This refers to Bhupesh Bhandari’s column (“Health care in bad health”, September 24). India’s health care problem isn’t about new hospital chains coming in or the “need for more private equity” nor is it about a “model that works”. It is clearly about the lopsided development and lack of investment in health care infrastructure.
He should be aware that health care infrastructure is divided into three tiers with primary health care at the bottom of the pyramid and the tertiary referral hospitals at the top. The issue is delivery of health care at the primary level. There is very little incentive for a doctor to work in the rural health care for a lack of basic facilities and infrastructure.
At the same time, the tertiary care hospitals in the public sector have seen a huge influx of patients who otherwise would have been managed easily in primary health care centres. This has not happened over the years and any greenfield project is going to take years before it starts serving its catchment areas. Further, sending out an “army of doctors” won’t ameliorate the malady; the structure will become top-heavy again unless the issue is addressed at the primary health care level.
Perhaps the author will never know that his best bet for colds and chills is the primary health care centre rather than a fancy five-star ISO-accredited hospital. But the tone of the article suggests that he is unaware of the millions who throng the public hospitals.
I also fail to understand why a doctor shouldn’t earn a “salary equivalent to a CEO”. Most doctors study for 30 years of their productive life, have social responsibilities and need stability. What is wrong if they earn good money by honest means?
Abhishek Puri, on email
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