Although the budgetary allocation for health is relatively low in terms of the GDP, it is still quite a large amount with the allocation for this year being Rs. 125 billion. The public health service has about 15,000 doctors, 29,000 nurses, tens of thousand of other Para-medical personnel and minor staff.
We have about 700 public hospitals, more than 400 public medical clinics. It is a gigantic structure, and the overall service needs to be appreciated, though there are many faults and failings and acts of medical negligence which are often highlighted far too much as if to show the public health service is one hell of a mess. It is not. Having said that, we also need to point out the main problems caused by lack of regulation and proper management of the allocation.
Largely because of the political ills and ailments in the public health service, the 1977 switch to the globalised capitalist market economic system, a cancer invented by British Premier Margaret Thatcher who died recently, enabled the Government here to gradually privatise the health sector. According to latest figures, nearly 70% of the out patients today go to private hospitals or clinics, though where warded patients are concerned, some 90% go to public hospitals and only 10% comprising mainly the richer classes can afford to get warded in private hospitals. The charges in some private hospitals are as high as five-star hotel rates, and they have become so profitable that more and more business magnates and government political leaders are setting up private hospitals. Often highly-expensive drugs under various brand names are prescribed along with non-essential expensive tests.
Sometime ago the Government passed a law for monitoring and regulation of private hospitals. For reasons that could be easily diagnosed, the law itself appears to be gravely ill and warded in a private hospital. According to Dr. Joel Fernando, a patients’ rights activist and distance education coordinator of the Post-Graduate Institute of Medicine, one of the main problems in the health service today is the lack of a referral system. Most people do not have a family doctor who treats not only the disease but more so the patients also. Through a long association and the availability of records of past ailments in dispensary files, a family doctor knows the patient physically, psychologically and otherwise. Thus the family doctor is able to diagnose the ailment and give effective treatment. If the family doctor believes that the ailment is serious and requires treatment by a specialist, then the family doctor refers the patient to a consultant. Unfortunately the principle of family medicine is virtually dying or has been killed by vested interests. Therefore millions of patients go to private hospitals and pay heavily to see a consultant who often does not know them and just prescribes expensive drugs or tests. If the Government cannot or does not want to implement the private hospital laws, it must take steps to revive the principle of family medicine and encourage every family to first see the family doctor.
Comments - 2
Samanthi Bandara Wednesday, 17 April 2013 07:32 AM
This is completely true. Absence of a referral system makes health system a mess. But, my argument is this. Though, health sector needs more money for health in the country, I believe that health sector can gain "More health for the existing money". For this transformation, as the author mentioned above, ‘good governance’ and ‘effective stewardship’ is essential in order to formulate a strong regulation system with a proper system to manage the sector. To improve the health outcome furthermore, every organ of the health system must be technically sound.
R.Sunthar Tuesday, 16 April 2013 02:10 AM
A complete overhaul is the need of the day. Health facilities inspite of the various moves still remain beyond the reach of the man in the street.If the ideal is from the womb to the tomb much remains to be donemore by the profession itself than the poor hapless patients.Lot of reforms have to done that too immediately if there is to be meaningful health service within reach of the average man.The family physician is a must if the higher rungs depend on the history and not smattering by the suffering patient.
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