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Tuesday, 3 September, 2002, 14:34 GMT 15:34 UK
India's deteriorating health care system
All India Institute of Medical Sciences, Delhi
'Non-existent' health care in rural areas puts pressure on city hospitals

The deaths of 15 children in a government - run hospital in the east Indian state of West Bengal has brought into focus a debate on health care facilities in the country's public sector hospitals.

The local government denies accusations by parents of the babies that hospital staff have been negligent.

Health campaigners, however, point to the larger issue of lack of health facilities available to the average Indian.

Basic health care is almost non-existent in rural areas. That puts a lot of pressure on city hospitals.

Dr Amit Sen Gupta, spokesman, Public Health Campaign

They say the state of health care in India has never been satisfactory but it has deteriorated alarmingly in the last decade.

Dr Amit Sen Gupta of India's Public Health Campaign (Jan Swasthya Abhiyan) says the problem being highlighted by the recent deaths is just the tip of the iceberg.

"The incident has taken place in a metropolitan city therefore there is so much of media attention. The main point is... that basic health care is almost non-existent in rural areas.

"That puts a lot of pressure on city hospitals, which cannot cope with the large number of patients as they are not equipped to deal with them" he told the BBC.


Overcrowding is a common feature in government hospitals.

In most such places - particularly in the children and maternity wards - on an average two to three patients are made to share beds.

Most hospitals have double or treble the number of patients than they have the capacity for.

Senior health officials say that, under the law, they cannot turn the patients away, and that the patients also have nowhere else to go.

Grieving relative
The majority turn to government-run hospitals
"Most of those who come to government hospitals cannot afford the money charged by the private hospitals," a senior health officials at Delhi's Lal Bhadur Shastri hospital told the BBC earlier this year.

"So the choice for them is between inconvenience and discomfort or no treatment at all."

Health activists say public health services are creaking because of the constant squeeze on budgets by the central government.

"The government spends barely .09% of the Gross Domestic Product (GDP) on health care. It is an incredibly small amount for such a large country as ours," Dr Sen Gupta says.

"The government's spending on health care amounts to 16% while the rest of the 84% comes from the private sector.

"Most people go to government hospitals rather than the private ones", he added.


Health experts say there is no political will to improve things.

They say the emphasis in the past decade has been on economic development rather than human development.

Nearly all political leaders in India emphasise the need to make health a priority.

India's constitution envisages the nation as a welfare state.

The Indian Supreme Court in its various rulings has observed that as a welfare state, the government is obliged to run hospitals and health care centres to provide efficient medical services.

But critics say the promise remains a distant dream.

Health campaigners say they have reworked their strategy by placing greater emphasis on raising awareness about health as a fundamental right for the citizens.

See also:

05 Nov 01 | South Asia
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