Strengthen public healthcare

Hospitals survive on human distress... It has become a big industry at the cost of human suffering.’ This observation by Supreme Court Justice DY Chandrachud, while hearing a suo motu case over a Rajkot hospital fire that killed several patients and staff, would strike a chord with patients and their caregivers. The Covid pandemic brought out the best in frontline warriors such as doctors and nurses, but it also brought the worst out of managements of many hospitals — across India, countless complaints have been made against private hospitals for charging fees higher than those permitted by the government. In this context, this observation by Justice Chandrachud is highly significant: ‘It would be better for the State to create Covid facilities and better hospitals rather than have these small nursing homes with just four beds in a building.’

The example of Kerala shows that Justice Chandrachud’s prescription is based on sound analysis: Kerala’s Covid-19 fatality rate is 0.48% as against Maharashtra’s 2.04% despite their overall economic situation being similar, as their per capita Gross State Domestic Product shows. However, Kerala has fared better during the pandemic because of its better public healthcare system. The state allocates over 1.5 times funds per capita on public health than Maharashtra.

While private hospitals provide critical support to India’s crumbling healthcare system, it is clear that public healthcare infrastructure needs to be strengthened. Yet, Niti Aayog’s recent invitation to private parties — through its document titled ‘Investment Opportunities in India’s Healthcare Sector’ — suggests that the government wants to increase privatisation in this critical sector. This invitation cites Covid-19 to lure investors: ‘The pandemic has not only presented challenges but also several opportunities... In the hospital segment, the expansion of private players to Tier 2 and Tier 3 locations, beyond metropolitan cities, offers an attractive investment opportunity.’ However, the pandemic has shown that private hospitals can often be unscrupulous. It is incumbent on the State to free citizens from the grip of unscrupulous private hospitals and build a robust health infrastructure. The first step would be to raise spending on public health, which is a little over 1% of the GDP per annum.