An overview on the Health manifesto of both fronts in Kerala indicate that there is a welcome awakening but more attention is required.
UDF has included Health in its prime slogan (food, shelter and health for all), while the LDF has spelt out its priority for health in the manifesto. These are definitely welcome measures in a state where Health is yet to get due importance. This beginning is good, but the path is hazy and end is not in sight.
Health, by and large, is seen by many as merely treating diseases. The basic principles are often forgotten or ignored. It’s quite understandable as one gets glory for the diseases treated but only an intelligent society can appreciate the value of those prevented. Plenty of dialysis centres, cath labs, organ transplantation and medical colleges are promised whereas primary care gets largely ignored. How long can “an inverted pyramid” be stable?
UDF has health in its slogan but nothing more to cheer about in the detailed description. Its idea of declaring health as a right is the need of the hour. It lays more emphasis on public private mix, which again is a welcome initiative. The idea of eradication of communicable diseases by 2020 is only wishful thinking especially with no road map set. There are very few policy directions outlined in the manifesto which dwells primarily on few diseases and programmes. The idea of integrating different systems of therapy is most unscientific.
LDF, on the other hand, do spell out some clear policies though few lack clarity and some measures are detrimental. The promise to increase health expenditure to 5% is the most laudable measure in the entire manifesto. This was something which health activists had been demanding for quite some time now. The promises of improving staff pattern in Government hospitals and bringing in health insurance too are welcome measures. The suggestions that KSDP and similar drug manufacturing units will be promoted to produce quality drugs for the Government sector, inclusion of health topics in school curriculum, establishment of Medical service recruitment board and evidence based approach to traditional systems of Medicine will all be valuable if implemented. However the idea to start IP care in PHC and advanced treatment facilities like Cath lab in Taluk hospitals cannot be seen as scientific measures. The hub of preventive care today is the PHC, which is already fragile and no attempt to dilute the Primary care further should be done. Super Specialty services should be established and strengthened at district level. Private partnership should be encouraged in this area. It wouldn’t be wise to spend the meager resources in establishing too many specialty centres at the cost of compromising Primary care.
While the manifesto of both fronts have set some directions, much need to be done once the new ministry comes in. First and foremost will be formation of a huge health initiative incorporating all political parties, scientific organisations, voluntary and other health agencies. The first priority should be to delineate and declare a health policy with both short term and long term goals. A separate department for Public health (PH) is mandatory. DHS should be responsible for curative care and the PH department should be empowered for preventive care and public health. The four health determinants namely clean air, safe water, healthy food and safe environment should receive top priority. We urgently need a lifestyle policy, providing adequate allowances for safe food and exercise. We need to evolve effective strategies to combat the rising trend of communicable and non communicable diseases. Prompt promotion of Research and establishment of Mono faculty University for Modern Medicine are also required. Only Scientific medicine and methods should be promoted. Medical education policy has to be clearly spelt out. The young medicos should get quality Medical education and also adequate opportunity for higher education. Adequate utilisation of Medical manpower should be ensured. Cost of medical care should be curtailed and quality ensured. Drugs should be manufactured in public sector and distributed through public distribution system. Huge initiatives for health education and promotion should be ensured utilising all available resources.
It’s heartening to note that Health is beginning to get some attention but much more is due. With both fronts taking up health seriously let us hope that a new dawn will break in the state’s health scenario with primary health getting due priority and affordable quality care ensured for all citizens.
