Voices raised against privatisation of healthcare

Special Correspondent

 Bangalore, December 16, 2012 , The Hindu

Participants of a convention on ‘Universal Access to Health Care’, organised in the city by the Janaarogya Andolana Karnataka (JAAK) on Saturday, resolved to oppose privatisation of the public health system in all forms.

The aim was to bring together communities and organisations in support of the demand for free, universal and comprehensive healthcare to people from all sections of society.

Discussions at the convention focussed on the Union government’s proposed changes in the health policy as drafted in the 12th Five-Year Plan.

“The Planning Commission in its 12th Five-Year Plan’s draft chapter on health is suggesting several dangerous moves in the health policy designed to strengthen the unregulated, profit-oriented private health sector and further weaken and decimate the public health system,” said Akhila Vasan from JAAK.

‘Flawed models’

“Under the pretext of providing universal access to healthcare, the Centre is pushing two seriously flawed models of healthcare — the managed care model and insurance. Both of these have been found to be ineffective in reducing out-of-pocket expenditure on health,” she alleged. Abhay Shukla from Maharashtra’s Jan Swasthya Abhiyan (JSA) said the country has a public system that has been weakened over the last 60 years by the government’s privatisation-friendly policies and an unregulated private sector. “We need to have a paradigm shift in how we understand the existing situation by building a people-organised struggle to reclaim public health systems through community accountability and control,” he said.

Blanket opposition

Agreeing that strengthening public services was non-negotiable, the participants resolved to oppose privatisation of public health systems in all forms.

Panelists at the convention included H.V. Vasu from Karnataka Jana Shakti, Mandya; Anasuyamma from the Karnataka Rajya Raitha Sangha (KRRS); Y.J. Rejendra from PUCL, Karnataka; and Lakshmi from Janwadi Mahila Sanghatane. The session was moderated by E. Premdas from the JAAK.

Representatives of various organisations from across the State, pourakarmikas’ union, sexual minority communities, people living with disabilities, people with mental health issues narrated the challenges faced by them in accessing healthcare.


Ministry opposes plan to overhaul healthcare #Goodnews

The ministry has asked Planning Commission to rewrite its chapter on health in the 12th 5-year Plan document

Vidya Krishnan

New Delhi: The health ministry has opposed the Planning Commission’s proposal for a radical overhaul of the public healthcare system, saying it deviates from the government’s primary goal of providing health coverage to all.

The ministry has asked the apex planning body to rewrite its chapter on health in the 12th five-year Plan document that covers FY12-17, a top ministry official said, asking not to be identified.


Voicing opposition: Health secretary P.K. Pradhan (PIB)

Voicing opposition: Health secretary P.K. Pradhan (PIB)


Several of the commission’s suggestions contradict recommendations of the high level expert group (HLEG) on universal health coverage, or UHC, set up by Prime Minister Manmohan Singhin October 2010 with the mandate of developing a framework on affordable healthcare for Indians, this official said. The bone of contention is the Planning Commission’s proposal to switch to a “managed healthcare network” model in which public and private hospitals may have to compete with each other for patients. 

Also, under the plan, the government’s primary healthcare function will be limited to essential interventions such as immunization, antenatal care and disease-control programmes, leaving clinical services to the managed-care model. The government’s role will in effect diminish from providing health services to managing the network.

Under the managed-care model, while networks of largely private hospitals will be paid per patient registered, doctors will be paid per prescription, according to the Plan document. The transition to this model is proposed to happen over two Plan periods (2012-17 and 2017-22).

“We have to learn from the Chinese experience where reform led to creating of public doctors with a private mindset. China is now revising its health policy because of growing inequity,” said Dr. Srinath Reddy, who headed the HLEG.

“We have to ensure the public sector remains committed to providing quality healthcare without chasing money in any and every manner. We need to develop a model of UHC wherein the private sector will assist the public sector in serving a public purpose rather than privatising the delivery of public sector healthcare,” he added.

HLEG members will meet on Thursday to discuss the health plan and will give their feedback to Montek Singh Ahluwalia, deputy chairman of the Planning Commission.

The health ministry will within 10 days send its feedback strongly advising the Planning Commission to rewrite certain aspects of the health chapter, said health secretary P.K. Pradhan, who was also a member of the HLEG that drafted the report on providing UHC in India.

“Our main objective is to strengthen the public health sector. At this juncture, we are convinced that a network-based approach will be very difficult to achieve that objective,” he said.

“Having read both documents, I know that some of the strategies made in the plan document are far removed from the basic tenets proposed by HLEG,” said Abhay Shukla, public health activist with Jan Swasthya Abhiyan, a non-governmental organization.

“The Plan document gives two scenarios of India’s public health reforms. Either the public health system should start behaving like the private sector, with performance-based remuneration, etc., or it should compete with the private sector and reshape itself in the image of the private sector to compete effectively,” Shukla said. “In both cases, privatization and coporatization of healthcare in India appear as the dominant direction. They (Planning Commission) are using HLEG’s name to push these recommendations.”

The Plan document also proposes a significant expansion of publicly funded insurance schemes such as the Rashtriya Swasthya Bima Yojana to provide universal health coverage whereas the HLEG had recommended strengthening public sector hospitals instead of using the insurance route to provide health services.


“Free Medicines for All” soon to be a reality in Govt Hospitals

Feb 13, 2012 NEW DELHI: Free medicines to all patients visiting any government health facility across the country could soon be a reality with the health ministry ready to roll out a nearly Rs 30,000 crore ‘free-medicines-for-all’ scheme with the PMO‘s strong backing.

The free medicine initiative along with an expansion of the National Rural Health Mission to urban areas, a more district-oriented approach and implementation of recommendations of the K Srinath Reddy committee on universal health coverage will be important focus points of UPA-2’s health policy. The scheme is also expected to be strongly backed by the Sonia Gandhi-chaired NAC at a meeting on February 17.

At a meeting chaired by Pulok Chatterjee, principal secretary to the PM, on Friday, the medicine-for-all scheme and other thrust areas got a thumbs up with PM Manmohan Singh keen to roll out health sector initiatives. The medicine proposal will help cut India’s tremendously high out-of-pocket (OOP) expenditure on health care.

Speaking to TOI, a ministry official said, “We are ready to roll out the scheme which will provide free generic medicines to all those who visit government health care facilities across the country. This will reduce OOP expenditure and also encourage more people to visit government health facilities. However, we can’t make the announcement now with the elections on as it would violate EC guidelines.”

Instead of increasing public spending on drug procurement when millions of Indian households have no access to medicines, several large states have decreased fund allocation. Consider the case of Kerala. Even though the state spent the highest in India on drug procurement last year – 12.5% of its health expenditure – the expense was significantly less than in 2001, when it stood at 17%.

“We estimate that an increase in the public procurement of medicines from around 0.1% to 0.5% of GDP will ensure universal access to essential drugs, greatly reduce the burden on private OOP expenditures and increase the financial protection for households,” a report has said. Drug prices have shot up phenomenally in India over the past decade and a half. This has been the main reason for the rising costs of medical care, which more than tripled between 1993-94 and 2006-07.


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