Doctors and politicsBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2901 (Published 23 April 2014) Cite this as: BMJ 2014;348:g2901
Promises on a platter. It is election season in the world’s largest democracy and politicians are willing to bend over backwards to woo voters. As India moves decisively towards a new government, we bring to you in The BMJ a series of articles aimed at stimulating discussion on what the general elections should mean for health and healthcare, and hoping to inform the health agenda of the next government.
Health has traditionally been relegated to the sidelines with neither politicians nor citizens making a noise about it, when it is indeed central to the vitality of our population. However, it is beginning to climb up the political agenda, reports Patralekha Chatterjee, as she examines how the future of health is carved out in the election manifestos of various political parties (doi:10.1136/bmj.g2703).
Pushing a rights based agenda, the Indian National Congress promises legislation towards realising the right to health. The party however faces a credibility crisis as some of its broad welfare schemes have been mired in irregularities in implementation. The main opposition to the ruling government, the Bharatiya Janta Party, proclaims “radical reforms” in healthcare delivery, as senior leader, Arun Jaitley, explains, “What is more important is to implement effectively those new rights. Conferring them in law and not implementing them renders them mere slogans. So you have a right to health but your public health system does not improve. I think the Congress is looking for legislation. We prefer the actual implementation.”
A rookie on the electoral scene, the Aam Aadmi Party, too promises a comprehensive “right to healthcare” legislation that would guarantee high quality healthcare for all citizens irrespective of wealth. A view that is supported by Yogesh Jain, a public health physician, as he urges the next government to “work towards setting up a universal healthcare programme, and not health insurance for the officially poor, lest a poor people’s programme becomes a poor programme.” Seemingly, party manifestos promise us the moon, but they are largely silent on the roadmap to get us there. Dinsa Sachan sought views from a few powerhouses of Indian healthcare on strategies the next government must prioritise to realise this dream of health for all (doi:10.1136/bmj.g2479).
A major bane affecting healthcare access has been what Amit Sengupta, of the Delhi Science Forum, labels as “India’s 70-70 problem”—namely, that 70% of healthcare expenses in India are borne by people from their pockets, of which 70% is spent on medicines, with episodes of illness driving people to impoverishment. A model of public procurement of drugs as implemented in the states of Tamil Nadu and Rajasthan has been shown to lower the cost of medicines and allow free access to generics (doi:10.1136/bmj.g2050). However, recent reports from Rajasthan suggest that a lack of political will may be weakening the landmark free medicines’ scheme in the state (doi:10.1136/bmj.g2729).
A staunch campaigner for the right to free treatment, Narendra Gupta, has thus chosen to enter politics after decades of work at the grassroots. Contesting from Chittorgarh, Rajasthan, as a candidate of the Aam Aadmi Party, he believes that conscientious doctors can raise many issues if they enter the political arena. “Our healthcare system is in the ICU [intensive care unit]. We need radical changes. My experience in clinical practice and community medicine; my field work in tribal areas; and my first-hand knowledge of how the government system works both at the centre and at the state level puts me at a vantage point to serve the people,” says Gupta of his foray into politics (doi:10.1136/bmj.g2814).
What do you think? Do more doctors need to join politics to improve healthcare in India? Vote now in the latest BMJ India poll.
Cite this as: BMJ 2014;348:g2901