Manifesto to promote health and healthcare in Haryana:
The right to health is a fundamental and universal right of all
citizens and this will need to be respected and realized within a time frame.
The Right to Health needs also to be located in the underlying determinants of
health such as access to safe water and sanitation, adequate food and
nutrition, housing, and secure livelihoods. Above all social inequities --
based on disparities along gender, caste, class and other lines – have a
profound impact on the health of the poorest and the most marginalized.
The following concrete proposals are designed to reverse the present --
entirely unacceptable -- situation in the health sector, and to secure
conditions of living and health care services that promote health in all its
dimensions..
1.
Act
on the Social Determinants of Health: In Haryana this aspect is not taken
seriously .This would include promotion of food security by universalization
and expansion of the Public Distribution System (to also provide local cereals,
pulses and oil)in an effective way; a national policy on Child Health and
nutrition and universalization of ICDS with expansion of staff and services to
effectively cover under-3 children; ensure universal availability of safe water
in each village and habitation of Haryana ; and universal access to safe
hygienic toilets in all habitations.
2.
Address
the Gender dimensions of Health: In Haryana gender bias is very predominant.
This is reflected in sex ratio .Guarantee comprehensive, accessible, quality
health services for all women and transgender persons for all their health
needs which includes but is not limited to maternal care. Abolish all coercive
laws, policies and practices that violate the reproductive, sexual and
democratic rights of women; and regulate use of invasive reproductive
technologies. Recognize gender based violence as a public health issue and
ensure access to comprehensive health care (physical as well as psychosocial),
screening, documentation, referrals, as well as coordinated, ethical
medico-legal processes for survivors. Guarantee comprehensive, quality,
accessible, adolescent-friendly health care, including for their reproductive
and sexual health needs. Health Education in schools should be undertaken with
pro gender orientation.
3.
Immediately
reverse Caste Based Discrimination: Haryana is having caste domination in our
social life. Take immediate and
effective steps to entirely reverse all forms of caste based discrimination,
which is one of the most important social determinants of ill health. Immediate
ban on manual scavenging. In the health care sector, special measures to
promote priority access to discriminated sections of society.
4.
Enact
a Right to Health Act in Haryana which assures universal access to good quality
and comprehensive health care for all the entire range of primary, secondary
and tertiary services, and that makes denial or non-availability for reasons of
access, affordability or quality a justiciable offence.
5.
Increase
Public Expenditure on Health to 3.6% of GDP annually (Rs 3000/- per capita at
current rates) with the central government’s contribution being at least 1% of
GDP (Rs 1000/- per capita). All public health expenditure to be tax financed.
Public health spending to be increased to 5% of GDP in medium term.
6.
Ensure
quality and assured availability of health care: A lot can be said about the
present infrastructure and staff in Haryana Health Sector. It should be updated
as per laid down norms. Quality of care to be ensured in all health facilities,
which would mean health care that is effective, safe and non-exploitative,
provided with due dignity and respect to patient rights, and which aims at
patients’ comfort and satisfaction. Quality norms and standards shall not mean
conforming to infrastructure or other standards, which favor large corporate
hospitals, or worse medical tourism, and make it impossible to provide low
cost, rational and effective care. Every public health care facility would be
required to provide guaranteed health services appropriate to their level in
assured manner. Public health facilities to be entirely free of user fees and
the entire range of services to be provided directly by government run
facilities and not through Public Private Partnerships (PPPs).
7.
Stop
both Active and Passive Privatization of health care services in Haryana: Necessary measures to stop active
privatization in the form of transfer of public resources or assets to private
entities that provide services on a commercial basis. Measures to stop passive privatization by
increasing investment in public health facilities, increasing number of beds
and facilities in the public sector, and by expanding range of services
available in public facilities. Public facilities to provide comprehensive
health care services, not limited only to reproductive health care,
immunization and a care for a few diseases of national importance.
8.
Training
of Health workforce in Haryana on war footing : Increase public investment in
education and training of the entire range of health personnel. Ensure that
government run colleges to train a range of health workers, nurses and doctors
are located in areas where they are needed most. Training to be reoriented to
impart skills that address the health needs of local communities. The trend of
commercialization of higher education in medical and allied health sciences to
be reversed, along with stringent mechanisms for regulation of existing private
institutions in a transparent manner. The functioning of the Medical Council of
India and the Nursing Council of India to be thoroughly scrutinized and
revamped to weed out rampant corrupt and unethical practices in these
institutions.
9.
Well
Governed, Adequate Public Health Work force in Haryana :Create adequate posts
for the entire range of health personnel in the public health system.
Regularize contractual employees and provide ASHAs, ANMs and all levels of
public health system staff with adequate skills, salaries, and decent working
conditions .The health and safety of workers, particularly of women to be
assured. Act on available evidence from many states which show that the problem
of the lack of doctors in rural areas is more a result of administrative
incompetence and political failure than a matter of professional culture. Creation
of a cadre of doctors, nurses and other paramedical workers who have training
in primary health care, public health and in working as a team.
10.
Secure
access to quality assured essential medicines and diagnostic services in all
public health facilities, free of charge in Haryana . This would be achieved by
developing autonomous and transparent procurement and demand driven
distribution mechanism (on the lines of Tamil Nadu, Kerala and Rajasthan). For
chronic illness it would mean ensuring such access throughout the year from a
distribution point most accessible to patients. Generic prescriptions to be
made compulsory in all health facilities. The various schemes for benefit of
patients should be implemented earnestly. Monitoring system should be there from
top to bottom.
11.
Participatory
Planning, Community Participation and Community Based Monitoring of health
services in Haryana to ensure accountability and responsiveness of services.
Community Based Monitoring and Planning will be generalized and made a core
component of all public health programs and health care services, to help
effective delivery of services and ensure accountability and transparency.
12.
Eliminate
Corruption in the Public Health System. Deep rooted problem in Haryana . Can be
contained through transparent policies
for appointments, promotions, transfers, procurement of goods and services and
infrastructure development – all of which are legislated through a Transparency
Act (as in Tamil Nadu for procurement and Karnataka for transfers). Institution
of robust grievance redressal systems, which are adequately financed and
managed with some degree of autonomy from the management.
13.
Reverse Exploitation by private hospitals and
protect ethical private non commercial private providers in Haryana : The
national Clinical Establishment Act would have provisions for: observance of
patient's rights in all clinical establishments; regulation of the rates of
various services; elimination of kickbacks for prescriptions, diagnostics and
referrals;and establishment of government supervised independent grievance
redressal mechanisms for patients. Standards would be designed in a manner that
would prevent corporatization of health care. This would promote genuine
not-for-profit and ethical health care providers and would contain costs of
care in the private sector.
14.
Absorb,
over a period, existing publicly funded health insurance schemes (RSBY and
different state health insurance schemes) into an expanded public health system
publicly financed through general taxation .All entitlements available under
these schemes would be made available through the public health system,
suitably expanded and adequately resourced. This should include a comprehensive
system for health care protection of unorganized and organized sector workers
(providing primary, secondary and tertiary health care), linked with expansion
and rejuvenation of the ESI.
15.
Eliminate
the role of multi-lateral and bilateral financing agencies from all areas of
technical assistance or health policy formulation. Eliminate the influence of
agencies -- such as the World Bank, USAID and Gates Foundation, as well as
consultancy organizations such as Deloitte and McKinsey – in formulation of
national priorities and approaches to health care provisioning and financing.
Build international collaboration for generation and sharing of knowledge
resources, especially with other developing countries. Exert pressure at the
governmental level to free WHO, UNICEF and other UN agencies from dependence on
corporate financing and influence. Critically examine the offer of advise and
expertise from such agencies till such time as they continue to be influenced
by corporations and private foundations.
16.
Build
National and State level capacity for Health research and development: The
government would invest at least 5% of its public health budget on health
research including health systems research. The government, for the purpose of
promoting health systems research and research for domestic priorities, would
develop institutions and strengthen existing institutions that are financed
through public funds.
17.
Ensure
access to essential and safe Drugs & Devices :Cost-based price-control of
all medicines, measures to ensure drug and device safety ,banning of irrational
medicines and irrational combinations, opening of generic medicine outlets in
adequate numbers, mandatory provision for doctors to write generic names of
medicines ,use of the public health safeguards in the Indian Patent Act to
promote access to medicines, and active promotion of indigenous manufacture of
most drugs and devices.
18.
Regulation
of clinical trials and ethics in biomedical research: Develop a clear framework
for the ethical conduct of clinical trials in India, combined with the regulation
of all those that are involved -- sponsors of trials, CROs, ethics committees
etc. Ensured that the CDSCO and the ICMR monitor the conduct of clinical trials
at the trial sites and only permit trials at sites which are equipped to handle
emergencies and adverse events. Fair compensation norms for trial participants
who suffer from adverse events to be expeditiously developed and implemented. A
charter of rights of clinical trial participantsto be developed and made
justiciable.
19.
Ensure
access to treatment and care of persons with mental illness (PWMI) through
integration of the revised District Mental Health Program with the National
Health Mission. The rights of PWMI need to be protected by adoption of the
Mental Health Act and action on the draft mental health policy.
20.
Ensure
facilities for estimation of residual effect of pesticides in human beings.
Stop irrational and unethical use of Oxytocin in buffaloes and cows,
21.
Stop
Nuclear Plant in Gorakhpur . It will have many health hazards. Be more vpertinent
about environmental issues related in development of Industry.
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