PM Modi launched the Ayushman Bharat Health Infrastructure Mission from Varanasi on Monday. Seen as the largest pan-India scheme for strengthening healthcare infrastructure and being brought in along with addition to the National Health Mission, the launch of the scheme was accompanied by the inauguration of nine medical colleges across the state. The PM’s visit comes just months ahead of assembly elections in the politically crucial state.
Public health experts in UP said the move will boost penetration of health care services in the State known for its inadequate public health services. They have also pointed out that apart from investment in infrastructure that the scheme promises, there is a need to address basic problems of the sector including inadequate human resources, shortage of medicines and beds. Earlier this year, Chief Minister Adityanath had urged MPs and MLAs to adopt a CHC or a primary health centre and contribute to improving the condition of medical facilities in the state, and as an example, had himself adopted four health centres. Many reports have pointed out that during the height of the surge of Covid-19 second wave, the health infrastructure in the State was overwhelmed and critical medical supplies were in short supply, although the State governments have refuted the reports.
UP based health specialist Ranjana Srivastava said the State has its own healthcare scheme to provide free medical aid to those not covered under the flagship central government scheme of Ayushman Bharat and there was a need to know how many people are actually under the cover of health benefits. “There is a dearth of doctors, nurses, pharmacists in States such as UP which can only be countered by an effective micro strategy on ground, with empowered district committees working with other stakeholders such as community members, social activists, and NGOs. The existing PHCs and equipped with trained staff should be revamped so that people don’t have to travel for more than 5 km for any health issue. The public health system needs to be monitored, and should work despite administrative lapses,” she said.
The focus on exclusive critical care hospital blocks as promised by the scheme is important and commendable, and so is the plan to have integrated public health labs in districts, giving people access to “a full range of diagnostic services” through a network of laboratories across the country.
In Niti Aayog’s assessment of hospitals in the district released last month, Uttar Pradesh at 14.8 per cent, had the highest proportion of hospitals with bed occupancy rate greater than or equal to 90 per cent, followed by Madhya Pradesh (10.9 per cent) and Maharashtra (8.2 per cent).
Anjela Taneja, Inequality Campaign Lead, Oxfam India told ET that it is critical to enhance the public health system in the country.
“As such the enhancement in the diagnostic services and critical care infrastructure under this scheme is welcome, especially as India emerges from the pandemic. However, most of the provisions are already part of existing commitments under Ayushman Bharat,” she said.
She added that while the 11,000 new Urban Health centres and enhancement of the infrastructure of 18,000 urban health centres promised under the scheme are welcome, it is critical to remember that India needs to have 1.5 lakh Health and Wellness Centres (HWCs) by Dec 2022. “This enhancement is a drop in the ocean. Investment in infrastructure alone, furthermore, will not address the basic problems of the sector including inadequate human resources, shortage of medicines and beds. At the same time, the planned enhancement in diagnostic facilities should not promote further privatization of the diagnostic services in India.”
Poonam Muttreja, Executive Director Population Foundation of India said the PM’s move is a step in the right direction towards strengthening the country’s healthcare capacities, and community-level access to primary health care must be improved by ensuring adequate human and financial resources, for the scheme to succeed. “These ambitious schemes will need an increased financial investment, which would necessitate a bigger health budget. This does not mean simply a numerical hike, but one that also accounts for inflation. It is encouraging to see the Union government’s emphasis on a holistic approach to health, focusing on both preventive and curative measures, disease surveillance mechanisms as well as strengthening research and diagnostic infrastructure.”
The Congress has reacted sharply to the PM’s announcement. Party leader Adhir Ranjan Chowdhury said, “As polls are impending, there’s a spree of inauguration of developmental projects. If the hospitals existed earlier, people of UP could’ve been saved from Covid where we saw hundreds of bodies in river Ganga.”