Binayak for law to make healthcare a legal entitlement

From The Hindu:

KOLKATA, September 18, 2011

Raktima Bose

With the Planning Commission’s steering committee on health scheduled to submit its draft report within two weeks, noted human rights activist and committee member Binayak Sen has advocated immediate enactment of a law that would make health care at staffed health institutions a public-funded legal entitlement for every citizen.

Dr. Binayak Sen also has highlighted the need to validate the role of accredited social health activists (ASHA) and enhance their involvement at the local self-governance level so that they can articulate the right to health care on behalf of the community and help towards attaining the goal of a universal right to health.

He was appointed a member of the 40-member steering committee within weeks of getting bail from the Supreme Court on April 15 in connection with charges of sedition. The committee will advise the panel on the 12th Five Year Plan.

In a detailed e-mail interview to The Hindu about his recommendations to the committee as a veteran in the field of community health, Dr. Sen pointed out that strengthening inter-sector linkages, especially at the panchayat level, is a vital requirement to ensure nutrition security, the absence of which in several parts of the country makes a large section of the population vulnerable to health-related complications.

Apart from providing better facilities to the ASHAs and devising community-based monitoring strategies, he stressed the need for a universal public distribution system that will include locally available pulses and oil in addition to cereals. He further emphasised the need for promoting community interface through self-help groups and public relations institutions regarding re-introduction of locally-grown greens, fruits and vegetable into ordinary diet as necessary for ensuring nutrition security.

Emphasising the need for enacting laws at both Central and State levels, Dr. Sen said that mere “access” to health care excludes any notion of legally enforceable entitlements or of people’s agency.

“The content of such entitlements should be made specific in the form of standard diagnostic and treatment algorithms which would have mandatory status. Such algorithms would also serve as the backbone for secure digital record systems accessible only through portable smart cards,” he added.

Advocating a “single-payer system” that would warrant cashless treatment, including free drugs, to all who approach the publicly-funded facilities, Dr. Sen also recommended a prohibition on private-practising by public sector health personnel as well as putting in place a rational drug therapy and standard treatment protocol.

He was hopeful that prohibiting private practice would help in segregating privately-funded healthcare system from the publicly-funded one such that health care is not treated as a “commodity”.

He also underscored the necessity of boosting the morale and ideological commitment of the currently lacking health personnel working in publicly-funded systems. Referring to the alarming drop in female child sex ratio in the country as “a reflection of a deep sickness in our society”, Dr. Sen said investing in a positive programme of population education that validates the role of women in society, would be more rewarding in tackling the menace than penal measures which would only drive the preference for male child further underground in society.