The recent incidents have been significant with governments getting into an overdrive to rein in the private healthcare providers. The bold legislations that the West Bengal and Karnataka governments brought into force to regulate the private sector, the manner in which the Delhi Government cancelled the license of Max, a well-known corporate hospital, and the show-cause notices issued by the Haryana government to the Fortis hospital, yet another well-known corporate hospital, are reflective of the distress and unrest that the people are feeling about the functioning of the health system.

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With near-stagnant budgets, the government hospitals are working at the seams in trying to treat as many of the poor as possible. Overcrowding and stressed-out doctors lead to a compromise in quality, resulting in those able to pay opting for the private hospitals. But the unregulated private sector, in the name of providing quality care, are increasingly being perceived as exploitative, indifferent to patients’ health and only interested in making profits. In the absence of any regulations and processes for ensuring accountability, the people have been increasingly taking law into their hands, beating up doctors and nurses. Like never before, the health system is deeply scarred with the near total breakdown in the trust between doctors and patients, between government and private.

In light of the above, the first task of the government in 2018, that up until now has displayed a benign indifference to the functioning of the private sector, is to restore trust and faith in the system. In other words, governments at the federal and state levels can no longer allow the unbridled power of the markets to play havoc in the health sector  and have to bring in regulations, rules and processes to ensure all stakeholders function with a sense of responsibility. Alongside this, it is also important that there is a dialogue between different stakeholders.

The second task for the governments at the federal and state levels to institute platforms with all stakeholders sitting across and discussing issues and problems to find solutions that are acceptable to all. Part of the problem is that  in the absence of any fora for dialogue and in the absence of information, apprehensions and fears influence perceptions that may not always be right. This gap needs to be bridged.

My third wish is that government increase health budgets – to build delivery infrastructure in the highly deficit areas and to employ required personnel in others.  Rather than investing on acquiring the latest devices, its more important to have the human resources that can attend to the medical needs. Rather than focusing the scarce energies available in trying to work out PPP programmes, it’s more important for governments to optimise the resources already available on the one hand and ensure convergence of all basic public goods on the other. Just these few incremental steps can yield massive dividends. But these first steps need to be taken. It is thus hoped that government will increase public investment in 2018 in health and incentivise convergence of all program interventions.

The fourth critical area of action is enforcing the new National Medical Commission. It was in 2009 that the Prime Minister of India mooted the idea of revamping the archaic MCI. The draft bill got the cabinet approval in December 2017, a full eight years later. There are several misgivings about the bill. There are apprehensions that in seeking to reduce corruption by liberalising and rationalising some aspects, we may end up creating a situation where medical education may become unaffordable for the middle classes.

The above list of interventions, if implemented, can be game changers.

The author is former Union Secretary, Health and Author of ‘Do We Care? India’s Health System