The general impression of public is that the Government sector and public sector are not that ef?cient. But today when the country is facing the Covid-19 pandemic, the worst of the crisis in human history it is only the Government sector that has risen to the occasion and its organs are working round the clock. It was the Air India and its crew who ?ew, risking their own health to the hotbeds of the coronavirus, Wuhan (China) and Italy to bring back the stranded Indian students. During the lockdown period wheels of Indian Railway have not come to a grinding halt even for a minute as the national carrier is engaged in carrying coal from coal ?elds to power stations so that our electricity supply goes on uninterrupted, food grains reach to people in different parts of the country, milk products and baby food are available to millions of infants and children.
Besides, if Railways has made available hundreds of coaches, PSUs like ONGC, BHEL have spared their guesthouses for use as isolation centres for Covid. Government school buildings have come handy for keeping people in quarantine. Municipality vans regularly come to pick up garbage and so also are safaiwalas (sweepers) of the urban bodies dutifully turning up every morning so that our hygiene and sanitation are maintained. Similarly, the police are out in the sun and rain for last forty days so that we are safe. But it is in the health sector where Government hospitals have distinctly proven their value in this testing time.
From the infrastructure point of view, Government hospitals are no match to private hospitals in India. Two-thirds of hospital beds and 80% of ventilators in the country are with private hospitals, so are the number of ICU beds. The general public perception is that private hospitals are better-equipped; so, there is a demand for these hospitals especially from those who can afford. It is better demonstrated from the fact that about 70% of nearly 10 million treatments received under Ayushmann Bharat Yojana have gone to private hospitals and nursing homes and so also the fund out of the scheme. But today, most of the Covid tests and treatment are done in public facilities. Private hospitals are handling less than 10% of the critical Covid patients.
At the early stage of the pandemic, some renowned hospitals didn’t lose time to pull down their shutters after their staffs tested positive. Many hospitals, playing safe, have refused patients to be admitted. My friend from Mumbai did share a heartbreaking incident of apathy and insensitive attitude of private hospitals. A 75-year-old man in their apartment fell down in the bathroom and got his ribs badly fractured. When he was taken in a serious condition, hospital after hospital refused to admit him and with Government hospitals fully pre occupied with Covid cases, the patient had no option but to return to home. And next day the poor chap expired. Similarly, the Orissa High Court has ordered a probe into the death of a person during the lockdown after he was allegedly denied dialysis at a private hospital in Cuttack because he didn’t have a Covid test certi?cate. In another heart-rendering case, a 61-year-old retired BSNL employee fell critically ill in the dead of night in Bhubaneswar but was refused admission or even check up at two private hospitals; and by the time he was taken to the third one, he had already expired.
For fear of contamination, most hospitals are turning critical patients away unless they have a Covid-free certi?cate. Nationwide, private hospitals employ four out of every ?ve doctors, especially in urban centres. But the disturbing reports coming from several cities and towns are that many of them are locking themselves down even when it comes to providing non-Covid healthcare. From Patna to Mumbai, private hospitals cite excuses for the non-availability of their services like lockdown restrictions, lack of internal protocol to handle the pandemic, fear of infection to their doctors and nurses. The Bihar Principal Secretary, Health has gone on record stating that forget Covid even regular services have become unavailable from private hospitals. Following a spate of incidents of patients being refused treatment, mostly in private hospitals few State Governments and now the Union Ministry of Health has issued orders warning action against hospitals that turn away patients, Covid or non-Covid.
The pandemic has made the world, especially the champions of private healthcare system like the United States of America or Italy to learn a lesson. Despite having the best of the healthcare system the pandemic has taken a heavy toll of over 64,000 in the United States of America, the highest for any country. Current mortality rate in the US shows that Blacks account for 70% of Covid deaths though they form only 26% of the population. Blacks are the poorest ethnic group in America and a large percentage of them cannot afford expensive hospital care. They are the ones who try self-medicating for as long as they can, fearing medical bills. When they cannot manage any longer and go to hospitals, it is often too late. This has thoroughly exposed the weaknesses of a private healthcare system. Similarly, Italy’s Lombardy had the best of private health system in Europe. But today, the same region is the most devastated by Covid as their death rate is disproportionately high. In Britain, the Government run National Health Service (NHS) was always very popular. However, 2015 onwards the Conservative Government started cutting in its funding and nearly crippled its functioning. But it is the same NHS that nursed Prime Minister Boris Johnson to health after Covid struck him, which is why he is now a changed man. Johnson today is willing to do anything to improve the State run health service. In the changed circumstances, those in Britain who once demolished public health delivery are ready to switch sides.
At various benchmark numbers, India with not so better health infrastructure seems to have done relatively better than most advanced countries. India has a very impressive recovery rate of over 25% of its over 35,000 of Covid cases. Similarly, 1,000 deaths in India have taken place out of 31,332 Covid cases whereas same number of deaths has occurred out of 15,113 cases in Italy, 17,089 cases in Britain, 15,348 cases in Belgium and 22,304 cases in France. For this, much of the credit goes to our frontline warriors, doctors, nurses and paramedics.
The biggest fallout of the pandemic is that both the Government and people have realised the importance of health and healthcare. To save millions of live, Prime Minister Modi took the historic decision of nearly two months’ lockdown for an a 138-crore population even at a big cost to national economy. And people across the country have responded to it in all earnestness as human health is a prerequisite for the economic health of a country.
(The writer is a former Senior officer of Indian Railway)