The Uttar Pradesh Government is leaving no stone unturned to foster its healthcare delivery system, enabling people at large to avail best services at their doorsteps. Despite huge challenge of infrastructure in terms of shortage of doctors and equipment, the State Government envisions to create best exemplary model of patient care, says Jai Pratap Singh, Minister for Medical, Health and Family Welfare, Government of Uttar Pradesh, in conversation with Arpit Gupta and Mukul Kumar Mishra of Elets News Network (ENN).
Q As the health minister, tell us about various plans and strategies to boost healthcare delivery mechanism in Uttar Pradesh?
Education and healthcare are two important factors which determine economic prosperity of a country. Around 60 percent of population still lives in rural areas in India. Since initial days when country got independence, policymakers should have prioritised these sectors to develop. But things didn’t happen as it was visualised.
Nonetheless, after seventy years, BJP came to power at the Centre and State. Since then, it has been leaving no stone unturned to create a healthy and prosperous India. Our objective is to facilitate accessible healthcare to 22 crore people of the State. I am taking stock of the situation at PHCs, CHCs, and District Centres. Services at many of these centres are not up to the mark. Our main focus is to improve infrastructure at these centres, enabling masses to avail quality and affordable care.
Q What is your prime concern in terms of improving infrastructure so that skilled medical professionals including doctors could facilitate care at primary centres?
There is a standard process of availability of residential buildings for doctors, pharmacists, ward boys, associated with PHCs, CHCs, and district centres. The glaring issue is maintenance of old structures. We are taking all measures to improve facilities at existing centres in terms of availability of human resource—doctors, nurses, and technicians, required equipments, and maintenance of residents buildings, so that inclusive care could be facilitated to people. In interior areas, residential quarters are not in good shape.
The Government’s first priority is to kick-start things at existing centres so that not a single person gets deprived of basic care. Subsequently, we will focus on old residential structures and ensure to get them functional. Doctors need to provide required facilities to make them work in remote areas.
Q Can a model district health centre be developed which would be cited an example and attract doctors?
It is practically not feasible due to constraints at different levels. We aim for better functional district health centres and community health centres where basic medical care should be available 24/7. These may not be model ones, but at least stand up to the level of basic standard. At CHCs, now doctors, experts and high-end equipments are available. In addition, telemedicine, and surgery facilities are also being explored at these centres. If people can get primary care at these centre, only serious patients needed to refer to medical colleges and tertiary care hospitals.
Q What measures need to be taken to improve situation in public hospitals which lack facilities, affecting patient care?
India spends 1.4 percent of GDP on healthcare. It should be ideally three percent to ramp up infrastructure. Many of the hospitals have now improved on various parameters. They are being given good ratings by National Accreditation Board for Hospitals (NABH) for their overall performance especially in area of clinical outcome. The rating is an indication that people would get best facilities in these hospitals. We are trying to improve things on every front. It’s our moral responsibility to provide better healthcare facilities to people at large. For that, budget needs to be increased and allocated money should be spent in prudent manner. There has been a substantial increase in budgetary allocations in recent years since the government took reins.
Q Uttar Pradesh was one of the worst performing States in recently released Niti Aayog Health Index report…Isn’t it disturbing as a Health Minister?
The report indicates State’s performances on various health parameters. There are eight aspirational districts across the State. To take stock of the programmes implemented by the State Government, the Central government team visits here once in a month. They monitor various points of health indicators minutely. Their ratings indicate progress of various programmes and areas where the State needs to work upon.
To provide holistic care to women and child, there are programmes like Janani Suraksha Yojana (JSY) and Pradhan Mantri Matru Vandana Yojana (PMMVY). Expecting mothers who are registered under the scheme get Rs 6,500, and free medicine, so that they could take good care of their own health and baby’s as well. After the birth of baby, we ensure proper nutrition to child and mother. The Government also makes available free vaccination to child on different interval of time. The State may not have performed well as per the expectations of Niti Aayog. But we will strive to improve our records in coming years.
Q How digital tools are being leveraged to improve delivery of care in rural areas?
Through telemedicine, we are leveraging IT technology to bridge communication gaps between patients and doctors. Patients are being given particular time slot when expert doctors sitting in cities like Delhi or Lucknow appear on the tech- driven web screen and guide patients about clinical treatment. Best part of the technology is both patient and doctors don’t physically present at the location but communicate in better manner to exchange information. Telemedicine is very useful in the light of shortage of expert doctors in remote areas. The technology is already available at some of the CHCs and working to increase the facility.
Q There is huge a shortage of doctors all across the State. How is the Government planning to improve the situation?
The Government understands the urgency to improve number of skilled medical professionals to boost patient care. We have made a committee in every district where doctors are invited to work in rural areas directly through walk-in-interview. Many of the expert doctors have joined through the process. The Government is also working on bidding process to recruit skilled professionals. Till date Uttar Pradesh had only 13 medical colleges. In last two and half years, a total of 15 colleges have been added up. Out of these, seven have become functional and rest eight are at various stages. In addition, the Centre has also directed us to establish 14 medical colleges and work is on full swing on that front.
We have started signing a bond with all the undergraduates studying in the Government medical colleges. As per the bond, they will have to serve for two years in rural areas. These efforts will bear fruit soon which will ultimately fill gaps of shortage of doctors and other medical professionals in coming years.
Q PPP is being perceived as pivotal tool to improve infrastructure under Centre’s Ayushman Bharat initiative. How do you analyse the statement in context of UP?
Many of the private hospitals and NABH and Kayakalp accredited government hospitals have been empanelled under Ayushman Bharat scheme. There is a Government’s coordinator in these hospitals who ensures patients get required care under the scheme. People with Ayushman card get Rs 5 lakh treatment facility for 1400 diseases across these hospitals. We have a redressal committee as well which resolves issue pertaining to increased cost of any treatment facility. People are also coming to government facilities to avail quality care now.
Q The Government has banned many hospitals on the charge of forgery and irregularity under the Ayushman Scheme. What measures are being undertaken on this front?
Yes, we are taking strong action against such hospitals. Many of such cases have come to the fore. But, when mega schemes like Ayushman Bharat are implemented on such a scale, some cases are bound to be cropped up. Important point is it needs to be tackled with iron hand. There are clear guidelines about whole process of treatment. Hospitals must be empanelled to provide treatment facility. Moreover, the coordinator guides the patients how to go about whole processes.
Q Corruption is one of the biggest issues jeopardising system to facilitate delivery of service to masses. What is your viewpoint?
Corruption can’t be eradicated by any vigilance system or minister or political leaders. It is ingrained within the system and can’t be wiped out. System can rein in but can’t stop it completely. Despite getting good salary and other perks some of the government officials are found to be involved in such practices. System can teach you a lesson not to resort in such practices through punishment, but ultimately it’s your own conscience that should stop you doing such things.
Q It has been alleged that BJP government has stopped 108 ambulance emergency services…is it true?
No, 102 and 108 numbers are very much active. A large number of people avail ambulance facilities through these numbers. GVK is our service partner and every month we review the response time. We get feedback from every district about response time and investigate if the response time increases or any other sort of issue arises. Service provider faces action if response time increases. We aim to make the service much more efficient in coming days.
Q You recently took over as Minister in Health Department. Tell us what all three issues you zeroed in to focus upon on priority.
First is shortage of doctors and the Government is working on plans to improve situation on this front. Second issue is paramedics staff who wants to be posted as per their choice of districts. These are backbone of care delivery system and play a vital role. Our priority is to convince these staff to move to those places where they are utmost needed. And last but not the least is to improve infrastructure to bolster patient care in remotest corner of the State.