On Thursday, West Bengal chief minister Mamata Banerjee ordered an inquiry into the death of 12 infants at a hospital in Kolkata. The babies had died due to complications associated with low-weight or premature delivery.
This is not the first case where mothers and children have died in hospitals in large numbers in recent months. In Rajasthan, to give another example, scores of women have died during delivery in recent months. The cause of death: Infected IV fluids. There also have been instances where medical negligence at government-run hospitals has been glaring.
It is, perhaps, unfair to link two different cases in different states and blame the government for what is happening. But what cannot be denied is that in recent years the demands on the healthcare system have multiplied greatly, while the investment on the system has remained stagnant at best. In real terms, government spending on the healthcare system is barely 1% of the gross domestic product (GDP). There are plans to increase this to 2-3% of GDP. They have remained what they are: Plans. The results are obvious: Only half of pregnant women receive the medical attention required. Barely half the children aged 12-23 months receive immunization. These are shocking statistics for a country of India’s economic prowess.
If investment and public expenditure on health is one issue, that of seriously misaligned incentives in the system close this vicious circle. From primary healthcare centres to district hospitals, absenteeism of doctors and paramedics is a common story. Most of them prefer private practice that pays more as compared with what the government salaries yield. This is a burden on the poor of the country. In fact, the number of persons pushed into poverty due to financial burdens imposed by medical treatment is large. In 2004, the National Sample Survey estimated that 12 million households fell into poverty due to these costs.
These are systemic issues to which the Union government has hardly devoted the attention they deserve. The last thing that is required is another set of laws to tame doctors. What needs attention are design issues to ensure that incentives and rising demand for healthcare are better aligned. More money is certainly needed, but in the absence of reforms, resources will not solve the problem.
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