Q1) Niti AAyog recently submitted a report suggesting solutions regarding problems plaguing the healthcare sector in India. In this context, what are the various problems faced by the healthcare sector in India?What is the Niti Aayog’s proposed model contract? (GS3)
Problems of the healthcare sector in India
- Corruption in MCI
- Shortage of medical doctors due to the emigration of physicians and the fact that the current MCI rules and guidelines prohibit qualified MBBS doctors without a PG degree from performing procedures such as ultrasound and interpreting chest X-rays
- The challenges in Availability and maintenance of equipment and supply of drugs in the local public health infrastructure
- The capacity of district level public health institutions
- A weak primary healthcare sector with a Lack of intensive care units and issues like sanitation and drainage.
Unequally distributed skilled human resources
- There aren’t enough skilled healthcare professionals in India despite recent increases in MBBS programmes and nursing courses
- Shortage is compounded by inequitable distribution of these resources.
- India does not have an overarching national policy for human resources for health.
Large unregulated private sector
- The National Sample Survey Office (NSSO) numbers show a decrease in the use of public hospitals over the past two decades
- significant portion of these private practitioners may not be qualified or are under-qualified
- many new institutions set up in the past decade encouraged by commercial incentives, have often fuelled corrupt practices and failed to offer quality education
Low public spending on health
- Economically weaker states are particularly susceptible to low public health investments.
- Many state governments also fail to use allocated funds
Fragmented health information systems
- getting quality, clean, up-to-date data is difficult in the health sector
- Data is incomplete (in many cases it excludes the private sector) and many a time, it’s duplicated
Irrational use and spiralling cost of drugs
- Costs of medical treatment have increased so much that they are one of the primary reasons driving people into poverty
- Jan Aushadhi campaign to provide generic drugs at affordable prices, but their implementation has been patchy and varied in different states
- Corruption also increases irrational use of drugs and technology.
- kickbacks from referrals to other doctors or from pharmaceutical companies lead to unnecessary procedures such as CT scans, stent insertions and caesarean sections
Weak governance and accountability
- many of the new laws have not been widely implemented
- missing trust and engagement between various healthcare sectors
- poor coordination between state and central governments as the main constraints why universal healthcare is not assured in India
- unwillingness on the part of the state to prioritize health as a fundamental public good, central to India’s developmental aspirations, on par with education
- India continues to lag several health indicators such as mortality rates and malnutrition
Niti aayog’s Proposed Model contract
- Niti Aayog and the Union ministry for health and family welfare have proposed a model contract to increase the role of private hospitals in treating non-communicable diseases in urban India.
- The agreement, which has been been shared with states for their comments, allows private hospitals to bid for 30-year leases over parts of district hospital buildings and land to set up 50- or 100-bed hospitals in towns other than India’s eight largest metropolises.
- According to the model contact, the district hospitals will need to share their back-end services such as blood banks and ambulance services with the private players. The state government could also provide part of the funds needed by these private players to set up the new hospitals. The district health administration will ensure referrals for treatment from primary health centres, community health centres, disease screening centres and other government health programmes and ventures are made to these private hospitals
- Under the model contract, these private hospitals will provide secondary and tertiary medical treatment for cancer, heart diseases and respiratory tract ailments at prices that are not higher than those prescribed under government health insurance schemes. For non-communicable diseases needing these three kinds of specialised treatments, the hospitals will need to have out-patient departments, in-patient beds, beds for intensive care, operation theatres, centre for angioplasty and angiography, laboratories and radiology services.
- The district government hospital will be expected to share its ambulance services, blood blank, physiotherapy services, bio-medical waste disposal system, mortuary services, parking facilities, electricity load, in-patient payment counters and hospital security with the private enterprise running out of its campus, the contract says.
- Beneficiaries of the government insurance schemes will be able to get treatment at these hospitals but there will be no reserved beds or quota of beds for free services. General patients will also be allowed to seek treatment. Patients not covered by the state insurance and health schemes would be required to pay the full cost.
- The private hospitals operating from these public hospital campuses will be able to refer complicated cases either to other government hospitals or other empanelled private hospitals. However, sending patients further to other private hospitals would require the permission of the medical superintendent of the district hospital..
Q2)The need of domestic procurement for cybersecurity is being increasingly emphasized in India. In this context, what is cyberterroism? Why do we need to regulate the Cyberspace? (GS 3)
Cyber terrorism is the convergence of terrorism and cyber space. It is generally understood to mean unlawful attacks and threats of attacks against computers, networks, and information stored therein when done to intimidate or coerce a government or its people in furtherance of political or social objectives.
Further, to qualify as cyber terrorism, an attack should result in violence against persons or property or at least cause enough harm to generate fear. Attacks that lead to death or bodily injury, explosions, plane crashes, water contamination or severe economic loss would be examples. Serious attacks against critical infrastructures could be acts of cyber terrorism depending upon their impact. Attacks that disrupt nonessential services or that are mainly a costly nuisance would not.
WHY WE NEED TO REGULATE CYBERSPACE?
There has been a rapid increase in the use of the online environment where millions of users have access to internet resources and are providing contents on a daily basis.
- The use of internet particularly for the distribution of obscene, indecent and pornographic content. The use of internet for child pornography and child sexual abuse and the relative ease with which the same may be accessed calls for strict regulation.
- The increasing business transaction from tangible assets to intangible assets like Intellectual Property has converted Cyberspace from being a mere info space into important commercial space. The attempt to extend and then protect intellectual property rights online will drive much of the regulatory agenda and produce many technical methods of enforcement.
- The major area of concern where some sort of regulation is desirable is data protection and data privacy so that industry, public administrators, netizens, and academics can have confidence as on-line user.
- Internet has emerged as the ‘media of the people’ as the internet spreads fast there were changes in the press environment that was centered on mass media. Unlike as in the established press, there is no editor in the Internet. People themselves produce and circulate what they want to say and this direct way of communication on internet has caused many social debates. Therefore the future of Cyberspace content demands the reconciliation of the two views of freedom of expression and concern for community standards.
- Another concern is that, money laundering, be ‘serious crime’ becomes much simpler through the use of net. The person may use a name and an electronic address, but there are no mechanisms to
- prove the association of a person with an identity so that a person can be restricted to a single identity or identity can be restricted to a single person. Therefore Cyberspace needs to be regulated to curb this phenomenon.
Q3) Who are the world’s “modern slaves”? What does the Indian Constitution say about Slavery/bonded labour? What are the socio-economic impacts of modern slavery in India? (GS1)
- Slavery is an extreme form of inequality, and exists within a competing matrix of political, economic, societal, cultural and religious pressures. Modern slavery is bound to some of the most complex issues facing world leaders.
- Modern slavery refers to situations where one person has taken away another person’s freedom – their freedom to control their body, their freedom to choose to refuse certain work or to stop working – so that they can be exploited. Freedom is taken away by threats, violence, coercion, abuse of power and deception.(Source- WFF official site)
- Men, women and children who are forced to work against their will, or who are living in forced marriages are the “modern slaves”.
- The first category covers domestic workers, construction labourers, factory workers, farmhands etc., working under threat or coercion.
- In many cases, the products (food, clothes, etc.) that they make, or the services (housekeeping etc.) that they provide, end up in seemingly legitimate commercial channels.
- The second category consists of individuals — an overwhelming number of whom are women — who are in marriages to which they had not consented. They have lost their sexual autonomy, and often provide labour under the guise of ‘marriage’.
What does the Indian Constitution say about Slavery/bonded labour?
Article 23. Prohibition of traffic in human beings and forced labour
- Traffic in human beings and begar and other similar forms of forced labour are prohibited and any contravention of this provision shall be an offence punishable in accordance with law
- Nothing in this article shall prevent the State from imposing compulsory service for public purpose, and in imposing such service the State shall not make any discrimination on grounds only of religion, race, caste or class or any of them
The Parliament, accordingly, passed The Bonded Labour System (Abolition) Act in 1976 and The Child Labour (Prohibition and Regulation) Act in 1986.
In 1982, the Supreme Court defined forced labour as any labour for which the worker received less than the minimum wage stipulated by the government — the logic being that no one would work for less than the minimum wage unless “he is acting under the force of some compulsion”. (People’s Union for Democratic Rights and Others vs Union of India and Others)
THE SOCIO-ECONOMIC IMPACT OF MODERN SLAVERY
- The services that fall under forced labour do not get due recognition in the GDP and hence, the economic data stays incomplete.
- The image of Indian labour and the associated laws are carefully studied by the foreign companies before they invest in India. This, therefore, is one major reason for delayed foreign inflows into India.
- The economic exploitation of labour leads to increase in inequality, poverty and unemployment in India that further effects the daily living of these people. This goes against the Right to Life as guaranteed in the Article 21 of the Indian constitution.
- FOR The superpower status that is desired by India and the permanent seat in the UN SC, it is essential that it improves the conditions of it’s labour class.