Inclusive Growth
India's economic growth, celebrated in aggregate terms, hides an uncomfortable truth: much of this progress has bypassed the majority of the population, particularly in rural areas.
When Jagat Prakash Nadda, 56, resigned his Cabinet berth in Himachal Pradesh and moved to Delhi in 2010 to be part of the BJP’s national set-up as general secretary, not many could foresee his stupendous rise. With roots deep in the organisation, Nadda, who played an important role for the BJP in the run-up to the 2014 Parliament polls, was elevated as Union health minister in the government led by Prime Minister Narendra Modi. Nadda has been in the limelight since then, bringing him in sharp focus in his home state, as many see a parallel in his rise to the career of former Chief Minister Prem Kumar Dhumal of the BJP. Ahead of the 2017 assembly polls, Nadda is tightlipped on the issue and says he is busy with his assignment at the Centre. “Health is a big field. The more I understand, the more I get absorbed,” he said. In an interview to Archana Phull and Sanjeev Kumar in Shimla, he spoke exclusively about issues in the health sector. Excerpts:
Q. What is special about the National Health Policy, 2017?
A. The 2012 health policy focused on care of the sick. The new policy talks of wellness of health, prevention and care. Now that 60 per cent of deaths occur due to non-communicable diseases (NCDs), our focus would be on them. The policy is ‘patient-centric’ and will empower the patients. We will have National Standards Organisation for medical care and establish a programme for treatment, set up health tribunals for addressing grievances of patients. At present, 70 per cent of medical equipment is imported. We will encourage that it is made in India. Health cards, with Aadhaar number, will be issued, for access by doctors anywhere. The digitisation of health records will help in tele-consultations and tele-medicine. On the whole, the policy has a self-committing implementation framework. By 2025, the health budget will increase to 2.5 per cent of GDP.
Q. There is criticism that the new policy gives more priority to the private sector?
A. The private sector has grown in the course of time. It needs engagement and regulation. It requires a balanced approach regarding the emerging demand and services, which have to be rationalised. The health policy was a manifestation of demand and has passed through maximum consultation process. It was finalised after discussions by 14 committees, their visits to states and brainstorming sessions with officials and stakeholders. The draft policy was put out in the public domain. We got 5,000 responses. It also went to the Group of Ministers for consideration and suggestions. Such exhaustive consultations have never been followed.
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Q. Has the National Health Mission (NHM) produced desired results all these years?
A. NHM is to work in mission mode and it’s a major component of the health budget. We keep reviewing it. The indicators of NHM have been encouraging as far as the Centre’s part is concerned. We have reduced Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR) and under-five mortality. The NHM has given results. However health being a state subject, the responses of the states are different. Twenty four states have brought down the Total Fertility Rate to 2.7. Two or three states are above 3. Pan-India, we have marked 148 districts which need special attention in NHM.
Q. What about your home state Himachal in this regard?
A. NHM is doing well in HP but it can do better. The fund utilisation has to improve in Himachal.
Q. Central health projects in HP are stuck. Doctors from Himachal are heading prestigious institutions in India, but they don’t want to serve back home.
A. I think Himachal is not giving priority to the health sector. Governance is an issue in Himachal. The Central government has sanctioned funds to the state for different works, including the State Cancer Institute, super specialty block of Indira Gandhi Medical College, ICMR funding for study on jaundice outbreak. But if the Himachal government is unable to move forward at its end and can’t even find land for such institutes, what can we do? Regarding doctors, I think there is no environment in Himachal.
Q. What about targets to eradicate various diseases from India?
A. Yes, we are aggressively working to achieve them. Kalazaar will be eradicated by 2017, leprosy in 2018, tuberculosis by 2025. We are also working to stabilise population by 2025. While the focus will be on NCDs, our programme on universal screening of people for blood pressure (the genesis of all diseases), breast and oral cancer, cervix cancer, and blood tests in 100 vulnerable districts free of cost in the first phase will simultaneously address communicable diseases. Chronic diseases will also come to notice and all this will help in prevention.
Q. The Central government has opened AIIMS and medical colleges across the country. Do we have qualified doctors for that?
A. We will increase post graduate seats by 5,000 within the next few years. In-house training is also being increased. The AIIMS established decades back are giving dividends now. All such institutions grow with time and continuously. We will, however, not dilute the culture of AIIMS and will not compromise with quality. We will not select candidates if quality is not there. It recently happened in one of the premier institutions in the North, where we chose to keep a number of posts vacant after interviews. Legislation is also being brought for revolutionary changes in the quality of medical education in the country.
Q. Do you have plans to strengthen Central Research Institute, Kasauli, and other vaccine institutes in the public sector?
A. Yes, immediately after coming to power, we had released funds for CRI, which was being starved previously. We will continue to strengthen these institutes and see that they manufacture vaccines as per capacity.
Q. What is the focus area to develop health infrastructure now?
A. Our focus is now in the east and north. Southern and western India have progressed a lot and have an established private sector component too. The concern, however, is that many states are not adopting the Clinical Establishments Act properly.
Interviewed by to Archana Phull and Sanjeev Kumar.
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