector must be managed exclusively by the professionals from this sector. It is a very important sector, but unfortunately, we have not given it due importance Thousands of villages still don’t have easy access to primary health care centers, safe drinking water, good sanitation facilities, nutritional diet, and health care counseling.

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We organized a group discussion on this issue. Budding health care professionals presented their opinions on various aspects related to health care. P: I think that entry of private sector is very good. It is not possible that only government sector can cover health care requirements of the country. It is not possible to have government sector hospital in every nook and corner. There are all types of diseases and there are different requirements. If every person goes to the govt. hospitals, there are possibilities of difficulties in management in the hospitals, further contaminations are also possible. If a person is suffering from some specific disease, that person should go to the specialized hospital. P2: health is the most important and challenging problem of our society. Due to changing lifestyle, there are many health hazards, there are many problems relating to health care. Commercialization has both positive and negative impacts – privatizations create lots of jobs, opportunities, and standards. There are so many good hospitals – which were not there earlier – they are now running and providing very good facilities due to freedom to the private sector. Although the government sector is trying its best, but due to entry of private sector, there are also fewer burdens on government sector and it is easier to approach government hospitals. Now we can see that in every street there is some or other clinic. There are also increased research and developments taking place due to increased investments in health care sectors. Private sector hospitals are also doing research. There are heavy uses (or misuses) of advertisements by private sectors. There are also hospitals, which are involved in fraudulent practices. There are also hospitals, which are involved in unfair practices. Expenses on treatment of people is also increasing R: commercialization has increased in India. There are many advantages and disadvantages of it. I personally believe that commercialization is good – due to privatization there is increase in health care facilities. The facilities
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offered by private sector hospitals, are comparatively better – particularly in terms of cleanliness, order and systems. For the health care sector – these issues are important P: health services have become costly – it is not possible for poor people to avail of health care facilities from these private sector hospitals. Poor people can approach government hospitals. The government hospitals have to provide free (or low cost) medicines and facilities. This is a transition period – in future, we will witness a large number of hospitals in private sectors. On the whole the private sector hospitals will provide good services –as they are running it on profit motive. A substantial part of our population is rich and they can afford to visit private hospital. They don’t have time to stand in queue and they need private sector hospitals. There are also good safety practices, they are also improving. If we compare our health care hospital with international hospitals – we will find that hospitals in our country are very economical. There are possibilities for medical tourism. R: there will be better guidance in private sector hospitals – in government sector, there is no body to guide and help the patient. There is lack of accuracy and lack of response in government hospitals. P2: private sector hospitals have also checked the migration of skilled doctors to other countries. Due to lack of opportunities, many doctors left our country. Now with the entry of private sector, these doctors are able to get opportunities in private sector. In the case of health issues, no person looks at budget – we know that health care is the first priority for every person. In government sector, patients don’t get appointments from the doctors. Looking at issues like money involved etc. it is a very important issue. There are many new diseases and the government sector is not able to cope with the increased pressures. Private sector hospitals invite experts from across the globe and raise the health care standards.
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P: after the god, the status of Doctors is very high. Now the doctors are totally money minded. Doctors getting very low salary might indulge in wrong practices. In government sector, we have seen that doctors prescribe medicines on which they get commission – sometimes even of very low standards. Government sector hospital, doctors don’t bother about providing services to the patients. But the private sector hospitals have to establish their reputation and therefore they have to provide good quality medicines and facilities. Thus government sectors, where you find only queues and non-cooperative doctors, have an option today and the private sectors have opportunities. They treat the patients in a very cooperative manner. They also try to provide good facilities and order. R: in government sector, the doctors are also totally commercialized. The doctors don’t give good advice. When patients visit the doctors and offer them their fees, then only they are able to get good advice. This is sheer commercialization. P2: Yes, it is a major problem. In government sector, the doctors invite the patients to their home and earn money by private practice. This is a major problem these days. Some companies have come up with low quality medicines, but they are able to lure the doctors to prescribe these medicines and they offer lucrative incentives to the doctors – this is a major problem now. Private sector hospitals are by now trying to maintain quality. P: India, being a very big country, need huge budget for health care also. It is not possible to have hospitals of the standards of AIIMS in every part of the country. There is only one hospital of the standards of AIIMS. But in private sector, we can have many hospitals of good standards like: bridge candy, hearts, escorts, Apollo, etc. private sector can thus meet the increasing demand of our country. Hospitals also follow hierarchy system. From rural areas, we go to bigger cities. There are thousands of patients who want to go to AIIMS. However, it is not possible for AIIMS to satisfy the requirements of every person. Thus there are problems and we can solve
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these problems only by privatization. In private sectors, we will be able to have world class hospitals and also we will find an increase in medical tourism. R: Private sector is good in health care sector. Patients are able to get good facilities and response in the private sector. In private sector, they have to make arrangement of good response, good communication and thus there will be increase in health care standards in our country. Thus we will be a better ranked country. P: a large number of people in our country are now in middle class. They are willing to spend money for health care. There are people in the middle class – who should spend money. No person wants to compromise with quality in the health care issue. Patients in our country are in need of good facilities. P2: we have seen that only treatment related issues were important earlier. But now people look at health care management and practices also. People also look at prevention of health related problems. There are companies that evolve products for prevention of diseases. These are creating job opportunities and raising standards. P: if we look at 50 years back, we find that people at that time looked at the basic requirements only, but now we are looking for better facilities. Now we are demanding. It is an opportunity for business persons. As income is increasing, we are also willing to spend more. There are different levels of problems. P2: if we look at the past few years, we find that there are people today are aware of treatment facilities for different diseases and are also aware of various health related companies and their products. Companies are trying to popularize their products and services.

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P: earlier our patients had to go to the USA for critical diseases, but now we need not go abroad, as all kinds of medical facilities and medical treatments are available in our country. If we visit the nearby hospitals, we find that while earlier we had a few companies, but now we have a large number of good hospitals, pharma companies and allied services. It is good for both patients and for the profession of health care. P2: due to increased competition, they are reducing prices and also compromising in terms of quality products. There are a lot of fake products in the market. There are medicines, which are of lower standards, but are sold in bulk. Marketing and publicity are very crucial and private sector companies are mis-using these. P: health care is a very broad sector and there are a number of services. Today we have services like gym, spa, health counseling, nutrition counseling. Thus after 10 or 20 years, average life span of average Indian will increase and will strengthen our health care system. If we go to the ancient health care system, we can find that in places like Kerala, Himachal Pradesh etc, there are lots of ancient treatments – which must be promoted. The traditional health care practices must be promoted. These are also increasing foreign exchange revenue also. P2: many foreign companies are investing in our country. Their products were not available earlier – but they are available now. This is due to commercialization and globalization. P: yes, many pharmaceutical companies are entering our country. They are providing advanced facilities and latest medicines. They are providing latest medicinal facilities. Only government sector can’t do everything. We have to ensure that we are able to promote our health care facilities and are able to provide health treatment at lower cost to the common people. Private sector companies are not yet very strong – but they need support. We must promote small companies in private sector. There is a possibility that private sector may spread development. But freedom can’t be absolute.
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Contact Dr. T.K. Jain (91-9414430763) regarding starting AFTERSCHO☻OL centers in your college / institution / organization or for conducting workshops on social entrepreneurship. Promote social entrepreneurship, join PGPSE and become a social entrepreneur. Email us: afterschoool@in.com

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