A National Health Service In India

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.