As part of the recently held  ‘Difficult Dialogues’ conference in Goa, a discussion on “What plagues Indian Doctors” was held. One of the participants was Dr. Terence Stephenson, a Nuffield Professor of Child Health, Institute of Child Health, University College of London.

In an article that he wrote for The Hindu, Stephenson mentions the viability of drawing up for India something like the National Health Service(NHS)- the name given to England’s public health services. At a time when a way out of the poor quality of work culture that doctors experience in India is the need of the hour, it’s worth looking at some of the key points that Stephenson puts across in the article.

Common factors

There are certain factors common to both the countries, says the doctor. For instance, health spend has come down in the UK from its height before the world-wide recession of 2008. The health spend came down to about 9 percent of GDP in 2012 and hasn’t recovered since. India too sees a poor(er) spend on health.

Compared to many western peers, the UK has fewer doctors per thousand people, also fewer hospital beds for the same population. Such problems are faced by the subcontinent also- only to a greater extent. A rising demand is also faced by the UK as the population demographic turns older, thereby having more people surviving with long-term diseases.

Differences

The differences that the doctor points out between the two countries are also many, and big. For instance, the infant mortality rate in India is 40 deaths for every 1,000 live births. The rate for UK is ten times lesser. Also, vaccination against preventable childhood diseases is done much lesser in India than in the UK. As for causes of death among both adults and children in India, there are tuberculosis, malaria, dengue and HIV- diseases which are hardly seen these days in the UK.

Common solutions

The differences notwithstanding, the doctor says, the solutions that both the countries could adopt have a lot in common. Investment in both prevention and cure is a strategy which both countries should adopt. Recognizing the benefits of primary care for the community and hi-tech hospitals is also important. So is disinvesting in treatments that don’t work. Rather than having the private sector substitute the government sector, it should supplement the latter.

The biggest threat to India as per the doctor is that the fee-for-service system will drive up the expense unnecessarily. Such unwanted expenditure could hardly merit India given how plenty of poor Indians may get deterred from seeking care when it’s too expensive.

UK’s NHS- principles for India to adopt?

The NHS in the UK follows a different system. The Commonwealth Fund(based in America, notwithstanding the name) makes global comparisons of healthcare systems and scores regularly the UK’s NHS highly on both access and value.

At the point of delivery of care, the UK NHS is free- being funded from direct taxation. This means that the entire population contributes to the cause, recognizing that though they pay taxes from early on, they may not need the health service when they are young and fit. But when they need it in their old age, an affordable health service will be in place.

Such principles might be relevant to India as well, says the doctor.

Image credits: independent.co.uk

   Send article as PDF