Prime Minister Narendra Modi recently opened a Pandora’s box by condemning the allopathic doctors of the country during an interaction called Bharat ki Baat, Sab ke Saath with the diaspora in London. The PM condemned the Indian doctors on charges of corruption and malpractice. He emphasised on the doctor-industry nexus and shared concerns on the fallout of such a relationship.
The Indian Medical Association and other similar outfits have condemned the PM’s remarks largely because they were spoken on British soil, a country where nearly 50 per cent of doctors in the National Health System (NHS) happen to be of Indian origin. For me, that is hardly any reason to condemn what Modi said.
Broadly, the PM is not wrong but to believe that his regime (like his political predecessors) hasn’t contributed to this decay of medical ethics healthcare in the country is absurd. To analyse the debris of the ethical healthcare delivery system, it is essential to see the complete picture.
The decay in the ethics is the result of corporatisation of healthcare by a greedy industry and politicians (remember, a large number of private medical colleges in this country are owned by politicians or their kin). The overall health market in India was estimated to be $100 billion in 2015 and is expected to grow to $280 billion by 2020, at an annual growth rate of nearly 30 per cent. The disturbing aspect of this statistic is the fact that most of this growth is happening in the private healthcare sector. In fact, there has been substantial cost-cutting in public healthcare.
It was the current government which in its first budget in 2014 cut health expenditure by around 20 per cent. In fact, under the present government, we became one of the nations which were spending the least on its health as a percentage of its GDP — less than even Ethiopia and Bhutan. A Lancet report in 2016 mentioned that 80 per cent of India’s healthcare is now delivered by the private practitioners, the very doctors whom the PM now condemns as corrupt. The destruction of public healthcare in the country has resulted in this extremely lopsided situation and hence the increasing likelihood of the malpractices about which the PM spoke in London. This government, like others. however, has contributed to this situation.
The prime minister also mentioned the capping of implant prices under his regime. This is a welcome step but we were told that capping of total knee implants would be followed by capping of prices of the total hip implants, ocular lenses, and many other such items. Nothing has happened in the last eight months in this regard. I hope the government will show haste in capping prices of other implants as well.
To blame the doctors is easy. There is no doubt that significant numbers of doctors are involved in unethical practices. It is also true that doctors and pharmaceutical companies form an unholy alliance. But to paint the entire profession with the same brush country is a matter of serious concern, especially when it comes from the highest quarters.
We live in extremely dangerous times where violence against doctors is on the rise. Such imprudent statements coming from the top embolden those who resort to violence. The powers that be should realise that the only effective way to reduce corruption in healthcare is to strengthen the public healthcare delivery system. Corruption is not the handiwork of individuals alone, it is also systemic. Repair the system and the corrupt will melt away like snow under the sun.