ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Draft National Health Policy 2001-I : Debt Payment and Devaluing Elements of Public Health

Had the new health policy document proposed an overarching vision of how all the elements it enumerates would be put in place, it would have been a visionary document. As it stands the draft policy is riddled with contradictions and confusions. It spells a significant departure from the 1983 policy objectives of providing primary health care for all, specially the underprivileged. Instead of creatively utilising private sector to provide basic affordable health care, it all but hands over the task to the private sector, inevitably undermining existing national health programmes. By encouraging the corporate involvement in tertiary and secondary level medical care without first ensuring their access to the underprivileged, the draft denies the rights of the poor to good care.

The much-awaited National Health Policy (NHP) has finally been cir-culated as a draft, for public debate. On the face of it the document includes all that which is indicative of a progressive public health policy. For example, it talks of integration of vertical programmes, strengthening the infrastructure, promotion of public health as a discipline, filling the gap of availability of doctors by introducing short-term training for basic services (revival of the licentiate medical practitioner), decentralisation of health care delivery through panchayati raj and autonomous monitoring institutions, setting up a national disease surveillance system as well as a national accounting system, strengthening ethical practices, and regulation of private practice. It also talks of increase in investments, particularly from the centre. This would go up to 25 per cent from the present 20 per cent of the total health expenditure. It would also induce greater investment by the states as well, whose expenditure has gone down from 7 per cent to 5 per cent of their budgets.

If the NHP document proposed an overarching vision of how these principles would be enunciated, it could have been a visionary document written by bureaucrats. Unfortunately, the document is riddled with contradictions and confusions. It makes a valiant effort to cloak the reforms with intentions that are appealing but not necessarily applicable. Despite all commitments to quality, coverage and equity there is a complete break in continuity from the past. The draft policy ignores the 1983 policy’s objectives of protecting and providing primary health care (PHC) for all, specially the underprivileged. In fact, it appears to be more of a deterrent rather than an instrument for achieving the guiding principles of the past health policies. Instead of mobilising the private sector in a creative fashion, ensuring its support to achieve national goals, by handing over medical care to the private sector, without first streamlining and standardising it, the draft undermines the existing national health programmes. Also, through commercialisation of tertiary and secondary level medical care to earn foreign exchange, without first ensuring secondary and tertiary care to the underprivileged, the draft denies the rights of the poor to basic health care. We illustrate some of the key contradictions and confusions that are conspicuous in the document.

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