Someone at the health ministry has used his or her imagination, and a rating system has been proposed to incentivise government facilities — and state governments by extension — which keep their premises and services in good working order. Initially covering community health centres, it is an intelligent step towards a transparent, responsive and responsible health system, though the proposal is only foundational and admittedly requires development. A minimum head count of doctors, nurses and laboratory technicians assures a single star rating. More stars are earned according to pharmaceuticals available, services offered and success in engaging patients. The fifth and final star is to be earned by benchmarks like the performance of at least five Caesarean sections and implantation of at least three intrauterine devices every month.
Points aggregated by states can be redeemed for a 5 per cent incentive in the outlay from the National Health Mission. The innovation is designed to spark competition and should have a salutary effect, encouraging states to compete for extra funds. Institutions which contribute significantly to state aggregates will naturally earn prestige, and perhaps better allocations. However, statutory warnings must be issued against indiscriminate competition. For instance, Caesarean sections are already preferred in India for non-medical reasons like a favourable astrological chart, and further enthusiasm for the procedure would harm public health. IUDs should be cautiously used as a benchmark too, since the choice of contraceptive method is the patient’s right.
