TNB Q on health and responses from NPF, Congress and this blogger

'The Naga Blog submitted a list of 10 Core questions to all major political parties in Nagaland to get a better understanding of each respective party’s political roadmap and vision of ensuring a better future for the Nagas. Through this campaign The Naga Blog would like to appeal to all right thinking citizens not to ask for money, but to ask for development.'

Question No.6 was on health care.

 6. Healthcare: Healthcare has become very expensive even in government hospitals. Besides, few PHC and CHCs, Mon civil hospital and NHA Kohima, basic medicines and sundries are not available in healthcare facilities and healthcare providers are not in their place of postings. Our state has shortage of medical professionals. What is your party’s vision on making healthcare more accessible and affordable to the common man? 

The Naga People's Front response was:

NPF: The NPF led DAN Government have done a lot to improve healthcare delivery in the State. It has successfully implemented National Rural Health Mission (NRHM) throughout the State. In addition to communitising all the PHCs, the Government have upgraded and renovated most of the District Hospitals, providing them with latest equipments. The functioning of Naga Hospital, Kohima had improved significantly to a national standard after it was given autonomy. Mon District Hospital has become one of the best district hospitals after a joint management on PPP mode was implemented with a world class NGO, “Medicin Sans Frontier” as a partner. We are planning to duplicate these success stories in other district hospitals. To see that doctors are fully engaging themselves to their assigned duties, the Government has banned private practice by Government doctors.

To take care of shortage of healthcare personnel in the State, the Government has recently inaugurated a new Nursing School attached to CISHR, Dimapur. We are also in the process of setting up a new Medical College in the premises of the CISHR. The CISHR has become one of the best hospitals in the North East region after its management was handed over to CMC Vellore.

Health insurance for BPL families (RSBY), have been successfully implemented, whereby 90,000 BPL families have already been covered. In fact, the State Government have been receiving special awards for this effort from the GOI during the last four consecutive years from 2008-09 to 2011-12. Our further aim is to cover all NREGA card holders in the State with health insurance by the year 2014-15.

Our long term vision of “health for all” is an aim which we are constantly striving towards and several steps have been initiated in the past years and a comprehensive plan to pursue the realization of quality health care at all levels ia already under active implementation.

My comment:

 As far as responses to health care is concerned, there is not a single point to take from both NPF and Congress. As Longri has rightly said, NPF cannot take the credit for implementing the NRHM. In fact it has hampered its implementation in several ways. NRHM has become an excuse for the State to neglect health care. Health is a State subject but NRHM (a mission to help the State) has taken over the department. The State’s allocation to health care is so low that it struggles to even give its 15% State share to NRHM. This is an agreement between the NRHM and State government that for every Rs.100 approved by NRHM, the State has to give Rs. 15. The State struggled to even give that. Backlog after backlogs. It was brought down to 10%. But there is still so much delays. In a financial year, the first instalment from Delhi comes during the second quarter, the State delays its share, then the second instalment is so delayed that staff salaries are not paid on time, and works are not carried out, and then the financial year ends. Audit is done with huge unspent balance, carried over to the next financial year, and so on go the vicious cycle. Mon DH is run well by MSF but it is also receiving from the State government more fund than other DHs. How many surgical procedures are done in the 8 DHs of Wokha, Zunheboto, Longleng, Kiphire, Phek, Peren, Tuensang, and Mon? So, what is this so-called upgradation? New building is important but before adequate manpower, equipments and supplies are brought in, the structure may wear off. Then maybe, we have to build a new building again. Setting up of Medical College at the present CIHSR has become riddled with problems. It is not just a problem of funding. Though I won’t go into details, it won’t see the light of day several years. RSBY in the State is funny. We have been repeatedly getting awards, no doubt. Awards for coverage, not service. Coverage without service means premium money flowing from government’s pocket into private insurances’ purse without the beneficiaries getting benefit. ‘Health for all’ is a slogan of the last millennium. It was a hope and an aspiration for the year 2000 and still is a dream we aim for. The NPF says it is ‘already under active implementation’. 

Here's the response from Congress:

CONGRESS: The Health Care scene in Nagaland reveals a gamut of frustrating realities. On one hand, the government hospitals and health centres have no patients since they are ill equipped and very often unmanned. The patients therefore go to private hospitals whose charges are exorbitant yet not adequately equipped. These private hospitals are never a one-stop health care facility. In such a situation, running health care facilities on PPP (Public Private Partnership) mode will be a good option to adopt. It has been observed that PPP mode in all service industry has delivered desirable outcomes. There is a subsidisation of cost since infrastructure, land and building will be provided by the government. Even portion of manpower can be provided by the government, while management will rest with the private partner. In this way, efficiency will improve and significant reduction in cost will be ensured. As soon as we assume office, our party would initiate promotion of Health Tourism since Nagaland is an ideal place for such an activity because of the picturesque landscape and pleasant climate round the year. Non-conventional health care practice such as naturopathy, ayurveda, yoga, chiropractor etc. would also be promoted so that the visitors will have option to choose from. Delivery mechanisms under NRHM would be seriously reviewed andrevamped for operational enrichment as well as enlargement.

 My comment:

 Congress: Their logic is: The govt hospitals have no patients since they are ill equipped, the private hospitals’ charges are high but are also ill equipped; so let us go for PPP. Height of stupidity. To talk about medical tourism in Nagaland at this stage is laughable. How many crores of rupees is the Nagaland government spending on its employees going for treatment outside? Let us first have health centres and hospitals which can treat diarrhea, malaria, typhoid, and do basic routine surgeries for our own folks.