Context

Initiative taken by Government of India to draft the new National Public Health Bill.

Background

• Need has been felt for quite some time now to replace the colonial Epidemic Disease Act, 1897 to deal with public health emergencies.
  • The Epidemic Act 1897 was drafted by the British administration to prevent the outbreak of bubonic plague.
  • The bubonic plague recorded the first case in Bombay and the disease quickly spread swiftly to other parts of the city, and the death toll was estimated at 1900 people per week through the rest of the year.
• Requirement of such a law was amplified during the time of Corona pandemic.
• The National Public Health Bill is expected to be introduced in the Monsoon Session of the Parliament this year.

Right to Health Articles 39, 41, 42 and 47 in the Directive Principles of State Policy (DPSP) contain provisions regarding Health. Article 21 provides for the right to life and personal liberty and is a fundamental right.

 

Analysis

What are the objectives of National Public Health Bill?

• It is important to note that existing Epidemic Disease Act lacks provisions for management of a pandemic like Covid.
• This short coming will be addressed by the new National Public Health law.
• This draft Bill has defined various measures (such as isolation, quarantine and lockdown) that could be taken by the government during a public health emergency.
• The draft of National Public Health Bill shows that the new law will deal with updated, scientific and comprehensive provisions on surveillance, disease notification and public health emergencies.
• The Bill lays down several situation in which ‘Public Health Emergency’ can be declared.
• The above definition of Public Health Emergency will include:
• Bioterrorism
• Appearance of a novel or previously controlled or eradicated infectious agent or biological toxin
• A natural disaster
• A chemical attack or accidental release of chemicals
• A nuclear attack or accident

Which new organisations would be created by the National Public Health law?

• The draft Bill proposes the setting up of four-tier health administration architecture with public health authorities at national, state, district and block-level.
• The abovementioned authorities will have “well defined” powers and functions to deal with “public health emergencies”.
• National public health authority will be headed by the Union Health Minister.
• Health Ministers of states will lead the state public health authorities in their respective states.
• At District level, the Collector will oversee the functioning of the public health authority.
• Block Medical Authority or Medical Superintendent will head the public health authority at Block level.
• All the above mentioned authorities will have powers to prevent the rise of non-communicable diseases and infectious diseases.
• The proposed law will also create Public Health Cadre.

Issues in India’s health sector

• Inadequate reach:The inadequate reach of basic healthcare services, shortage of medical personnel, quality assurance, the inadequate outlay for health, and most importantly insufficient impetus to research.
• Inadequate Fund:The inadequate fund allocation by the administrations is one of the grave concerns.
• Optimal Insurance:The concept of health insurance is still not clear in India and the market is still virgin.
• No focus on Preventive Care: In India, there is a very low emphasis on preventive care, which can be proved very effective in solving a lot of problems for the patient in terms of misery or financial losses.
• Less emphasis on Medical Research:In India, there is no much impetus is being given to R&D and cutting-edge technology-led new initiatives. Such technologies could be useful in an unprecedented situation like Covid-19.
• Issue of Policymaking:For providing effective and efficient healthcare services policymaking is certainly an important aspect. In India, the problem is fundamental of supply than demand, where policymaking can be effective.
• Shortage of Medical Workforce:In India, there is a shortage of doctors, nurses, and other staff in the health sector. As per a report laid down by a minister in Parliament, there is a shortage of 600,000 doctors in India.
• Inadequate outlay for health:As per National Health Policy 2002, India contributes only 0.9 percent of its GDP to the Health care sector.
• Lack of structure:Private hospitals are expensive and public hospitals are either not enough for the Indian Population or lack the basic facilities.

What measures are required in the sector?

• Improving infrastructure: There is a need of improvising the infrastructure of public hospitals which have a lot of burden due to the high population in India.
• Focus on private hospitals: Private hospitals must be encouraged by the government because their contribution is important. Private sector also needs to participate because the challenges are significant and these cannot be resolved only by the government alone.
• Efficiency enhancement: More medical personnel must be recruited to enhance the capabilities and efficiency of the sector.
• Technology utilisation: Technologies must be used to connect the dots in the health system. Medical devices in hospitals/ clinics, mobile care applications, wearables, and sensors are some forms of technology that should be added in this sector.
• Awareness: People should be made aware of early detection and preventive care. It would help them in saving pocket expenditure also.