MLAs and MPs should start using public healthcare facilities: expert
Dr K. Srinath Reddy is a public health intellectual who doesn’t mince words. An alumnus of Osmania General Hospital, the honorary distinguished professor at the Public Health Foundation of India (PFHI) in an interview with Siddharth Kumar Singh shares his thoughts on the evolving healthcare scenario in the country.
Legislators using public health facilities, funding challenges in public health, modernisation of public hospitals, and the controversies surrounding NEET, are some of the questions he fields in these excerpts from an hour-long interview.
Q. Primary Health Centres (PHCs) are often neglected. What measures can be taken to strengthen them?
A. Primary health care often suffers neglect because legislators and parliamentarians hailing from districts prefer to stay in the State capital, where they also receive medical treatment. If these MLAs and MPs volunteer to get treated in village health centres, that would drive the strengthening of Primary Health Centres (PHCs) and Community Health Centres (CHCs).
Q. How can public health sector be revilatised?
A. Robust public health sector is essential. Firstly, it provides access to healthcare for those who cannot afford private care. Secondly, it sets standards for the private healthcare sector in terms of affordability and accountability, preventing inappropriate practices and ensuring equitable healthcare.”
Q. What are the challanges faced by public health system in utilising allocated funds?
A. The Central government argues that current funds allocated to public health facilities are under-utilised, with some even being returned. The core issue is public health system’s inability to efficiently absorb and use these funds without upfront investments in infrastructure, supplies, and equipment. This front-end spending is crucial for enhancing institutional capacity. It is like depriving a starving person food. Unless the hospitals function at optimal level they cannot absorb additional funds.
Q. Why has the demand for modern hospital facilities increased?
A. Doctors advocating for modern hospitals have observed the rise of advanced facilities nationwide over the past 15-20 years whereas the argument should be that hospital interiors can still be modernised, ensuring doctors work in state-of-the-art environments while preserving historical value. We are in this scenario because economists considered healthcare as an inefficient expenditure compared to other sectors.
Q. Should Public and Private Health Sectors Compete or Collaborate?
A. The public sector should coexist with, not compete against, the private sector. Without a public presence, the private sector may engage in inappropriate, unnecessary, and unaffordable care. Public health management prioritises efficiency and equity, unlike the private sector, which focuses on efficiency and profit. Training of medical students in private hospitals can lead to a generation of doctors who prioritise high-cost care models, even if they are inappropriate and unaffordable. A well-functioning public sector is crucial.
Q. What does the future hold for India in terms of medical tourism?
A. Many high-income countries are struggling to expand healthcare facilities, turning the people’s attention to South Asia and Sub-Saharan Africa for future development. Countries like India can meet their medical needs but such cooperation also requires co-investment to address deficits in these regions.
Q. What are your views on the current NEET-UG controversy?
A. When NEET was proposed within the health ministry in 2013, a standing parliamentary committee was formed which was chaired by Professor Ram Gopal Yadav, with Rajya Sabha MP Jairam Ramesh as a key member. I opposed it as I felt imposing a common standard for undergraduate admissions was unfair given the varying educational standards across the country. However, once students are admitted to medical colleges, they become better prepared and are more suitable for a common NEET-PG exam.”
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