Mr Surya Kanta Mishra is not West Bengal’s first health minister to admit that the government healthcare system in the state is on the brink of collapse. Most of his predecessors said as much, if not as bluntly. Recalcitrant doctors unwilling to work in the villages, perennially agitating hospital employees and incompetent administrators have all but ruined the system. The result is a steady exodus of patients to other states for even basic medical treatment. Mr Mishra has shown some promise of remedying the situation in hitherto untested ways. He seems to have rightly diagnosed that the proper utilization of manpower, rather than of the infrastructure, is the key to improving things in the healthcare system. In his budget speech this year, he admitted that the government’s investments to create a large infrastructure of primary and subsidiary health-centres had not shown expected results mainly because of inefficient use of manpower. His earlier move to disband all district health committees and replace them with new and supposedly more professional bodies was widely welcomed. He spoke the language of reforms when he invited the private sector to supplement the government’s efforts.
But it is the government system that needs to be restored to good health first. It would be unwise to expect the private sector to reach out to remote villages where there is little scope for business and where the quality of the infrastructure leaves much to be desired. It is not as though Mr Mishra does not know this. In fact, his latest call to non-governmental organizations to fill in the vacuum in rural healthcare is an admission of the inadequacy of the government system. What is needed for the NGOs to join the official efforts is a complete break from the culture of absenteeism and apathy among government health-workers. Mr Mishra has been making the right noises against errant employees and doctors. He now needs to act as decisively. A beginning may be made by demolishing all unauthorized structures and evicting all squatters from hospital premises. Employees’ agitations in hospitals must be firmly put down. It is not enough to cry out to the private sector and the NGOs for help. They must be assured that the government too means business.