Comprehensive treatment for medical education

Assessing the growing percentage of mortality due to the lack of medical facilities in India, time has come to follow the recommendations of the Randeep Committee. To change the scenario of the healthcare services, the committee asked to revisit the MBBS curriculum on the ground of practical needs. But this is not enough, the government should allocate a sufficient amount for health care sectors.

Hyderabad (Telangana): We are a country where around 24 lakh people are losing their lives on an annual basis, only due to the lack of availability of timely and proper medical service. On the other hand, there are millions of people who have been plunged into a miserable life every year, in order to meet the medical expenses.

In such circumstances, the ‘Right to Live’ provided to the citizens by the Constitution of India is getting diluted.

Earlier, the Parliamentary Standing Committee has not only pointed out various loopholes in the standards of the medical field in the country but has also stated that there is no standard medical education in the country that can completely satisfy the health needs of the country. The services of over lakhs of medical personnel and specialists are needed to overcome this plight.

The key recommendations of the Six-member Committee appointed by the 15th Finance Commission under the leadership of Dr Randep Guleria, Director of AIIMS (All India Institute of Medical Sciences), New Delhi, seem to target qualitative changes in the medical and health sectors across the country, over the next 5 year period.

The Committee, which is to declare ‘Health’ as a fundamental right, wants to transfer ‘Health Care’ from the State-List to the Concurrent List.

The Randeep Committee stressed on the need for revisiting the MBBS (Bachelor of Medicine and Bachelor of Surgery) curriculum, while also suggesting on increasing the number of PG Courses in the medical care equivalent to the MBBS seats in the country, by the end of 2025.

As part of the wide range of reforms, it has also stressed upon the need of having the setup of a private hospital with at least 3000-5000 beds, in every second and third class city and town.

There is a need to respond to the recommendations of introducing specialization at the MBBS level itself, thereby improve the ground-level conditions in the healthcare field. In the wake of the scenario wherein there is a dearth of medical colleges, it is required that private and government hospitals should be utilized for training the PG students.

The governments should take a call on these recommendations, with utmost care.

India is home to 17% of the total world population. The official estimate is that 27% of neonatal deaths, 21% deaths of children below five years, and 20% of the international disease burden is seen in this country itself. As per the World Health Organization (WHO) estimates, for every 1000 populated area, there should be at least 1 medical officer/doctor.

However, to meet this standard, it is being analyzed that India shall have to wait at least a decade from now and this analysis speaks for itself as to the reason why the health schemes being introduced in the country are not up to the mark.

As a corrective measure, the introduction of PG seats in parallel to the MBBS seats is being proposed. However, the cost on the government for taking this step solely is dependent on the cost factor.

At present, the number of MBBS seats in the country is about 80,000. PG seats are 1/3rd of this number. The centre announced five months ago that 15,700 MBBS seats will be made available in 75 new government medical colleges by the academic year of 2021-22.

If MBBS and PG seats are granted in excess, to government medical colleges anywhere, the states will have to rise up to 40% of the cost for infrastructure development. Going by this calculation, if the PG seats are to be introduced on par with the previous and current MBBS seats, the state governments will have to bear huge costs towards the infra and other development, so as to make it possible for accommodating both – PG and MBBS seats equally.

It is better if the central government purges the existing rules so that the States that have been already pressurised under the financial crisis are not affected further.

At present, new infectious diseases are on the prowl in the nation. To enhance the access to medical education according to the practical needs, the priority agenda for the Centre is to set the best standards in teaching and to ensure quality health services.

While Britain is implementing the National Health Service (NHP) scheme for all its citizens irrespective of their socio-economical status of being rich or poor, Germany is applying a compulsory Social Insurance Scheme to 1/3rd of its population. Switzerland is taking all precautions to protect the health of everyone living on their soil. China, Italy and Greece compete in the practice of universal health protection plans. The percentile of citizen’s self-funding towards their medical and health needs is about 18% internationally.

However, it is about 63% in India, where citizens will have to self-fund towards their health needs.

In countries like Switzerland, France, Germany, etc, about 10% of the Gross Domestic Product (GDP) is allocated to the medical and health needs of the citizens, thereby making these countries exemplary in the public health sector. However, in India, it is just 1.5% of GDP that is allocated for public health, thereby creating a huge personal obligation for the Indian citizen at large!!!

Apart from the states like Uttar Pradesh, Bihar, Rajasthan and Madhya Pradesh, the health care budgets of both the Telugu states is also not very encouraging in terms of the GSDP (Gross State Domestic Product).

The Randeep Committee stated that by the year 2025, the national level public health care allocation should not be less than 2.5% of the national GDP, and 2/3rd of it is to be set aside for basic medical treatment.

On the basis of the availability and quality of the SWASTH services, it is unfortunate that India is still restricted to 145th position in the list of 195 countries.

The duty of responsible public governments is to put proper budget allocations to the public health care stand accountable, fulfil staff vacancies, supplying essential equipment and medicines, and transparent supervision.

Only when the people-elected governments succeed in this process, can the affected population feel relieved and can be said to proclaim their ‘Right to Live’!!