Kerala’s new health policy advocates a steady increase in public expenditure on health, while at the same time, launching effective measures to bring down disease prevalence, morbidity and mortality in the State.
The ultimate aim of the State should be to institute a “publicly funded, free, universal and comprehensive health care system” which will bring down child and maternal mortality and increase the healthy life expectancy of the population, the document says.
The new Health Policy for Kerala 2017 (draft) has been brought out by a 17-member committee of doctors and public health experts, with B. Ekbal, member of the State Planning Board, as chairperson, and K. P. Aravindan, well-known public health activist, as convener.
The document notes that the acclaimed Kerala model of health has been stagnating and that with the public expenditure on health a mere 1.2% of the Gross State Domestic Product (GSDP), Kerala has the highest out-of-pocket expenditure on health in the country today.
The committee notes that of the current overall health expenditure of about ₹25,834 crore, only 19.65% comes from the government while 76 % is from households. Its recommendation is that the government increase public spending on health by 15% every year for the next five years so that the out-of-pocket spending can be brought down to less than 20%. The new health policy advocates an increased focus on primary and preventive care through primary health centres.
Medical ombudsman
A major recommendation in the policy is that the government set up a medical ombudsman, who will investigate and address all complaints of the public regarding the violation of people’s health rights in the public and private sector.
The private health sector should be made more accountable by bringing in the Clinical Establishments Act. The tariff for various procedures and ICU care should be made public. Small and medium hospitals should be given tax rebates and inclusion in public health schemes. The policy recommends that full functional autonomy be given to government medical colleges to improve the functional efficiency of these institutions.
The Ekbal committee points out that constant transfers were discouraging doctors from taking up a career in medical education and that it impeded long-term projects and research projects.
The committee recommends that a multidisciplinary working group be constituted to assess the HR and infrastructural needs of the health system for the next 25 years.
