Print Friendly, PDF & Email

Insights into Editorial: Public Health Act Needed to Keep Private Hospitals in Check: Parliamentary Panel

covid_cost

 

Context:

Any vaccine against COVID-19 should be granted emergency use authorisation only after proper consideration and conducting its trials on a sufficient sample size, a parliamentary panel has recommended to the government.

In a report submitted to Rajya Sabha chairman and vice-president, the Parliamentary Standing Committee on Home Affairs also said there was a need for a comprehensive public health law to keep a tab on private hospitals and check black-marketing of medicines.

The report comes even as the government considers applications of at least three firms seeking emergency approval to roll out their vaccines against the coronavirus in India.

Need of the hour: Comprehensive public health law:

There should be a comprehensive public health Act with suitable legal provisions to keep checks and controls over private hospitals in times of a pandemic and to curb black marketing of medicines, the standing committee on Home Affairs, has said in a report that was submitted to Rajya Sabha Chairman.

There had been several reported instances of beds reserved for COVID-19 patients in private hospitals being sold at exorbitant rates, the report noted.

The committee strongly recommends a comprehensive public health Act, preferably at the national level with suitable legal provisions to support the government in keeping checks and controls over private hospitals as there have been reports about the selling of hospital beds by them.

Government should be proactive in Health care Expenditure:

  1. It is also necessary to make people aware through campaigns on cheaper and effective repurposed medicines to prevent them from panicking and spending a huge amount of money on expensive drugs.
  2. The committee recommends that good quality and affordable medicines be provided to everyone, especially at a cheaper or subsidised rate to the marginalised sections of the society especially at the time of Pandemic like COVID-19.
  3. The parliamentary committee report noted that the committee of Central Drugs Standard Control Organisation (CDSCO) has given no emergency use authorisation in the past, and suggested that all necessary and mandatory requirements must be duly fulfilled and all trial phases completed.
  4. The Act, it stated, should keep a check on black marketing of medicines and product standardisation.
  5. It flagged the initial confusion over medicines that ‘helped’ in containing the COVID-19 infection and how they were sold at higher rates.
  6. It suggested that the government should be proactive by holding awareness campaigns on cheaper and effective repurposed medicines to prevent people from panicking and spending a huge amount of money on expensive drugs.

COVID-19 insurance:

  1. The committee observed that in the initial phase of the pandemic, medical insurance was not extended to patients with COVID-19 infection. With exorbitant charges levelled by private hospitals, many had to suffer.
  2. There is need to have regulatory oversight on all hospitals working in the country to prevent refusal to accept insurance claims.
  3. The committee strongly recommends that the target should be to make COVID-19 treatment cashless for all people that are having insurance coverage.
  4. While appreciating the work done by the National Disaster Management Authority (NDMA) by coming out with standard operating procedures (SOPs), guidelines and awareness generation, and most importantly, acting as a nodal centre for funding manpower deployment to meet exigencies, the committee said the ongoing pandemic was unlike any natural disaster that the NDMA had handled.
  5. The committee recommends that a separate wing may be formed in the NDMA that will specialise in handling /managing pandemics like COVID-19 in future.
  6. This wing may take a leading role in building a partnership of government with the public sector, corporates, NGOs and other stakeholders.
  7. At the time of a pandemic, measures should be taken to avoid social stigma and fear of isolation and quarantine, by making people aware and treating them with respect and empathy.

Schemes implementation:

  1. On the economic front, the committee said that while the government had taken a host of measures to ameliorate the impact of the pandemic on the economy, many schemes have not been implemented properly.
  2. The committee observes that few of these schemes need effective implementation at the ground level. The problems being faced by farmers, non-corporate and non-farm small/micro enterprises in getting loans need to be addressed.
  3. Consumption had been severely curtailed due to huge job loss and fall in income due to the lockdown.
  4. It would take some time to mend, especially after the GDP having a contraction of 23.9% in the first quarter of 2020-21.
  5. The report said that more interventions and schemes were required to support the recovery and to sustain this economic revival especially for the MSME (Micro, Small and Medium Enterprises) sector.

On Mid-day meal:

The committee expressed concern that with schools shut down now for more than nine months, many children were deprived of mid-day meal. Many States continued the scheme by delivering dry ration to students at their homes or giving them allowances. But this was not uniform.

“The committee, therefore, strongly recommends that the Ministry of Home Affairs, along with the Department of Food and Public Distribution, take up the matter with the State governments to ensure that the local administrations are delivering the rations/ allowances in time and this should be continued until the schools reopen.

Learnings from Cuba’s Healthcare system:

  1. The Cuban health system is recognized worldwide for its excellence and its efficiency.
  2. Cuba’s health care system is based on preventive medicine and the results achieved are outstanding. Despite extremely limited resources and the dramatic impact caused by the economic sanctions imposed by the United States for more than half a century, Cuba has managed to guarantee access to care for all segments of the population and obtain results similar to those of the most developed nations.
  3. The Cuban healthcare system, borne out of its revolutionary socialist ideology, regards accessibility to healthcare as a fundamental right of its citizens. It focuses heavily on a preventative approach to medicine and offering the simplest check-up to the most complex surgery, free of charge. Dental care, medicines and even home visits from doctors are all covered by the system.
  4. The centrepiece of this system is the community-based polyclinic, each of the 498 nationwide serving a catchment area of between 30 000 and 60 000 people.
  5. The polyclinics act also as the organizational hub for 20 to 40 neighbourhood-based family doctor-and-nurse offices, and as accredited research and teaching centres for medical, nursing and allied health sciences students. These are the backbone of Cuba’s health system.

Conclusion:

Therefore, more fund should be allocated to public hospitals to strengthen the public health infrastructure, so that they can equip themselves appropriately to handle such pandemics in the future, the committee suggested in the report.

It also recommended that learning from the experience of the pandemic, there is a need for a comprehensive public health act preferably at the national level with suitable legal provisions to support the government in keeping checks and controls over the private hospitals “as there have been reports about the selling of hospital beds by them”.

This is the right time for the legislative body of India to introduce Public Health Bill-2020 to empower the governments to handle such unforeseen situations like the COVID-19 pandemic.

This Bill will dawn a new era of healthcare wherein every citizen of the country would be able to avail the basic healthcare facilities with due deliberation.