The Union budget has posited the Health ministry on a journey without maps. The forbidding reality of health care in a country, where medical treatment is for those who can afford it, runs counter to the tinkering with a critical segment of public policy.
More accurately, there is little or nothing by way of assertion. The saccharine assurance of a 23 per cent increase in outlay has been advanced with scarcely an action plan to achieve the ambitious targets. Specifically, this entails the eradication of kala-azar and filariasis by 2017, leprosy by 2018, measles by 2020, and TB by 2025.
Given the resources at its disposal and medical infrastructure generally, it is an ambitious calendar. On closer reflection, with effect from All Fool’s Day, the government has set itself the time-span of the coming fiscal to eliminate the almost chronic ailments of kala-azar and filariasis, that have defied an enduring cure for as long as they have.
The second, sad to reflect, is particularly endemic in predominantly rural Odisha. The time-frame to eliminate tuberculosis must seem to be particularly daunting not least when contextualised with the World Health Organisation’s projection that India will not be in a position to eradicate TB “even by 2050”.
In terms of periodisation, this renders another generation susceptible to the ailment given the extent of food insecurity and the resultant malnutrition among those below the poverty line. However, viewed through the prism of social security, Arun Jaitley’s proposal under the Janani Suraksha Yojana (Maternity Benefit Scheme) to transfer Rs 6000 to the bank accounts of pregnant women who undergo “institutional delivery” and vaccinate their children will be generally welcomed as a welfare measure that will benefit both mother and child.
Given the dearth of doctors and the reluctance to serve in rural India, the focus on medical education is without question a positive initiative. Towards that end, no fewer than 5000 post-graduate seats are proposed to be added in the medical colleges, with two more AIIMS in Jharkhand (under-developed even 15 years after its foundation) and Gujarat (why not?) for specialised care of the rural populace.
The fact remains that it is only a fraction of meritorious medical students who can make it to the post-graduate (MD and MS) level. A holistic approach to expand medical education, indeed the MBBS course, from the urban to the rural areas is yet to be spelt out.
Medical education still remains an essentially urban facility. Above all, rural India must boast doctors who can teach as well as treat. This is the fundamental that the budget has not addressed.