Government hospitals and health centres in West Bengal’s rural areas will be providing free basic medicines and diagnostic services to patients both below and above the poverty line. This is what the chief minister has announced as a “landmark decision” on Facebook, taking health-sector reforms a step beyond the fair-price medicine shops that were opened at the state-run hospitals in Calcutta and the districts. What the chief minister has promised Bengal’s villages already exists in states like Tamil Nadu and Rajasthan, but being able to fulfil and maintain such services would mean radically enlarging and invigorating a medical, paramedical and administrative infrastructure that has been notorious for its inhuman dysfunctionality for decades — and this reality includes state-run urban healthcare facilities as well. In a chronically unequal society, poor, illiterate people, who exist beyond the ken of the urban privileged, are often regarded as undeserving of quality-control, especially when they are officially availing themselves of ‘free’ healthcare.
So, the chief minister, the health minister and the state’s medical establishment will have to set up an efficient and self-sustaining system of administering — in both the medical and managerial sense of the word — this elaborate network of services in regions that are often remote and outside the reach of, say, internet connectivity. Besides, relentless monitoring of standards and quality, efficiency and guarding against corruption and all kinds of discrimination will also have to be kept up. Not only trained and motivated doctors and nurses, but also technicians, pathologists and administrators are required to sustain such a promise, and this is going to be the primary challenge for the chief minister’s fulfilment of her promise. Somehow working in the rural sector will have to be made materially and professionally rewarding enough for people to do this work properly. This might be difficult to pull off.