The parliament in its meeting on 15 March 2017, approved the National Health Policy, 2017.
The main purpose of the National Health Policy 2017 is to achieve the highest possible level of well-being and good health in India. The ways which are formulated by this policy to achieve its desirable objectives are promotive and preventive health care orientation in all developmental policies. The Policy also aspires to achieve universal access to good quality health care services without anyone having to face financial hardship as a consequence.
The formulation of The National Health Policy, 2017 was adopted after stakeholder consultations. On the basis of that, the Government of India formulated the Draft National Health Policy and put it in public domain on 30th December 2014. Thereafter the Draft National Health Policy was further fine-tuned by detailed consultations with the stakeholders and State Governments.
The draft received the approval of the Central Council for Health & Family Welfare, the apex policy- making body, in its Twelfth Conference held on 27th February 2016.
In India, the last health policy was formulated in 2002. Since then there have been many socio- economic and epidemiological changes which necessitated the formulation of a New National Health Policy to address the current and emerging challenges.
Key Factors of the National Health Policy 2017
1.The first aim of the National Health Policy, 2017, is to clarify, inform, strengthen, and prioritize the role of the Government in forming health systems in all its dimensions- organization, investment in health, and financing of healthcare services, promotion of good health and prevention of diseases through access to technologies, cross- sectoral action, developing human resources, building the knowledge base required for better health, encouraging medical pluralism, financial protection strategies, and regulation and for health.
2. The new National Health Policy focuses on strengthening and reorienting the Public Health Institutions across the country, so as to provide universal access to diagnostics, free drugs, and other essential healthcare.
3. The Policy aims to reach everyone in the country in a comprehensive integrated way to move towards wellness. It aims at delivering quality health care services and achieving universal health coverage for all at an affordable cost.
4. The NHP, 2017 looks at problems and solutions comprehensively with the private sector as strategic partners. It aims to promote quality of care and focuses on emerging diseases and investment in promotive and preventive healthcare. It addresses health security and make in India for drugs and devices.
5. The NHP, 2017 advocates a positive and proactive engagement with the private sector for critical gap filling towards achieving national goals. It envisages private sector collaboration for capacity building, strategic purchasing, awareness generation, skill development programs, disaster management, and developing sustainable networks for a community to strengthen mental health services. The policy also offers financial and non-incentives for encouraging the private sector participation.
6. In order to provide financial protection and access at secondary and tertiary care levels, the policy proposes free diagnostics, free drugs, and free emergency care services in all public hospitals.
7. The NHP, 2017 advocates increasing public health expenditure to 2.5% of the GDP in a time bound manner. The Policy envisages providing the larger package of assured comprehensive primary health care through the Health and Wellness Centers’.
This policy recommends the important change from very selective to comprehensive primary health care package which includes palliative care, geriatric health care, and rehabilitative care services. The policy advocates allocating two-thirds or more of resources to primary care followed by secondary and tertiary care. The policy envisages to provide at the district level most of the secondary care which is currently provided at a medical college hospital.
8.The NHP, 2017 allocates specific quantitative targets aimed at reduction of disease incidence /prevalence. It seeks to strengthen the health and surveillance system and establish registries for diseases of public health importance, by 2020.
9. The policy affirms the commitment to pre-emptive care to achieve highest levels of child and adolescent health. The policy foresees school health programs as a major focus area as also health and hygiene being made a part of the school curriculum.
10. In order to leverage the pluralistic health care legacy, the policy recommends mainstreaming the different health systems. The policy seeks to mainstream the potential of AYUSH and envisages better access to AYUSH remedies through co-location in public facilities. The policy also seeks to the introduction of Yoga in school and work places as part of the promotion of good health.
11. The policy recommends extensive deployment of digital tools for improving the efficiency and outcome of the healthcare system and proposes the establishment of National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care.
Shortcomings in the National Health Policy 2017
The National Health Policy passed by the Union Cabinet in this month has fallen short of the promise of its 2015 draft. These shortcomings are described below:
1. No Right to Health
The NHP 2017 which talks about an “assurance-based approach” abandons a radical change proposed in the draft policy of 2015. The draft policy advocated National Health Rights Act aimed at making health a right.
Health Ministry officials said the idea of national health right was dropped because state governments felt that health infrastructure was not yet that capable at which health could be made an entitlement. If this idea is made an act then the citizen could theoretically take a government to court for its denial. Drugs, Diagnostics, and essential health care services are already free in many states.
2. Old Targets Restated
The NHP, 2017 states that 2.5% GDP spend target for Health would be met by 2025. But the HLEG report of 2011, quoted in the 12th Plan document, had set the same target for the Plan that ends at the end of this month.
The Government should increase public expenditure on health from the current level of 1.2 percent of GDP to at least 2.5 percent by the end of the Twelfth Plan, and to at least 3 percent of GDP by 2022.
A health cess was a path-breaking idea in the Health Ministry’s draft policy 2015; it has now been given a quiet burial, with the health minister maintaining that there is no dearth of funds.
3. Silent on Health Governance
As per the NHP 2017, the National Healthcare Standards Organization (NHSO) will decide the standards of private and public health institutions, and an empowered tribunal will deal with grievances. The policy keeps clear of one of the most debated questions of health governance in India i.e. whether Health should continue to be in the State List, or be brought, like Education, in the Concurrent List for better regulation.
The regulation of Health when it is in state list lies with states; the Centre can only make model laws to which states can voluntarily subscribe.
The Clinical Establishments Act, 2010 has not been started by most of the states in the country as only four among the big states have adopted it until now. The rest have either ignored it or failed to frame Rules that are stringent enough for its effective implementation.
It is impossible for a national health authority like the NHSO to work effectively without Health being on the Concurrent List. Even if the NHSO or any other body sets standards, it will be the state government’s responsibility to decide whether those are met by the private sector, with the Centre having little say.
Despite some loopholes, the National Health Policy 2017, would set a platform for health programs in India. If the points suggested by the policy are implemented sincerely by the government, then its likely that it will be beneficial for the people of India.
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