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India has made steady progress on all fronts of human and economic development since becoming a republic in 1951. During the previous two decades, India has grown into the world’s largest democracy and one of the fastest expanding economies. However, the country has numerous serious concerns, including sustaining excellent health for the world’s second-largest population. In terms of health-care reform in India, the last few years have been quite active. Providing healthcare for a billion or more people has long been thought to be unachievable for a developing country like India. India spends only approximately 1.2 percent of its GDP on health care, which is among the lowest in the world.

12th National Plan (2012-17)

The Planning Commission was established in March 1950 to further the Government of India’s declared objectives of promoting a rapid rise in the people’s standard of living through efficient exploitation of the country’s resources, thereby increasing production and providing opportunities for all to work in the community’s service. In crucial areas of human and economic development, the Planning Commission plays an integrative role in the creation of a comprehensive approach to policy making. In the near future, spending on health would increase from 1.2% at the current level to 2.5% of GDP over the five year period. The 12th Plan will prioritise convergence among all existing

Universal Health Coverage

In 2010, a High level Expert Group (HLEG) was constituted by the Planning Commission to develop a framework for providing easily accessible and affordable healthcare to people of India. The HLEG compiled a report in November 2011 with elaborate financial plan and framework for human resource development.

National Rural Health Mission (NRHM 2005)

The National Rural Health Mission (NRHM 2005) was established to improve rural public health. The mission’s goal was to offer adequate healthcare to the country’s rural population, with a concentration on the States and Union Territories (UTs). The National Rural Health Mission is being amalgamated with the National Urban Health Mission to become the National Health Mission.

Benchmarking Healthcare

 National Accreditation Board for Hospitals and Healthcare Providers Accreditation, Clinical Establishment Act, and Indian Public Health Standards The key to success in the UHC programme is reasonable health care finance. Because huge sums of public cash will be available to purchase treatment from both public and commercial providers, the healthcare units must be standardised and regulated. It is now widely recognised that patients’ rights to rational, high-quality care at a fair cost should be respected. Medical audits and standard treatment protocols should become commonplace. These standards are defined in India by NABH, IPHS, and CEA.

National Accreditation Board for Hospitals and Healthcare Providers

NABH is a member of the Quality Council of India (QCI), which was established to design and run a healthcare accreditation programme. All parties, including business, consumers, and government, support the board’s functional autonomy. Accreditation of a healthcare organisation is a never-ending improvement process. NABH certification demonstrates a company’s dedication to providing high-quality treatment. It increases customer and community trust in the services provided while also allowing healthcare units to compare themselves to the best. Accreditation offers access to trustworthy and verified information about a facility’s infrastructure, services, and level of care. As a result, accreditation offers an objective mechanism for insurance and other third-party empanelment.

The Clinical Establishment Act 2010

The Clinical Establishments (Registration and Regulation) Act of 2010 was just notified, and its provisions have already taken effect in a few states. Medical professionals’ trade unions have spoken out against the law’s implementation as a whole, believing it to be an infringement on their professional autonomy. Until today, a medical practitioner could only practise in his or her clinic if he or she was registered with the medical council. A standardised infrastructure and clinical procedures are now required.

Indian Public Health Standards 2012

The IPHS for Sub-centers, Primary Health Centers (PHCs), Community Health Centers (CHCs), and Sub-District and District Hospitals was first published in January/February 2007 and has since been used as a reference point for state and union territory public healthcare infrastructure planning and upgrades. The IPHS 2007 has been changed, and the most recent edition, IPHS 2012, has been issued. IPHS 2012 provides regional flexibility and builds on the NRHM’s previous expertise.

Pradhan Mantri Swasthya Suraksha Yojana:

Six new AIIMS institutions

Six additional AIIMS (All India Institute of Medical Sciences) institutions are being established by the Ministry of Health & Family Welfare, Government of India under the Pradhan Mantri Swasthya Suraksha Yojna (PMSSY) by an act of parliament. The aim of this initiative is to correct regional imbalances in quality tertiary level healthcare in the country and attaining self-sufficiency in graduate and postgraduate medical education. These institutes are being established in the underserved areas of the country. These new AIIMS have already have admitted their first batch of the MBBS students. Twenty six medical colleges have also been supported under Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) and 46 State Government owned medical colleges have been given assistance for the strengthening and up-gradation of facilities needed to start new post graduate departments. It is proposed that nearly

  • 90% of all government medical institutions would be upgraded during 12th five year plan.
  • A Medical College in each District of the Country (reported 2012)

Healthcare Reforms in India

According to a recent report, the government is planning to offer financial assistance to state  governments so that each of India’s 626 districts might establish a medical college. Under the NRHM, vacancies in rural India are projected to increase in the future. Sixty percent of specialist positions at community health centres remain unfilled. In the following four years, the scarcity is predicted to increase to almost 50%. The number of MBBS and postgraduate seats is expected to treble in the near future, thanks to current infrastructural and faculty requirements for medical institutions.

Uniform Code of Pharmaceutical Marketing Practices – Positioned to become Mandatory Code (2012)

In 2011, the Department of Pharmaceuticals (DoP) released a draught Uniform Code of Pharmaceutical Marketing Practices (UCPMP), which will be implemented on a voluntary basis in the first instance. Companies cannot directly or indirectly support travel entertainment or hospitality for medical practitioners and their families under current standards. Unregulated marketing methods are partly to blame for the country’s rise in irrational medication usage. There is a legitimate increase in demand for generic medicine advertising.

Medical Education Reforms: NHSRC Bill & NEET

NHSRC Bill 2011

The National Commission for Human Resources for Health (NCHRH) was proposed to be an overcharging regulatory body for medical education and allied health sciences with a dual purpose of reforming the current regulatory framework and enhancing the supply of skilled manpower in the health sector.

NEET (National Eligibility con Entrance Test)

The medical council of India announced NEET in response to a public interest lawsuit brought by prospective medical students seeking a single admission exam. This was also considered as a chance to reduce the unlawful capitation charge and bring medical education in India into line. However, the Supreme Court of India recently rejected this notification, claiming that it infringed on the rights of public and private organisations to govern such institutions. A petition for review has been filed. The outcome of this case is expected to have a long-term influence on medical professionals and their practices.

Dr Meghna Chotaliya | CS, CMA, LLM, Ph.D. , MBA | Assistant Professor and Head- Department of Accountancy |
R.D. National College, Bandra West, Mumbai

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