India needs radical restructuring of its health care delivery system: report

India would not only need to allocate more resources for healthcare but also radically alter the structure of its healthcare delivery system, if it is to achieve the government's vision of assuring health for all, according to a paper published in The Lancet yesterday. The health-care system in India was riddled with several deficiencies and structural problems failed to assure health coverage for all in India, says the report.

''No government has treated healthcare with the same attention as education,'' says  professor Vikram Patel, the lead author of the paper from the Delhi-based Public Health Foundation of India. ''There is no ownership of health as a national public good by the medical sector, the government or the civil society.''

''Treating health as a private commodity without adequate checks and balances would result in irrational practices leading to impoverishment,'' said Patel. ''Health seen as a private commodity is not consistent with universal health goal.''

It was an undeniable fact that a significant proportion of the population stood impoverished as a result of high out-of-pocket health-care expenditures and people also suffered the adverse consequences of poor quality of care.

Even today, there existed widespread inequities in health outcomes between and within states, urban and rural population, rich and poor, boys and girls. Mortality rates in infants, for example, in rural and urban areas differed by 17 points. Further, around 25 per cent of children born to the poorest people suffered severe malnutrition as compared with 5 per cent children born to the richest people.

The paper, authored by Patel from London School of Hygiene & Tropical Medicine and colleagues, documents India's progress on major health indicators in the past decade and also many deficiencies."The health time-bomb ticks on due to the rising burden of non-communicable diseases. There are widespread inequities in health outcomes that are apparent in the large morbidity and mortality differentials across socio-economic status, caste, class, sex, and geographic location," Patel said.

The most disturbing indicator of the deficits of the Indian healthcare system was the observation that healthcare costs were driving millions into poverty.