Medical deceit, non-performance bane of healthcare: Amartya

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Medical deceit, non-performance bane of healthcare: Amartya

Kolkata, Nov. 19 (PTI): After his criticism of the poor state of

primary education in two eastern states of the country, Nobel

laureate Prof. Amartya Sen, has carried out another investigation

into the healthcare sector which he says is reeling under " non-

performance, exploitation and medical deceit " .

In a stinging report brought out by the Pratichi (India) Trust run

by him, Sen is baffled at the two widely acknowledged maladies in

Indian medicare -- " public health servants prefer seeing patients

privately for money and quacks fleecing patients in exchange for

providing nothing other than placebo satisfaction. "

The culmination of a survey undertaken among a cross section of

rural population in West Bengal and Jharkhand, the Pratichi

healthcare report brought out recently also speaks of the economic

ruination of the poor ill who go into indebtedness and have to sell

assets because of the high " charges " of private practitioners.

" We found many cases in which the patients were economicaly

strained -- or even ruined -- through high charges, sometimes for

services falsely claimed to be curative like giving saline

injections to deal with malaria, " Sen says in the 134-page report.

In 24 villages that his team of investigators surveyed, Sen says the

most immediate problem was the non-functioning of public health

service, particularly in the Dumka region of Jharkhand.

The situation, Sen says, is much worse in the sub-centres.

" Alas, only 11 of the 18 sub-centres in Birbhum were actually

functioning and the picture was much worse in Dumka, with only five

of the 13 designated sub-centres working, and even those functioned

with much irregularity, " the Nobel laureate mentions in the report.

The lack of basic facilities in the clinics that actually did

function was the second problem that the team encountered.

" The availability of medicine is extremely limited in both the

districts. Some of the patients interviewed claimed that the Public

Health Centre (PHC) and block PHC staff charged them money for

medicines which were meant to be provided free as a part of public

health service, " he says.

A major fallout of the non-functioning of public health services was

the wide use of private practitioners, to whom the patients were

forced to go.

" Sometimes, they are sent there by the public health servants

themselves who in some cases seem to prefer seeing patients for

money in private rather than for free as part of public service, "

Sen rues.

Another problem was also the ignorance of the patients, which

allowed quacks and " miracle healers " to operate in the private

sector.

On the neglect of basic healthcare knowledge, Sen says " the fact

that some patients believe that faced with dehydration they should

drink less rather than more water is an appalling example of this. "

To this, he adds the almost total neglect of awareness of AIDS as an

epidemic, " the grip of which over India is expected to rise

sharply. "

The economist prescribes greater regulation and monitoring,

something comparable to the " inspection system " of schools.

" Another policy possibility is much greater control and supervision

of the activities of state sector doctors... When some citizens can

not even get free medical diagnoses or blood tests, or obtain basic

medication for clearly identifiable substantial illnesses, there is

something deeply wrong with the framework of state health services, "

he says.

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http://www.hindu.com/thehindu/holnus/004200511191010.htm