'We need to build capacities'
CK Mishra, Health Secretary tells R&M that the government has done a lot to reach last mile for health services and now focus is on underserved areas
India is facing dual disease burden. What measures the Ministry is taking to meet this challenge?
Health Ministry has decided to implement universal screening for diabetes, hypertension and three types of cancer for everyone over 30 years in 100 districts. The target is to ensure that once there is a fullscale rollout, every Indian is screened for these diseases at least once in three years. We will go beyond screening and it will be based on ‘ Test and Treat’ model. The programme will be integrated with one of referrals so that any early signs are treated to pre-empt “catastrophic health expenses” which many of these diseases entail. Hypertension and diabetes are the first warning signs of heart disease and stroke.
All said and done, it is widely admitted that the government has failed to provide last mile healthcare service. Is that a correct projection?
It is not correct to say that the government failed to deliver in last mile health services. We have improved rural healthcare under Mission mode. What we need now is to build capacities. Infrastructure is not problem. Main challenge is how to build capacities to meet the growing demand. So going forward, we have identified 184 pockets in the country where we need to focus more on health service delivery. For example, only eight states in the country accounts for 70 percent maternal deaths. We need to focus on those areas where health service delivery is poor and need improvement. That is why our new plans, programmes and schemes are being prepared in such a way that improves capacity and cater under-served locations especially rural areas.
What is new in New Health Policy 2017?
There are many. The Policy’s main thrust is on Universal Health Coverage and Affordable quality health care services for all. Moreover, it promotes quality of care, with a focus on emerging diseases and investment in promotive and preventive healthcare.
You said that the Policy envisages private sector collaboration, but there is a trust deficit between the government and the industry? How this can be tackled to take the sector to next level?
The healthcare sector needs huge funding. It is a fact that the government alone cannot meet the challenges. Public Private Partnerships(PPPs) are the best solutions. We need to work on processes so that nobody- patient, service providers and device manufacturers or supplier- is exploited. The government can take care of Primary and Community health centres with free drugs. But for free diagnostic would come with private participation with new insurance schemes. Though health insurance coverage is widening, but what is not rising is benefit. The government cannot provide wide range of health services through insurance but the private sector can. If we could bring down out of pocket expenses from 58 percent to 50 percent with the support of insurance schemes, it will make huge change. While making the new policy the government has taken views of all.
But the Private sector or Industry is not happy with regulations especially medical device pricing mechanism. How would the issue be resolved?
First of all, there is no consensus among industry people themselves. It is admitted that there are gaps on both sides. There is a price mechanism based on well established practices and deliberations. It is also very transparent. It makes sense to have a proper price mechanism so that nobody is exploited. There are, at times, discontent regarding tendering process especially ‘L1’ process. I think if capable players are competing then this process provides quality stuff, we need.