Lessons from Gorakhpur

Almost everyone who writes or speaks through the media has already done so much on the tragic event in Gorakhpur, with a range as wide as expressing shock, sadness, disgust, blame, analysis and offering of solutions. As I have served in the government health-care sector for over 30 years, and am a quintessential optimist with a ‘nationalist’ spirit, let me offer my two-pennies worth of ‘viewpoint’ as well.

1 The fundamental question is one of “vision”. Should we be confining ourselves to the malady of BRD Medical College, Gorakhpur, or looking at the larger picture?

2 To me this was just a case in point, where a tragedy of this magnitude occurred, due largely to systems failure and which was brought to the attention of the world by the media. Yes, government hospitals and medical colleges in most parts of the country are in bad shape. The ambience, facilities, equipment, quantity and quality of personnel are appallingly poor.

3 At the crux of the issue are 4 aspects:

Our public health care is in ■ doldrums because it needs money to make it good. All developed countries spend around or more than 5% of their GDP on health care. We spend around 1.5%.

The present approach of ■ allowing private players to come and fill in alone or with public private partnership (PPP) is ridiculous in this setting. The poor people of the country, such as the villagers around Gorakhpur, obviously cannot pay and private players will always invest for only “profitability”. The government needs to invest much more in health care, and realize that, along with education, is a priority.

Our expertise in managing ■ health care is bad. Remember the scams in our NRHM that screamed at us from the front pages of the papers not long ago. And who were the main culprits? We need better professional managers. If you want good efficient experts, you need to pay them more. Common sense!

Corruption has also ■ gnawed away at our scant resources. Contracts for food, cleanliness, supplies, medications and equipment all have their specific patrons and routes. And whom do you invest the authority to choose and decide these? The hospital administrators could well be the obedient 2-penny “helps” for the people in power who decide their postings, promotions and privileges as well.

4 Blaming government doctors alone would be silly. Government jobs are getting less attractive by the day, and very few, especially among the good ones, are applying for them. The huge numbers of vacant posts speak for themselves.

To solve the problem, many ■ would advocate forcing young doctors to serve in the government. I would favor making the jobs and remunerations more attractive so that they join and deliver without getting distracted by domestic necessities. Remember, “You can take a horse to the water but not make it drink”. And don’t be stupid to try it with reluctant doctors on who lives rest.

Let us have clear minds to seek solutions for our future generations.