Draft National Health Policy 2015
Draft National Health Policy 2015
Criticism of draft National Health Policy
- The national programmes provide universal coverage only with respect to certain interventions such as maternal ailments that account for less than 10 per cent of all mortalities.
- Over 75 per cent of the communicable diseases are outside their purview and only a limited number of non-communicable diseases are covered.
- As it stands, health will be recognised as a fundamental right through a National Health Rights Act only when three or more States “request” it. Since health is a State subject, adoption by the respective States will be voluntary.
- There is no commitment for regulating and increasing accountability of the private sector, where it advocates for ‘engagement’ and involvement with private sector on scale designed to facilitate corporate/ private heist of public resources, which can only mean further weakening and destruction of the public health system.
- Even though it makes long and winding declarations about the importance of strengthening the public health system there is no clear framework or roadmap for actions; it does not set any timelines to achieve key health outcomes and there is no commitment to allocating resources for strengthening the public health system.
- Though a different approach has been taken to improve adoption and implementation by States, the very objective of universal health coverage that hinges on portability will be defeated in the absence of uniform adoption across India.
- The draft NHP is silent on the expectations of ASHAs. The way they have been exploited and under-recognised in terms of payment, access to facilities, etc. ASHAs have credibly established themselves as “activists” in only rare circumstances. Certification of skills is essential, but not a substitute for compensation and social security. We should learn from Iran which has scaled up and supported thebehvarz (Iran’s community health activists) by creating posts and institutional structures for their activities.
- “Extractive industries and development projects that result in displacement or those that have negative impacts on natural habitats or the resource base can be considered for special taxation extractive”.
This stand of the government severely undermines and violates a sustainable and eco-preserving development model.
- More Medical Colleges: no rationale is provided for simply adding to the number of medical colleges, without interrogating the quality of medical education. It is common knowledge that a lot of medical colleges that have come up after 1990 are privately funded, often abysmally equipped, and arguably churning out inadequately trained professionals, while receiving accreditation through equally dubious means; there are accosting issues of seat auctionings as well (Seethalakshmi 2013; Nagarajan 2014). So, without even addressing these factors which are eating away at the existing healthcare system, a simple glorification of numbers of quality is naïve at best and criminal at worst.
- Possible Interfaces: The document does not explicate how it will interface with the other existing allied policies, such as, the health research policy of 2010, the drugs policy, the palliative care policy of 2012, the occupational health policy, and the changing terrain on patent regime in relation to ensuring availability of generic medicine.
- State Medical Councils: Yet another omission is the absence of discussion on the role and achievements of the state medical councils: the state medical councils have a strong and powerful role to play in regulating medical practice, service and delivery in the state; while it is known that the performance of most state councils have not been satisfactory (George 2011), as a national level policy document, the NHP 2015 should have emphasised the role of the councils, invested them with responsibility and made them accountable in more possible ways.
It is, therefore, crucial for the Union government to undertake proactive measures to upgrade the health-care services of poorly performing States such as Bihar and Uttar Pradesh.
From implementing the urban health mission to training a new cadre of urban ASHAs to facilitating the RTH, a health budget of 2.5% is far too less. The paradox of this third national health policy is that it is self-defeating.
Referencs: The Hindu, EPW