The transition of Maharashtra’s healthcare sector from a static and inconspicuous industry to an increasingly dynamic and significant industry is noteworthy. Suresh Shetty, Health Minister – Maharashtra, elaborates on the transitions in healthcare system within the state, its achievements, short comings and the way to go ahead, in a tète-à-tète, with Raelene Kambli
Maharashtra has been at the forefront to provide good healthcare services. What, according to you, are the areas where the healthcare structure has improved over the last few years and which areas need more attention?
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| Suresh Shetty |
The healthcare sector in the state of Maharashtra is growing year on year. The sector is mainly divided in two major components – the government sector and the private sector. The government sector comprises municipal hospitals run by the Corporation and Zilla Parishad healthcare centres within the rural areas run by the village Zilla Parishads. Whereas, the private sector in Maharashtra functions in various ways i.e. through hospitals, diagnostic centres and other healthcare delivery models. Maharashtra’s healthcare sector has seen growth in both private and government sectors, but the private sectors have been in the forefront, especially within metro cities. The private sector is also setting up hospitals in various small towns and cities.
On the government front, we have introduced many schemes that have helped us uplift the healthcare scenario within our state. Healthcare services in our state have improved over a period of time, especially in our rural areas. We have upgraded our primary healthcare centres and government hospitals throughout Maharashtra. The only problem in the government sector is that not many funds are allotted to the corporations, a big issue in itself. The other areas that need attention is the lack of healthcare infrastructure, especially within rural areas of Maharashtra, and shortage of trained healthcare professionals.
What are the most important prerequisites to enhance the healthcare system in Maharashtra?
The state of Maharashtra needs to increase proper healthcare infrastructure, especially in the rural areas. The other aspect that needs urgent attention is the shortage of trained professionals in the healthcare sector. The patient-to-nurse ratio is quite less. We also need trained paramedics to run our ambulance services efficiently.
Human resources is a problem not only in our state, it is a national problem as well. Recently, I visited an international conference where we learnt that countries such as Sweden, Canada and China are also facing a shortage of trained healthcare professionals. For this we need more educational institutes introducing medical and healthcare delivery based courses.
There seems to be a large mismatch between demand and supply when it comes to quality healthcare. What strategies are the government adopting to bridge this gap?
The Government of Maharashtra has introduced many schemes to increase accessibility and affordability of healthcare services. We are soon going to establish four institutes for mental health, incorporate vocation training for emergency services in our medical colleges and are also looking for collaborations with private sector players to build more hospitals, especially in the rural areas.
Tell us about the nature of the healthcare initiatives that have been taken by the Maharashtra government. Also shed some light on the way you see the actual impact of these initiatives.
The Public Health Department of the Government of Maharashtra, is making constant and concerted efforts to formulate and execute schemes in line with the National Health Policy to ensure adequate healthcare services to the people of our State. Some of schemes are mentioned below:
- National AIDS Control Programme
- National Programme for Control of Blindness
- National Rural Health Mission
- Reproductive & Child Health II
- Revised National Tuberculosis Control Programme
- National Leprosy Eradication Programme
- Rajiv Gandhi Jeevandayi Arogya Yojana
While implementing these schemes, steps are being taken to make improvements in the healthcare system of the State to cater to the health needs of the people in the rural areas, particularly in the tribal and backward regions of the State. So far, we have invested Rs 2900 crore in upgrading our current hospitals, primary healthcare centres and other medical institutes all over Maharashtra.
Our Rajiv Gandhi Jeevandayi Arogya Yojana (RGJAY), launched by the Maharashtra government enables families with annual income of less than Rs one lakh to avail free medical facilities worth upto Rs. 1.5 lakhs. The scheme is implemented throughout the state of Maharashtra in a phased manner for a period of three years. The insurance policy coverage under the RGJAY is meant for the eligible beneficiary families in eight districts i.e. Gadchiroli, Amravati, Nanded, Sholapur, Dhule, Raigad, Mumbai and suburbs. The scheme provides for 972 surgeries/ therapies/ procedures along with 121 follow up packages in 30 different specialisations. The scheme works in collaboration with some private hospitals and is doing really well. We have completed 20,000 surgeries so far. For us, this is a great achievement.
In September 2012, you had planned to set up a vigilance squad to audit National Rural Health Mission (NRHM) funds. What are the findings of the audit so far?
Yes, we set up a vigilance team to ensure that the NHRM funds are used effectively and there is no scope for misuse in the wake of the misappropriation of funds which came to light in some areas such as Dhule and Gadchiroli. We have already taken the culprits into custody and will be punishing their act.
Apart from this, you would be glad to know that Maharashtra has been rated as one of the leading states for optimum utilisation of NHRM funds. This year, Maharashtra was allotted Rs 1900 crore under NHRM and for the forthcoming year, the government has already announced a 30 per cent increase in the NHRM funds for our state. With this increase we will strengthen our medical services in the rural areas within Maharashtra.
High maternal mortality rate (MMR) is one of the biggest problems within Maharashtra’s rural areas. What are the government initiatives to curb this problem?
We have really worked hard to bring down MMR in our state and have been successful in doing so. Maharashtra has become one of India’s most progressive states with regards to infant, child and maternal mortality rates. We have collaborated with various NGOs and healthcare organisations to facilitate training and medical aid to women living in the rural areas of Maharashtra. This initiative within the rural areas of the states has helped us increase the number of deliveries within hospitals. We also conduct regular audits of maternal deaths in an effort to bring down the maternal mortality rate in the state.
Speaking about PPPs in healthcare, it is said that few other states in India seem to be doing better as compared to Maharashtra. How do you plan to promote and sustain PPP models within the state?
PPP is a very complex subject, it needs both parties to work in sync. Having the PPP model we are very soon going to come up with four institutes for mental health and vocational training centres in our state. We are always looking out for healthy partnerships with the private sector. We have the land we want, the private sector can provide us with their expertise in healthcare delivery. We are also trying out another unique model called the built operate and transfer (BOT) wherein we will provide the land and our private sector partner will build the facility and help us in operations as well.
There still seems so be a digital divide within the healthcare sector in our state. What are your plans to provide impetus to the healthcare IT sector here?
I do not agree that there is a digital divide in Maharashtra where healthcare IT is concerned. Our state has been in the forefront of adopting IT in healthcare. We have our National e-Governance Plan (NeGP) to provide services to the rural population at their doorstep at an affordable cost. Under the NeGP plan, the state government provides for telemedicine services to the rural areas of our state. Apart from this, our Director of Health sector’s office is completely paperless. We have a strong struck inventory system in place.
There are plans to introduce the Clinical Establishment (Registration and Regulation) Act in the State but Indian Medical Association (IMA) is opposing it since they feel it will unleash a “licence raj” in the state. What is your opinion on this issue?
The Clinical Establishment Act only speaks about registering a clinic. It has rules and guidelines for registering a clinical establishment. There is nothing like what the Indian Medical Association claims.
What is your agenda for 2013?
In the year 2013 we would be working towards creating more infrastructure for healthcare within our state and also increase skilled manpower in healthcare. Apart from this, we would be establishing 10 blood banks across the state and introducing blood storage units pan-Maharashtra. The blood bank and storage units will work as a service wherein blood would be collected at the door step of the donor by just dialling 102. We would be the first to introduce this service in the Satara and Sangli districts.
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