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Health regulations UPSC NOTE

 Why in news

  • Political parties began a blame game and the media coverage was intense, going overboard and reporting incorrectly that a number of nursing homes in Delhi function without a licence, after the incident of a devastating fire in a private neonatal care nursing home in New Delhi

  • Such tragedies are often followed by a question of who should be blamed, completely missing the point that these are almost always the outcome of a systemic failure — in this case, the failure of health-care regulations.

Challenges in regulation

  • The subject of regulation has always been of one of the weakest points in India’s health-care system

  • Unrealistic health-care quality standards is one of the challenges

  • Governments at every level in India — national and States — are known to draft policies which are near perfect. 

  • One such case is the Clinical Establishments (Registration and Regulation) Act, 2010, enacted 14 years ago, but not adopted by States. 

  • This is because State governments, in discussions with stakeholders, have realised that many provisions in the Act are impossible to implement.

  • Another example is the Indian Public Health Standards, or IPHS, drafted by the government for its own health-care facilities and proposed as essential in order to deliver quality health services. 

  • The IPHS were first released in 2007 and have been revised twice since then. 

  • Yet, in 17 years of existence, only 15% to 18% of government primary health-care facilities in India meet the government’s own standards

  • India has a mixed health-care system, where private health-care facilities and providers deliver nearly 70% of outpatient and 50% of hospital-based services

  • In most States such as Maharashtra or Kerala, the health indicators are better not because these States have outstanding government facilities but because the facilities and clinics in the private sector are fulfilling the health needs of the people

  • When it comes to health-care regulation, there seems to be an unfairness and overzealous attempt to enforce the regulations in the private sector

  • In health-care regulation, in the current scheme of things, the burden of responsibility is more on providers and facility owners

  • Most private nursing homes and clinics have often flagged the issue of approvals being delayed by the authorities for months even when these facilities apply for renewal well in advance.

Way forward

  • There needs to be supportive and facilitatory regulations to serve the public purpose of keeping health-care costs low and affordable.

  • Ensuring quality of health services is essential and the joint responsibility of all stakeholders.

  • There is a need to formulate guidelines that can be practised and implemented

  • There is a need to harmonise multiple health regulations and simplifying the application process

  • Such applications need to be disposed of in a time-bound manner

  • There is a need for a differential approach for different types of facilities

  • Yet, there should be essential and desirable points in each category overseen by regular self-assessment and regulatory visits

  • For effective adherence and implementation, the government should consider subsidies and funding to increase adherence to regulations

  • Representatives of doctors’ associations and the types of facilities for which regulations are being formed as well as community members should be involved in the process of the formulation of such regulation.

  • Most importantly, India needs to promote single doctor clinics apart from smaller health-care facilities, and nursing homes

  • These are what deliver primary care and contribute to keeping the cost of health care low

  • Every such facility and its doctors need to be supported rather than burdened with excess regulations.

  • India’s health-care system needs to promote providers and facilities that deliver out-patient care at lower costs

  • This requires health regulations being drafted from bottom up and not top down, and implemented in a nuanced and calibrated manner.



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Learnerz IAS | Concept oriented UPSC Classes in Malayalam: Health regulations UPSC NOTE
Health regulations UPSC NOTE
Learnerz IAS | Concept oriented UPSC Classes in Malayalam
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