Primary Healthcare is of critical importance in uplifting the overall health status of the state and making the life of its citizens more livable. It is the first level care facility, it should be accessible to the largest portion of the populace. It addresses, by definition, preventive, promotive, curative, general hygienic and nutritional requirements of the population, esp rural poor and is the most effective level to improve the maternal and child health. Primary healthcare is also the most economical system to provide comprehensive services at their door steps with the active participation of local communities. Punjab’s health delivery system is operating at three levels: (i) primary level, (CHC, PHCs and dispensaries); (ii) secondary level, (district and tehsil hospitals); (iii) tertiary level (medical college hospitals and central government hospitals). In addition, private health providers provide clinic based practice of general practitioners, and mostly concentrate on low risk cases. In addition there is a big force of quacks, who attend to a large percent of OPD patients. In Punjab, public health facilities increased up to the mid-1980s mainly due to increased allocation of funds to state health sector and pro-rural policy of state government. Thereafter, public funds to expand state health services declined drastically in the state. Between the triennium ending 1980-81 and 2004-05, total number of hospitals decreased from 244 to 219, the number of PHCs increased from 129 to 441, the number of dispensaries rose from 1255 to 1479. Unfortunately Punjab does not have an Integrated or reliable Primary Health Care System.
Private health services dominate
Covering over 90 percent cases of non-hospital care and over two-thirds of the cases of hospitalized care, private health services dominate and direct curative health. In many instances the private sector operates without adhering to regulations. Quacks though an accessible resource to first aid, are often a hindrance to making good health care available to all. Further, patients’ rights are often not adequately served in the private health sector. In most cases, the profit motive drives out any adherence to ethics. There are many arguments that private medical aid should be expensive because one, it will then guarantee quality medical care, and two, take the pressure of richer clientele off government facilities. This has not happened and completely unregulated medical care is causeing all sorts of problems. The fact that the poor have to pay for treatment from their own pockets reveals the breakdown of the public health care system. The techno-centric nature of treatment traps patients in a web of technology-centered medical system that is confusing, intimidating and expensive to unaffordable.
One step that Punjab can take is to set up ‘family clinics’ in PPP model for OPD treatment on the pattern of UK’s NHS. Poor people can be taken care of by the state in this model. Other step is to spread health education and to promote healthy life styles so that the situation of seeking treatment is curtailed. Unfortunately, Punjab has become a hotbed of drug addiction, Punjabis have lost touch with hard work with resultant obesity epidemic and their diet pattern is faulty.
Punjab takes a leap in the welfare of hospitalized employees & pensioners
As per the budget of 2015-16, the employees have been issued Mobile e-cards and any employee can download on his/her mobile the special App “PGEPHIS” and can look into the details of the scheme, empanelled hospitals, pharmacies, claim status, and authorization status etc. Every employee/pensioner has been informed through SMS regarding confirmation of his/her enrollment and the link for this App. Fortis Mohali which is empanelled and has agreed to provide cashless treatment to Punjab Government employees and pensioners. Fortis Amritsar, Ludhiana, are also providing treatment to beneficiaries under this scheme. Other hospitals like; MAX Bathinda, IVY Mohali, Gracian Mohali, Mayo Mohali, Grewal Eye Chandigarh etc. are part of this scheme. There are total 350 private hospitals all over the State, details of which are available on website www.pbhealth.gov.in, which are providing services under this scheme. AIIMS Delhi, PGIMER, GMCH Sector 32, and other Government hospitals don’t have manpower support to carry cashless transactions, so bills of such hospitals will be reimbursed to the employees and pensioners by the Insurance Company. Also, it has been informed that chain of pharmacies is being empanelled to dispense cashless medicines to the chronic disease patients.
Punjab’s health outlay is deficient
During all the Five Year Plans after mid 80’s, outlays on medical and public health have remained between 1.9 per cent and 4.5 per cent of the total outlay and nutrition 0.04 per cent to 0.5 per cent. In the latest budget presented in 2016 no significant allocations have been made for health sector. ‘Kanya Health Care’ kits announced under ‘Swasth Kanya Yojna’ has come as a silver lining in education budget under which girls will be getting sanitary napkins every month. A sum of Rs 70 crore has been proposed for this scheme. “In backward areas, girls still use cloth or miss school due to lack of menstrual hygiene awareness. If they will get sanitary napkins free of cost, it will be a great boon.
Other steps worth mentioning are:
Rs.172 crore fund created for cancer treatment infrastructure.
To set up five state-of the art 50 bedded drug de-addiction centres
.Rs. 50 crore- for rural rehabilitation and drug de-addiction centers in the state
Rs. 50 crore – Medical Insurance for the poor people.
The King’s College London will invest Rs 1,000 crore in a medical college &hospital in New Chandigarh.
Fortis Group would set up a medical university in Punjab.
Punjab Healthcare Commission (PHC) a regulatory body was established to improve the quality, safety and efficiency of healthcare service delivery .