What is often overlooked with health-care sector reforms, as is the case with the new National Medical Commission Bill, is the lack of basic medical infrastructure in rural areas. It is a fact that 70% of India’s population lives in the medically underserved hinterlands. Such a state of apathy from the government results in even doctors who are keen on social services becoming apprehensive about practising in these areas. The NMC Bill should propose infrastructural development along with structural reforms to achieve our national health-care goals (“Prescription for the future”, January 11).
Abanish Lal,
Ernakulam, Kerala
The most contentious provision of the Bill is of ‘cross-pathy’. The government, has unintentionally, in its attempt to meet the human resource shortage of medical practitioners at the rural level, ended up rubbing allopathic practitioners the wrong way. Allopathic practitioners, on the other hand, also need to understand that this provision allows AYUSH practitioners to carry out basic treatments and in no way enables them to go to the extent of conducting something as extreme as a surgery. The drafters of the Bill should have made things more clear by properly defining the boundaries for AYUSH practitioners. However, ‘cross-pathy’ should not be seen as a permanent solution to the human resource shortage crisis.
Shivam Koushal,
Jammu
There is no second opinion about the need to focus on planning for improvements in rural health care. However, resorting to half measures such as training those who strictly do not qualify as trained doctors in order to address the problem of a shortage of doctors in rural areas would be dangerous. Without the systematic accumulation of basic knowledge and rigorous training that medical students are imparted, these ‘doctors’ would be ill-equipped to serve the rural population. Instead of contemplating half-baked solutions such as designing bridge courses for practitioners of traditional systems to prescribe modern medicine, efforts should be made to persuade MBBS doctors to serve rural areas by taking suitable measures. When a State such as Tamil Nadu has ‘successfully attracted doctors to serve in rural primary health centres’, why cannot a similar scheme be adopted in the rest of the country? A major hurdle in attracting doctors to rural areas is the lack of medical infrastructure in primary health centres. Implementing measures such as offering partial fee reimbursement and additional marks for those willing to serve the rural areas for a certain period after completion of the MBBS course, at the stage of admission to the course itself, may prove to be successful in attracting more doctors to work in rural areas.
Kosaraju Chandramouli,
Hyderabad
