Unhealthy Binaries


  • As India moves towards creating structures for universal healthcare with the National Health Protection Scheme, we need to get rid of some bugaboos that have kept important providers of healthcare out of the purview of public good in India. 

Misleading belief:

  • The first, most deep-rooted misleading belief, is that private practitioners are less suited to deliver healthcare services than public healthcare professionals.
  • The second is that health outcomes of patients are immaterial, that there is no need to track patients or maintain records, spending more money on healthcare is enough. 

An institutional infrastructure:

  • An institutional infrastructure that tracks health outcomes is not difficult to set up. All that tracking health status really means is that patient outcomes like disease, death, infection and so on, be regularly ascertained, reported and monitored. In some countries, it is routine to set up such reporting systems. They even set up disease-specific registers in which a variety of hospitals and physicians participate. 
  • In India, till date, there has been no institutional framework fixing such key indicators, nor is there any general rule mandating that these should be reported regularly, whether in the public or private sector. Since India already had enough IT professionals for setting up such systems, we conclude that the need to track patient status is not given the importance it deserves.

Operationalise patient tracking:

  • This is merely a matter of setting up a simple user-friendly software application. This could be used to record patient data on a few key parameters.
  • Many state governments like Maharashtra, Andhra Pradesh and Tamil Nadu use such software applications for secondary and tertiary care programmes. These applications could be modified for patient tracking.
  • To successfully put care and quality back into healthcare, it is important to set up this kind of system to track the health status of patients.

Way forward:

  • Whether we spend one rupee or one thousand rupees, whether we use public healthcare professionals or private practitioners, will matter far less.
  • Tracking health status will.
  • The effectiveness of resource use has little to do with the size of resources made available.


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