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Need for nationalisation? COVID-19 puts private healthcare services in doldrums

By Sandeep Pandey*
Ram Shankar met with a fatal hit-and-run accident in rural area of Hardoi district of Uttar Pradesh on April 16, 2020 and was referred by the District Hospital to Trauma Centre of King George’s Medical University (KGMU) in Lucknow. He could not be admitted there and was referred to nearby Balrampur Hospital. From there he was referred to Dr. Ram Manohar Lohia hospital.
He was denied admission at these government facilities as only coronavirus affected patients were being admitted and beds had to be kept free for them. Leaving no choice for them the attendants had to take him to one private hospital after another because either it was too expensive or treatment was unsatisfactory.
After going through Almighty, Kamakhya, Charak, Maa and Madocks he finally landed at Galaxy Hospital in Thakurganj where Ram Shankar expired on the morning of April 21 but not before his relatives were made to cough up close to Rs 2 lakhs in all. The cost of using ventilator at Madocks was Rs 11,000 for a day but in the bill double the amount was charged. Ram Shankar belonged to an Other Backward Class with merely half an acre of land in his village.
Asghar, 35, who used to run a small shop from a kiosk in Dubagga, Lucknow, who was riding a motorcycle till a couple of days back, died on April 22, of some undiagnosed illness. The doctors of hospitals where he went were either unwilling or unable to treat him. It is a peculiar situation where some doctors or medical staff are unwilling to deal with patients for the fear of contracting coronavirus.
On April 23 Kiran went to get herself examined at Community Health Centre in Rampur Mathura of District Sitapur. She was asked to get some tests done at a private pathological laboratory at nearby Mehmoodabad. She was diagonsed of tuberculosis, given a strip of medicines and asked to buy more from the market.
Another patient came from Kanpur with a cardiac problem and sought admission to Lari Cardiology of KGMU. But he could not get admitted as every new patient needs to undergo a COVID-19 test to safeguard the essential cardiac care services. It is important to note that Lari Cardiology triages patients in wake of the pandemic so that entire cardiology facility does not face a risk of a shutdown or quarantine, bringing lifesaving services for the region to a halt.
Upon arrival, every patient is kept in a designated area with infrastructure and trained healthcare workers for such triaging while COVID-19 tests are done from within the KGMU. Only test reports done from KGMU are accepted here. Tests may take up to two days but turnaround time for report to come is reducing in every government facility. 
Upon negative test report, patient moves further in the regular cardiology care but only if it is a serious case. However, if test report is positive, then patient is triaged to regular care for COVID-19 positive people as per the government guidelines. 
Long-standing call from people who care about public health have fallen on deaf ears to stop privatization of public healthcare
It is no doubt paramount to ensure that infection control practices in every healthcare facility are strengthened to prevent transmission of hospital-borne infections. Before COVID-19, too, government hospitals were overburdened with burgeoning demands of healthcare needs. More worrying has been the fact that a significant number of diseases our populations and healthcare system deals with, is entirely preventable. 
Long-standing call from people who care about public health have fallen on deaf ears to stop privatization of public healthcare, to prioritise preventive healthcare and hold those corporations legally and financially liable who are knowingly selling products that cause diseases (or kill).
COVID-19 has put entire health system in spotlight where it is essentially the government run healthcare services that are struggling to withstand against the onslaught of potentially catastrophic pandemic. 
COVID-19 has put us in a situation where suddenly profit-making private healthcare industry is in doldrums. Entire hospitals have had to be shut down for quarantine for example. It is only the government healthcare services that are still running despite of looming threat of COVID-19.
We need to realize that in this moment of growing crises, we cannot afford that our government healthcare facilities should risk being shut down for quarantine, or healthcare workers face any undue risk of COVID-19.
But equally important is to ensure that while we try our best to prevent COVID-19 pandemic, we are not brewing more pandemics which could have been averted with timely and essential lifesaving care. On April 15, 2020, the Chief Minister of UP had asked authorities to “restart” emergency services in government hospitals, which were earlier suspended on March 25, 2020 to prevent the spread of coronavirus in hospitals.
People living with HIV or hepatitis C virus or active TB disease need uninterrupted treatment services. But due to lockdown, either health facilities were affected, or people were not able to go to the clinic to get their lifesaving medicines. There was some respite for HIV as National AIDS Control Organization of the Ministry of Health and Family Welfare had relaxed guidelines hours before the imposition of lockdown.
These guidelines enabled the volunteers among people living with HIV who stepped forward to home deliver antiretroviral drugs from government-run HIV clinics to over 45,000 people by early April 2020. But India has over 14 lakh people who are on lifesaving antiretroviral therapy.
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*Magsaysay Award winning social and political activist

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