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Distant hope

The cure for a lot of illnesses is sometimes a simple pill. At present, the ailing healthcare system in India could use a similar prescription. According to a study conducted in three blocks in Tamil Nadu, improving the condition of health sub-centres in the country can lead to a marked reduction in medical expenses. If HSCs are properly functional, out-of-pocket expenses would fall from an average of Rs 336 to less than five rupees for each patient. This is particularly relevant for India, where such expenditure comprises almost 62 per cent of total medical costs. Moreover, the government also stands to benefit by empowering HSCs. It will save at least Rs 200 in the cost of care for every out-patient diverted from higher public medical facilities to HSCs.

The percentage of the gross domestic product allocated to healthcare in India is one of the lowest in the world. Yet if there is one thing that this 'pilot' study asserts, it is the efficiency of the existing model of healthcare. But HSCs across the country are not only understaffed with poor infrastructure, some are also non-functional. Further, only 11 per cent of the 1,56,231 sub-centres across the country met the Indian Public Health Standards last year. Since these centres are the closest points of contact between the public healthcare system and communities, operational HSCs would immediately make medical aid far more accessible to all. But can this be done in isolation? There is the question of doctors and paramedical staff. And this is not just an issue of numbers. Doctors will need acceptable living conditions and security. This is a far bigger investment than just making HSCs operational. There also has to be a guaranteed supply of basic medicines, with allied materials from cotton wool to oxygen. The state of government hospitals outside cities suggests that this is a tall order. Yet, given that 70 per cent of the country's population lives in rural areas, active HSCs could create a real impact in giving economically viable healthcare to the sections of society most in need. As things stand, there is only one doctor for every 1,674 patients in the country. This crisis did not occur in a day. Instead, it exposes the apathy of successive governments since Independence. Whatever plan is formulated, the first step is for the State to be sincere in its intent.

Opinion

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