The parents of a six-year-old boy living in K.P. Agrahara had the most difficult time getting treatment for their son when he fractured his leg. The doctor in the nearest private hospital where he was taken to said he needed a surgery. Not having a BPL card, the family was not covered under any health insurance scheme of the government. The parents had to run from pillar to post to borrow money.
Despite both the State and Union governments announcing numerous schemes such as Yeshasvini, Vajpayee Arogyashree, Rashtriya Swasthya Bima Yojana, and Mukhyamantri Santwana Harish Yojana, many still remain inaccessible to those who deserve them. The problem: they are either unaware of such schemes or do not have the necessary documents to avail themselves of the benefits.
Take the case of a woman in Ambedkarnagar who had to take a personal loan of Rs. 20,000 so that her husband, who had been injured in an accident, could get the treatment.
M. Gayathri, a member of Mahila Arogya Samithi, who was part of a survey conducted by the Centre for Research and Advocacy to gauge how much of the welfare schemes was really reaching the needy, said, “Half of the people in K.P. Agrahara do not have a BPL card or ration card. As a result, they are denied health card or benefit under schemes. In recent days, we have had numerous dengue cases in the locality. Each family has had to spend close to Rs. 14,000 on treatment.”
Talking about how the public health policy of the government itself is skewed, Akhila Vasan of Karnataka Janarogya Chaluvali said, “Though numerous schemes are announced, access to them are made next to impossible. A poor person needs to prove that he is poor first, then spend a lot of money to get a card and still find himself excluded from many welfare measures. This type of card-based entitlement is designed to fail. Those who need it the most don’t get them.”
On another hand, the problem is also of dissemination of information. When Ms. Gayathri was asked if she knew about the scheme for accident victims, she said no. “No one is telling us about the schemes. Even if someone knows about a scheme, he or she do not know how to make use of it or where to go.”
‘Strengthen State-owned facilities’
The public health services need more healthcare and social workers who can ensure that the schemes announced by the government are accessible to those who need them the most, said activists.
Akhila Vasan of Karnataka Janarogya Chaluvali said that the government needs to invest more on strengthening the State-owned healthcare facilities. Launching a scheme and then empanelling private hospitals will not work, she said. “Most of these empanelled hospitals only treat till money is provided under a scheme, then a patient is asked to leave.”
In Bengaluru specifically, the problem is that the health programmes are administered by three different entities: the Bruhat Bengaluru Mahanagara Palike (BBMP), which runs health centres and referral hospitals; the Department of Health and Family Welfare, which takes care of primary helalth centres (PHCs) and general hospitals; and the Medical Education Department which runs Bangalore Medical College and Research Institute (BMCRI) and its affiliated hospitals including Bowring and Lady Curzon, Minto and Vani Vilas.
Experts said there was little coordination among these government-run facilities. As a result, it is the patients who lose out.
There is a need to de-fragment and streamline the system. Cross referral linkages must be established.
Expert speak
More health services should be made available in primary health centres. The government should also look at providing generic medicines for free in its facilities. This would drastically reduce the healthcare cost. Also, the attitude of the government needs to change. Because it is for the poor, health services can not be poor.
Upendra Bhojani, Assistant Director, Institute of Public Health
People speak
Selena, community volunteer, Magadi Road: Many people are unaware of the health schemes announced by the government. It was only after the Mahila Arogya Samithi was formed in our neighbourhood that people started getting some information.
P. Hegde, Centre For Advocacy and Research: We have seen a shift in priority of the poor to healthcare. Communities have started understanding and demanding their entitlements. From our side, we have created a single-window system to help these people get necessary documentation for availing of benefits under various schemes.
Readers’ letter
In my opinion, government schemes never reach beneficiaries. Many people are not aware of the schemes launched by government. Awareness programmes should be conducted in neighbourhoods whenever a new scheme is launched.
– Aisha Bansal
