Context: An Indian National Health Service based in the British National Health Service or NHS provides the necessary framework for reforming the healthcare sector in India.
Debilitating condition of healthcare in India
- Near-chaos amidst the pandemic: Herculean task before medical staff, patients' families, and governments to try and cope with tsunami-like rise in Covid cases.
- Desperate and over-stretched clinical infrastructure: Care staff working desperate-best despite being at high risk of contracting COVID-19.
- Fragmented responses: The responses are being carried out in respective jurisdictions.
- The railways are running special trains carrying oxygen supplies.
- Karnataka government ordered private hospitals above a certain size to reserve 75% beds for COVID-19 patients who will be paid for under a public scheme.
- Supreme Court, suo motu, called for national plan to deliver oxygen and vaccines.
- Fragmented healthcare: Fragmented, often corrupt, urban-centred, elite-focused and wretchedly underfunded agglomeration of clinics, hospitals, and variably functional primary health centres.
- Low public spending: Remained for long at 1% of GDP, though expected to double in 2021-22.
- Low doctor-population ratio: In certain rural areas, the doctor-population ratio is over 1:40,000.
- High incidental costs: Journal Lancet Planetary Health says air pollution accounted for 1.7 million deaths in India in 2019, annual business cost of air pollution estimated at $95 billion, which is 3% of India's GDP.
Historical Enumeration of Indian National Health Service
- In 1946, Sir Joseph Bhore proposed a national health service broadly modelled on British National Health Service (NHS), encompassing preventive and curative medicine integrated at all levels.
About British NHS: Depicting the post-war social democracy and mixed/welfare economy, it provides for top-class universal healthcare, including training, research, and changing engagement with public as society changes.
- Funded entirely from general taxation: Budget includes a payment to general practitioners, most of whom remain private providers but are paid by the state for treating NHS patients.
- Universal access: All hospital treatment and medicines are free, including outpatient and follow-up appointments, and provides highly localised access to care.
- Largest employer: With 1.1 million staff, NHS is the largest employer in the U.K. with budget of 7.6% of GDP.
- Problems associated with NHS:
- Unintended inequalities: In time and attention given to patients of different social classes.
- Administrative challenges: Huge and frequent reorganisations imposed by the Central government and often ideologically driven underfunding.
Conclusion: Precise structure envisaged by Bhore may need some adaptation for today's society, but dealing effectively with pandemic may itself require urgent creation of an Indian National Health Service.