Calcutta, Dec. 30: Economist Amartya Sen today said there was a lack of commitment by governments in using healthcare resources effectively and lack of accountability among doctors and health officials.

“The primary deficiency in healthcare is the inability to commit to resources available,” Sen said, delivering a lecture at NRS Medical College and Hospital.

Only 1.1 per cent of India’s GDP is allocated for health, lower than in most countries, the Nobel laureate said.

“Have we given up on equity in health?” he asked while pitching for more funds for primary healthcare.

According to a United Nations Development Project (UNDP) report on public expenditure on health in 2007-08, India’s allotment is lower than that of Bhutan (4 per cent), Sri Lanka (2 per cent) and Ethiopia (2.7 per cent).

“Even the amount of money spent is not spent very well,” Sen said.

He pointed out the lack of accountability among government health officials and doctors in state-run hospitals. “Sometimes, when one visits a rural primary health centre, the officials are not present. Doctors ask patients to go to private doctors.”

According to Sen, the dearth of funds was compounded by the inability to use the resources available, which “prevented attracting more funds”.

He said the best way to improve the situation was to earmark more funds for primary healthcare.

While underlining that education was still deficient in India, Sen said healthcare was more neglected.

Education can, however, cure some of the maladies. Sen said: “Education can make someone read about health, (the) problems of smoking and get information about other health issues.”

The number of nursing and paramedical staff has to be increased and more doctors posted in rural areas.

Poverty — income poverty and poverty in public health —and lack of public sanitation and drinking water are huge problems which should be addressed by the government, he said.

Trade unions will have to change their mindset and work for the larger benefit of the people, Sen said. “(The) inability of unions to think broadly has to change. Bengal has one of the longest histories of Left politics with the Leftist government in power for the last 30 years. But even during the high point of Left politics, the unions were responsible for their members only.”

Sen also slammed those who blamed American imperialism for most problems. “The US imperialism does not prevent us (from) having more rural doctors and nurses and spending more than 1.1 per cent of GDP in (the) health sector.”

Malnourishment in India, he said, was higher than in most countries and people were dying because of lack of basic healthcare.

The Chandrakant Patil Memorial Health Dialogue was organised by the Liver Foundation, formed by doctors and social activists to raise awareness on liver diseases and public health, and the Pratichi Trust, set up by Sen for research on health and education in India.