Free health-care plan gets PMO push

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  • Published 1.03.12

New Delhi, Feb. 29: A meeting called by the Prime Minister’s Office (PMO) today asked the Union health ministry and the Planning Commission to take steps to help the government offer free universal health care, as proposed by an expert group last year.

The PMO meeting asked the commission to allocate adequate funds to enable the government’s health spending to increase from the current level of 1.4 per cent of the GDP to 2.5 per cent of the GDP by 2017.

The meeting also urged the health ministry to strengthen facilities across primary and community health centres and district hospitals, in preparation to roll out free diagnosis, treatment, and medicines for a minimum package of services as recommended by a high-level expert group (HLEG).

The health ministry has also been tasked with developing a set of standard treatment protocols (STP) that are intended to avoid any irrational use of drugs after patients begin to receive free medicines from government clinics.

During the meeting, the commission was also asked to develop strategies to “motivate and incentivise” states to increase their own funds as health is a state subject. “The implementation of universal health care will hinge on states’ enthusiasm for this idea,” said Selvaraj Sakthivel, a health economist with the Public Health Foundation of India, who was not present at the meeting.

The meeting also called on the health ministry to set up a central agency for bulk procurement of drugs, a crucial step to facilitate the distribution of free medicines for all through public health facilities. The ministry has also been asked to help create additional human resources — doctors, nurses, auxiliary nurses and midwives, and paramedics — to support the proposed universal health care plan.

Public health experts say the implementation of the plan is likely to be occur in phases.

“We expect that the distribution of free medicines could begin within six months to a year — some states such as Bihar and Rajasthan have established mechanisms that can support a quick roll out of free medicines,” said Sakthivel.

Tamil Nadu is already distributing free medicines through its public health system, he said.

But public health experts believe that the process of identifying private clinics and hospitals that can be contracted in by the government to provide free services is likely to be a “long-drawn process”.

Contracted private clinics would need to meet specific quality standards. However, sections of the private sector have been opposing an independent plan by the health ministry to establish minimum standards for private sector health establishments.

The proposal for universal health care made by HLEG to the commission in November last year emerged amid concerns that spiralling costs of health care forced 40 per cent of households of hospitalised patients across India to sell assets or borrow money to treat illnesses.

The HLEG had recommended universal health care fully funded by the state, covering a minimum package of services that would cover common as well as major illnesses and all reproductive and child health services such as pregnancy, immunisation, and child care.

The minimum package of services may vary from state to state. HLEG members had earlier said non-essential or prohibitively expensive services such as dental implants or cosmetic surgery or liver transplantation were unlikely to be part of the health package.

The HLEG has recommended that funds for universal health care should be primarily sourced from tax revenues.