A day after the Rajasthan assembly passed the Right to Health Bill even as the private doctors continued to protest seeking its withdrawal, several public health experts slammed the agitating doctors calling their stir “unjustified” since the “state government agreed to their demands”
Under the provisions of the bill, no government or private hospital can refuse to treat patients. If they refuse, they will be fined and face disciplinary action. If a health facility refuses to treat a patient, they will be fined ₹10,000 the first time and ₹25,000 the subsequent times. Injured people will get free transport and treatment, the bill states.
According to the public health experts, the bill will help improve quality and access to health services for the public and reduce out of pocket expenditure.
Reacting to the protests, Chhaya Pachauli, state coordinator of the Jan Swasthya Abhiyan, said: “The state government has agreed to the demands of private doctors and they have no justification to continue the agitation.”
She said the demand of the doctors not to include obstetric emergency under emergency care was not valid.
“Obstetric emergencies is a serious issue. There can be complications in obstetrics cases. It is a good step to include obstetrics cases in emergencies,” she said.
Pachauli pointed out that if the government wants to improve health indicators such as maternal mortality rate (MMR), infant mortality rate (IMR), “such steps need to be taken.”
“I think their problem is that bill gives a framework for transparency and accountability. It also provides for a strong grievance redressal mechanism They (private doctors) don’t want to be brought under any kind of accountability,” said Pachauli.
She said if the bill was “implemented properly, it would improve access to health services for the public and reduce out of pocket expenditure.”
Under the provisions of the bill, health authorities will be established in each district which will act as the monitoring agencies and hear cases and complaints against the health facilities. The decision given by the health authorities cannot be challenged in any court. The patient will have the right to information about his or her disease, the line of treatment followed, and the cost involved.
Meanwhile, Dr Pavitra Mohan, a public health expert said the private doctors were uncomfortable that the bill envisages strengthening of the public healthcare system. “The private healthcare system thrives if the public healthcare system is weak,” he said.
Dr Mohan, who is co-founder of Basic Healthcare services, that works in remote areas in Udaipur, said the bill has the potential to improve public healthcare services.
“The bill talks of a training and human resources policy that will ensure manpower in health facilities and also framing quality standards that will improve quality of care,” he said.
Dr Mohan appreciated that the state government has made provision for financial resources in the bill that shows its commitment to keep health services free. “This will mean less burden and indebtedness on the public.” He said the “current out of pocket expenditure is 60-70% of the total health expenditure for a family.”
“With more availability of human resources and funds, the quality of care and access to care will improve. This will positively impact indicators such as IMR and MMR in Rajasthan,” he said.
Rajasthan has an IMR of 35 per 1000 live births while the MMR stands at 14.5, as per the Sample Registration Survey,2019.
Dr Prakash Tyagi, a public health expert based in Jodhpur, said the bill talks about access to healthcare.
“The guidelines are likely to be framed in the rules. This is an important aspect as in western and southern Rajasthan where distances are large and population is sparse and remotely located, access is a problem.”
He said if the bill ensures health services are available within a reasonable distance and adequate manpower is available, it will provide immense relief to the people.
“Western Rajasthan is located in the Thar desert and has a population that lives in far-flung areas and healthcare facilities are few. This region has high IMR and MMR. The bill will help provide better primary and secondary healthcare services to the population,” he said.
