JOIN USPanel spikes government's rural healthcare plan
The government’s plan to create a new cadre of trained individuals to provide basic healthcare in villages has received a setback with the Parliamentary Standing Committee on Health rejecting the proposal.
Instead, the panel suggested one year compulsory rural posting for fresh MBBS graduates, a move already tried by the Health Ministry without success.
To cater to the vast expanse of rural India, being largely served by quacks, the Health Ministry had proposed to create a new cadre of community health workers for running village sub-centres and providing primary health care. The new cadre of professionals are to be known as community health workers who have to clear a three-and-a-half-year BSc programme on community health.
The House panel took the controversial issue suo motu and after hearing a number of experts asked the government not to go ahead with it.
The argument they gave to turn down the proposal ranged from inadequate infrastructure at district hospitals where these students were to be trained, production of half-baked doctors to restrictive practices for these doctors curbing their work enthusiasm.
The independent experts and health ministry officials, who deposed before the panel, made it clear that these graduates would not be called doctors. Their responsibility would be looking after primary health care, government’s immunisation and mother and child programmes as well as referring complicated cases to block or district level hospitals.
Seven experts whose favourable views were overlooked by the House panel include K Srinath Reddy, president of Public Health Foundation of India (PFHI); eminent heart surgeon Devi Shetty; Vinod Kumar Paul and Bir Singh, both professors of All India Institute of Medical Sciences; and T Sundararaman, executive director of National Health System Resources Centre (NHSRC). The favourable report of a 2006 task force was also ignored.
Five people who opposed the proposed BSc (CH) course include Vinay Agarwal and R Rai from Indian Medical Association, India’s largest association of doctors that was opposing the new proposal from its inception.
Other critics who deposed were M K Daga, professor in Maulana Azad Medical College in Delhi and two West Bengal doctors Asok Samanta and Anusum Mitra, who represent an organisation called Medical Service Centre.
To increase the availability of doctors in villages, the panel in its report on Tuesday recommended increasing intake of MBBS graduates and to “make provision for one year compulsory rural posting” for them after internship.
In the recent past, two Central schemes for attracting fresh MBBS graduates and serving doctors had failed miserably because of poor response. The compulsory rural posting did not find favour because of legal complications.
The publication of the panel report coincides with a research carried out jointly by the PFHI, Johns Hopkins University and NHSRC that demonstrated how crucial role a mid-level delivery professional can play in bringing basic healthcare to all.