The delay in the enactment of the Right to Health Act in Rajasthan, for which the ruling Congress had made a promise in its manifesto for the 2018 State Assembly election, has caused a serious concern among the health activists here. A demand has been raised for the formation of the Select Committee to incorporate changes in the Bill, which was tabled in the Assembly on September 22.
The Jan Swasthya Abhiyan (JSA), a network of civil society organisations, sought the Committee’s appointment without delay to pave the way for the enactment of the Right to Health Act, which was expected to streamline medical services and guarantee the availability of essential facilities to citizens. The Bill was referred to the Select Committee following a protest staged by private doctors, outside the Assembly.
The JSA, which functions as the Rajasthan chapter of the global non-profit People’s Health Movement, had prepared a draft Act on the subject and submitted it to the Health department’s authorities shortly after the new government was formed in December 2018. The Bill tabled in the Assembly was stated to be much weaker than the draft put up on public domain in March this year.
Chhaya Pachauli, director of the voluntary group Prayas, said here on Wednesday that though Health Minister Parsadi Lal Meena had stated that the Select Committee would submit its suggestions within a week, it was yet to be formed. The process for getting suggestions from medicos and civil society was still not initiated despite a letter reportedly written by the Health Secretary to the Divisional Joint Directors, she said.
Representatives of about 85 civil society and health rights groups as well as public health specialists discussed the issue at a State-level consultation here recently, and demanded that the State government pass the Bill in the Assembly after incorporating the amendments suggested by the JSA, in a 29-page document. They also said that the focus in the proposed legislation should be shifted away from the hospital care to the outreach services.
After sending its suggestions on the Bill to the State government, the JSA’s representatives urged the Health Minister to hold a dialogue with the private sector doctors, who were opposing the Bill, and the civil society activists to take into account the concerns of both the sides and resolve the matter. But, Ms. Pachauli said no such meeting had been called by the State government yet.
The JSA stated that the current draft of the Bill was weak in several ways and needed some important changes urgently. The new version omits the term “guarantee of health care services” completely, which exhibits the government’s reluctance to guarantee these services as a matter of people’s right.
“Extremely focused” on hospital care
The Bill is “extremely focused” on hospital care and completely ignores outreach services, comprising a major part of primary health care delivery, such as immunisation, community participation and people’s engagement in monitoring, according to the JSA. Besides, the Bill should make it clear about the distance up to which the government would be committed to providing certain types of health care services.
“There is no clarity on which diseases and conditions are included in free emergency treatment and care mandated to be provided by private hospitals under the Bill, because of which the private sector doctors are feeling extremely apprehensive,” Ms. Pachauli said. The Bill should have the provision for a fund to compensate private hospitals for the expenses met on providing emergency treatment free of cost to the patients, she added.
The implementation of the Right to Health is not likely to put much additional financial burden on the State government if the Medical & Health Department rationally distributes and uses currently-available doctors, health care providers, equipment and medicines and evolves a robust monitoring system. The JSA affirmed that Rajasthan would be the first State to give the statutory Right to Health to the citizens, if the law was enacted.
“There is no clarity on which diseases and conditions are included in free emergency treatment and care mandated to be provided by private hospitals under the Bill, because of which the private sector doctors are feeling extremely apprehensive”Chhaya PachauliDirector, Prayas