Home > Musings > A wish list for the new Health Minister of India

A wish list for the new Health Minister of India

June 1, 2014

Dr. Harsh Vardhan, who has taken over as the Union Minister for Health and Family Welfare is well qualified to be undertaking this critical responsibility. Being both a seasoned politician and a well-known doctor, he has to now steer this important ministry at a time when the Prime Minister has made it clear that Health will be one of the key areas of focus of his government. Apart from ensuring oversight over a enormous machinery that will have to depend on the State Governments to deliver, some of the critical policy areas that he needs to focus on will be:

  • The challenge of meeting the growing burden of non-communicable diseases.
  • Address the shortage of qualified and competent professionals, especially in rural India.  This can be by the introduction of new courses for training a new cadre of Physician Assistants and taking a constructive view of the rural physicians’ course.
  • Relooking at medical education and making the curriculum relevant to meeting the present day challenges and introducing concepts of the practice of integrative medicine.
  • Providing palliative care, programs for aging populations and bringing mental health care into the mainstream primary health care delivery system.
  • Promote the usage of generic drugs.
  • Promote and develop AYUSH holistically, giving it full status of being a logical part of the health care system, rather than calling it ‘alternative’. The benefits of Yoga are now established beyond any scientific doubt and the government should look at popularizing it without giving it any ‘political’ or religious colour.
  • Encouraging traditional health practitioners after putting in suitable regulatory and facilitatory processes to ensure quality of care and preventing unscientific and irrational practices. The health ministry should also work in tandem with other relevant ministries in building the scientific knowledge base of the more than 30,000 medicinal plants in use and encourage bio-prospecting and product development.
  • Stop any future verticalization of health care programs, but also integrate existing ones into the mainstream primary health care delivery framework including the HIV/AIDS programs.
  • The Ministry should take forward the process of regulating quality of care rendered by the private sector and also bring in accreditation processes.

Though this seems like a long wish list, it should not be difficult for this government which has been voted in with the popular expectation of bringing in the much needed change that India is desperately crying for.

Balu

Categories: Musings
  1. Vinod Sharma
    June 6, 2014 at 7:21 pm

    Dr. Harsh Vardhan is a qualified & highly experienced Medical consultant. Health Department requires lot of concentration & devoted efforts on academic as well as health care delivery front.The corruption has marred the Department.
    Number of Medical institutions of all Medical systems approved for imparting Under Graduate as well as Post Graduate Training do not have Hospitals even but were allowed admission for large number number of students.
    Regarding procurement of Medicines sub standard companies were preferred. Drug Control Organisation with highly qualified & technical Staff should be empowered for procurement of Drugs instead of Directors or Store Officers.Every batch before marketing should be tested for Quality. DFCO should be strengthened with well equipped Laboratories & staff.
    Same parameters should be made applicable to Ayurvedic/Unani Medicines. There are a very large number of untested drugs of these systems in the Market. Health Ministry should should evolve parameters for quality & safety for these drugs.Unethical promotion of these drugs through Media should be stopped & the drugs promoted by unethical means should be deleted from the list of Drugs & high Rate of Tax should be imposed to generate more revenue.
    Every drug allowed by DFCO must be properly tested for efficacy & safety.Procurement Officer should be made accountable for ASU Drugs in the country before placing order should go through the documentary evidences including publications for quality,efficacy & safety.

  2. June 3, 2014 at 6:23 pm

    Balu,

    That is a well thought of write up on what is needed in healthcare in India. I am not in agreement with the concept that health should be privatized. The corporate entry into healthcare and medical education has only skewed the disparity in favour of the affordable. Health has to be declared a non-profit making sector by all stakeholders – doctors, state and central governments, pharma and the ministry. Health and Healthcare must also be taught and seen throught the optic of ‘service’ rather than business. Can doctors and pharma heads live simple lives first to lead from the front ? Can we do something to regulate unhealthy practices ranging from food, to traffic to lifestyle? The problem Balu is that policies are made and driven by babus without involving healthcare professionals at the ground level.

    Sunil Chandy

  3. June 2, 2014 at 10:18 pm

    I totally agree with AS Krishna that medicines should contain the API s and more effective solutions to improve the patients needs have to be made effective. MD Pharmacology students scope should be diversified and Safety aspect of drugs and ADR reporting should be taken into account.Thanks.

    • June 3, 2014 at 7:34 am

      We also need to take into account that the Pharma policies and the sector is technically under the ministry of Chemicals and Fertilizers.. Health ministry may only have a ‘user’ role and one needs to involve other stakeholders too in the conversation….

  4. June 2, 2014 at 3:25 pm

    Dear Dr Balu, medicinal plants are best used as per traditional knowledge and ayurvedic practice. The concept of extracting the active ingredient and duplicating it as a chemical has never worked. The use of various parts of a plant are clearly described in ayurvedic texts. Traditional healers too have with them a wealth of knowledge which is often kept hidden as a heirloom. However there are movements now, led by activists, that are ensuring transparency and wider dissemination.

  5. June 2, 2014 at 3:13 pm

    First things first…..healing is a concept,health is a outcome, we live in a society that cries ‘wolf ‘ for everything ….but this has made politics as the last resort of a career for scounderals, that apart.1..where does the public health records show their efficiency or deficiencies…this is a paradox., as we have either poor record keeping, or it is encouraged…
    2.public does not need policies and scraping of earlier ones totally, what it needs is a responsive heartfelt ground level workers enthused to deliver….do we have such people….
    3.whatever we call as health education is intact sickness education., medicines are for the sick, good and healthy food is health and wellness,so crack on spurious drugs.,spurious manure,encourage farmers,….this is a very short wish list too

  6. A S Krishna
    June 2, 2014 at 1:50 pm

    Health Ministry being the Regulator for the Pharma industry, should ensure the quality of medicines being produced in india. This is not only relevant for Indian patients but also very important for our exports keeping in view the kind of flack Indian pharma industry s facing these days ( Ranbaxy, Sun , Wokhart etc ). Strenghtening of regulatory system, including creation of a body on the lines of USFDA, is critical in this endaevor.

  7. Rakhal Gaitonde
    June 2, 2014 at 1:49 pm

    Dear Dr Balu,

    Coming from a development activist, this list is surprisingly medically oriented. While innovatively strengthening of the public health system and revamping radically the medical education system is key, these suggestions alone without keeping in mind (1) how these are supposed to be achieved and (2) the other social determinants of health, will defeat the purpose. Thus if revamping medical education occurs side by side with privatization of medical (and indeed all education) the types of doctors and even physician assistants will never serve in rural areas…… If mega developmental projects to encourage private access to natural resources are going to be encouraged that displace communities and increase inequities any amount of strengthening of the public health system will not do. I think the question we need to ask the minister is, “Can we envisage health as part of the overall development and empowerment of every individual in the country and can we evolve a health system that will facilitate this….and can the health system be a leader in ensuring proactively the health impacts of all policy making in all sectors? So that health becomes the committment of the government as a whole and not merely rhetoric of a single minsitry?”….that would be truly exciting….

    Rakhal

    • June 2, 2014 at 2:11 pm

      Rakhal,

      While agreeing with you, i was seeing this as a practical first step. Many of us activists have lost this battle only because of the impracticality and the enormity of the tasks that we advocate. I see this as the first of a series of iterative steps in a long drawn advocacy campaign. It is more about our strategy in addressing the more understood and relatable issues first and then incrementally moving on to the complex and challenging ones. Target the low lying apple first and then go higher. You may not agree with this approach, i but i find it useful and immensely workable.

      Balu

      • Rakhal Gaitonde
        June 3, 2014 at 4:47 pm

        I completely agree with the low hanging fruits concept…. however one thing I have found as an activist is that we get so caught up in the low hanging fruits that we fail to see that it is the wrong tree….. and yes this is the eternal debate…. yet we have to do something….

        My point however is can the health department take steps such that it kick starts such a process of rethinking development…. can it truly take community based planning seriously….can it push for Health in ALL policies….can it / will it question trade and its impact on health….will it make a start…. release a statement…..

        My question is what would be the type of health system that will encourage / facilitate such a transformation rather than merely mitigate the sideeffects of a diseased developmental model…. the mere provision of services however efficiently is mere band aid….

  8. Arun
    June 2, 2014 at 11:37 am

    I think this is a very realistic portrait of what has to be done in Indian health care sector. Looking at Indian public health with spectacles of UK AND US health sector is fanciful and far from reality. All the points enumerated by Mr Balu are acheivable and would have far reaching consequences in Indian Public Health. India as a nation has been matured enough to do away with established British Hierarchies including those in Public Health Sector. Take some bold steps involve people in this process (common mango people) not babus who always play safe and convenient. Lovely points I extend my full support to this vision document.

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