Context: Private healthcare in India usually offers quality service but is often expensive and largely unregulated
- The Niti Aayog and the Union Health Ministry have put forward a proposal to allow private entities to use the premises of the district hospitals to provide treatment for cardiac and pulmonary diseases and cancer.
- Recently, the Niti Aayog and Union health ministry have also put forward a public-private partnership (PPP) model for the management of non-communicable diseases in tier 2 and 3 cities across the country, with World Bank will be serving as a technical partner.
- The private hospitals said some provisions need to be clarified. This include the rates that can be charged to patient who aren’t covered by National Health Protection (NHPS), Rashtriya Swasthya Bima Yojana (RSBY), Central Government Health Scheme (CGHS), or state insurance schemes.
- There is shortage of infrastructure and human resources, 72% of the rural population and 79% of those living in urban areas have sought access to healthcare in the private sector.
- The proposal to allow the private sector to run district hospitals has its risks
- The potential of India’s district hospital system to dramatically expand access to quality secondary and tertiary health care has never really been realized
- The majority of patients today use the facilities created mostly by urban hospitals.
- There are only 763 functional district hospitals, with just five states led by Uttar Pradesh accounting for over 42% of the facilities
Loopholes of private healthcare in India:
- Private healthcare of India usually offers quality service but is often expensive and largely unregulated.
- Healthcare infrastructure is insufficient to cater to the needs of all its residents.
- In India there is low health spending as compared to other countries. India has little to show for the slightly more than 1% of its gross domestic product (GDP) that it spends on healthcare.
- Countries that have robust public health system spend much more for example Canada and the UK spends 8% of their GDP on healthcare.
- The national health policy notes “growing incidences of catastrophic expenditure due to healthcare costs, which are presently estimated to be one of the major contributors to poverty”.
- The Central Government Health Scheme (CGHS) has existed for decades and has been emulated by several states, which have floated similar schemes that discriminate between those who are employed by the state and those who are not. This is a violation of the principles of justice, and has not been notified by policymakers as they are the first among equals to benefit from such policies.
- A grave impact of the CGHS and similar plans on public health is that India’s ruling elite do not have an incentive to improve the system as they would never use it.
- India has set itself an unambitious target of 2.5% of GDP for distant 2025.
- The Niti Aayog said that despite there being ‘concerted efforts’ to establish services to tackle non-communicable diseases, the system remains constrained.
- There is lack of infrastructure and human resources in healthcare.
- The private sector dominates healthcare delivery across the country, a majority of the population living below the poverty line (BPL)- the ability to spend Rs 47 per day in urban areas and Rs 32 per day in rural areas-continues to rely on the under-financed and short-staffed sector for its healthcare needs, as a result of which these remain unmet.
- The majority of private healthcare professionals happen to be concentrated in urban areas where consumers have higher paying power, leaving rural areas underserved.
- India mostly compares with China and US in the number of hospital beds and nurses. The country is 81 per cent short of specialists at rural community health centers (CHCs), and the private sector accounts for 63 per cent of hospital beds, according to government health and family welfare statistics.
- Achieving universal health coverage
- A single-payer government –led model that mainly relies on public facilities.
- Strong oversight is also necessary to ensure that ethical and rational treatment protocols are followed in the new facilities, and procurement and distribution of drugs are centralized to keep costs under control.
- A provision for audits, penalties, and cancellation of contracts is essential.
- Given the recourse to tax funds for viability gap funding and use of public infrastructure, the operations should be audited by the Controller and Auditor General of India.
Conclusion: Low spending on heath is a major factor of governments and their employees being shielded from policies meant for the common man. Countries that have done well in providing quality care have one system for all. Therefore, there is need to boost spending on healthcare in India. The National Health Policy, 2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals. Economists such as Adam Smith and Amartya Sen have focused on justice as equally as economics-the two being inseparable, since without justice, economies is merely budgeting devoid of ethics. There is need that India’s private sector should take effort to improve the deplorable state of healthcare services for India’s large population
- The Comptroller and Auditor General (CAG) tabled a report in Parliament stating that the strategic missile system, a medium range supersonic surface to air missile system to counter aerial threats were “deficient in quality”.
- Over 70% of the under vehicle scanners (UVS) installed at Indian Air Force (IAF) bases were reported non-functional.
- The report also carried that the IL series of aircraft, which provides vital transport support to the IAF during contingencies, “has not been upgraded, and continue to fly with 1985 vintage avionics”.
- The report comes amid increased threat perception to defense installations in the wake of terrorist attack at the Pathankot airbase in January 2016.
- The IAF already in February pinpointed that out of the 57 UVS systems, 52 had been installed and only five were yet to be installed. However, 35 systems still remained in “unserviceable condition”.
- Due to such conditions, the security systems procured at a cost of Rs. 17.09 crore could not be utilized fully for the security of the air bases even after about five years.
- Besides, the security of the air bases could not be enhanced as predicted, according to the reports.
- Strategic missile system is vital for the country’s air defense and deterrence capability.
- Audit also found that the system delivered by Bharat Electricals Limited was deficient in quality.
- On July 24, 2017, a Bench of Justices had directed doctors to medically examine the 10 year old, rape- victim girl and file a report in court on the health of the girl.
- In a short hearing, the court perused the report filed by the doctors and denied permission for an abortion.
- Reports says that the abortion will endanger both the girl and her 32-week-old foetus.
- The Medical Termination of Pregnancy Act of 1971 bars abortion if the foetus has crossed the 20-week mark.
- An exception to the law is made if a registered medical practitioner certifies to a court that the continued pregnancy is life-threatening for either the mother or the baby.
- The court has observed that in the case of pregnant women, there is a state responsibility in protecting the life of the prospective child.
- Therefore, the termination of a pregnancy is only permitted when the conditions specified are fulfilled.
The Medical Termination of Pregnancy Act:
- The Medical Termination of Pregnancy Act stipulates a cap of 20 weeks within which an abortion can be performed.
- While advising an abortion, medical practitioners are expected to evaluate whether continuing with the pregnancy would involve a risk to the life of the mother or cause grave injury to her physical and mental health.
- At present women are forced to undertake the tiresome process of approaching different courts, from district courts to high courts and finally the Supreme Court, for permission to medically terminate their pregnancies which are over 20 weeks.
- An amended Bill of the 1971 law which extends the bar from 20 to 24 weeks has been pending for the past three years.
- This draft Bill allows women, whose pregnancies are within 24 weeks, reproductive rights in consultation with their medical practitioners.
- The draft Bill also allows abortion beyond 24 weeks in case the foetus suffers from substantial abnormalities.
- The Bench went on to urge the government to consider setting up permanent medical boards across the States so that women, especially child rape victims, could receive expedient access to medical care.
- The state needs to upgrade with its medical examination as far as pregnancy is concerned.
- National Security Adviser Ajit Doval called upon the Brazil-Russia-India-China-South Africa (BRICS) grouping to exercise international leadership in countering terrorism, in tune with the growing role of the emerging economies in setting the global agenda.
The BRICS meeting
- Doval advocated that the five emerging economies should work towards setting the agenda “on strategic issues of regional and global importance.”
Meeting with Chinese counterpart
- Mr. Xi, in his address to the BRICS NSAs, praised them for building a mutual trust and cooperation among the member nations.
- Mr. Doval’s called on Mr. Xi to develop a bilateral context in view of the Doklam face-off.
- The contradictory relationship, where collaboration co-exists with serious differences, was evident when Mr. Doval met with China’s State Councillor Yang Jichei on Thursday evening.
- Investigation of samples taken by drilling into rock will help discover the history of Zealandia.
Key points about Zealandia:
- Zealandia, which is mostly submerged beneath the South Pacific, was once part of the Gondwana super-continent but broke away some 75 million years ago.
- Covering five million square kilometers, it extends from south of New Zealand northward to New Caledonia and west to the Kenn Plateau off Australia’s east.
- It was a distinct geological entity that met all the criteria applied to Earth’s other continents, including elevation above the surrounding area, distinctive geology, a well-defined area and a crust much thicker than that found on the ocean floor.
- This region was important in influencing global changes.
- Drill ship will be implemented which will recover sediments and rocks lying deep beneath the seabed in an order to discover how the region has behaved over the past tens of millions of years.
- The recovered cores will be studied onboard, allowing scientists to address issues such as oceanographic history, extreme climates, sub-seafloor life, plate tectonics and earthquake-generating zones.
Academia has to do research in emerging areas: Sitharaman Context: Commerce Minister Nirmala Sitharaman on Friday sought inputs from the academia on three topics –Foreign Trade Policy (FTP) review, the proposed revamp of manufacturing and industrial policies and India’s proposal at the World Trade Organisation (WTO) on services sector liberalisaton. Introduction:
- The Centre is working on a new manufacturing and industrial policy to increase the contribution of the manufacturing sector in the country GDP to 25% by 2020 from the current level of about 16%.
- The government is working on these new policies to align the current manufacturing polity of 2011 and the industrial policy of 2009 with the Fourth Industrial Revolution that includes AI, robotics and IoT.
- The global Industrial Revolution 4.0 is happening, the country needs more research on this emerging area showing how Artificial Intelligence (AI), robotics, and Internet of Things(IoT) will impact India’s manufacturing and services.
- India’s new manufacturing and industrial policies will bring manufacturing and services closer to ensure an increase in the contribution of services to manufacturing.
- India is already a part of many global value chains
- The two new policies will aim to make India a global manufacturing hub in items including textile, pharmaceuticals and electronics.
Trade Facilitation in Services (TFS) pact:
- India proposed Trade Facilitation in Services (TFS) Agreement at the WTO for easing norms, including on movement of foreign professionals and skilled workers across borders for short-term work
- Many policy-level related challenges have retarded growth in the manufacturing sector in India.
- These challenges include, among other, difficult business environment, infrastructural constraints, including peak power deficit, labour market limitations including a surfeit of labour legislations and trade unionism as well as the difficulty in availing commercial bank credit particularly for small firms.
Conclusion: India needs to generate good quality manpower in large numbers at all stages of the knowledge pyramid if it has to become globally competitive in the manufacturing sector.
Recapitalisation norms not met: CAG
Context: The Centre’s Indradhanush’ scheme to recapitalize public sector banks (PSBs) based on their performance was not implemented in a manner envisaged, according to a report by the Comptroller and Auditor General of India (CAG) Introduction: The national auditor doubts that the public sector banks will be able to raise Rs 1.1 lakh crore from equity markets in the four years ending March 2019 under the government’s Indradhanush plan. Highlights of report:
- According to the CAG repot tabled in Parliament on Friday, as per the scheme, a portion of the recapitalization was to be based on the banks performance.
- The CAG report pointed out those gross NPAs with PSBs had risen sharply in recent years, from Rs 2.27 lakh crore as of March 31, 2014 to about Rs 5.4 lakh crore at the end of March 2016.
- The parameters used to determine whether banks required capital changed from year to year and in some years the rationale for capitalizing banks was not even recorded.
- The report said that the scheme’s target of raising Rs 1.1 lakh crore from the markets by 2018-19 was not likely to be met.
- The report also pointed out that in some cases the rationale for distribution of government of India’s capital among different PSBs (Public Sector Banks) was not on record.
- The report also emphasized that some banks that did not qualify for additional capital as per the decided norms, were infused with capital, and in some cases, banks were infused with more capital than required.
- In 2015-16 and 2016-17, it was decided that 20 and 25 per cent of the capital infused, respectively, would be based on performance, CAG said. However, capital was released without considering performance due to poor asset conditions of banks after the RBI’s asset quality review in 2015—16 and failure of most lenders to meet targets.
- The criteria for fund infusion, once finalized, may be consistently applied across all public sector banks, CAG suggested.
- There should also be an effective monitoring system to ensure intended objective of fund infusion are met, CAG recommended.
- The government has launched a seven pronged plan called Indradhanush Mission to revamp functioning of public sector banks (PSBs).
- It was launched by Union Finance Minister Arun Jaitley in New Delhi.
Facts about Indradhanush Mission
- The seven shades of Indradhanush mission include appointments, de-stressing PSBs, capitalisation, empowerment, framework of accountability and governance reforms.
- It seeks to achieve the objective of economic growth revival through improving credit and minimising the political interference in the functioning of PSBs.