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Poor primary care, overcrowded tertiary care

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Mumbai is the financial capital of the country, which is plagued by financial woes. The city sits atop a rapidly outdated and crumbling infrastructure, dismal roads and the worst, killer trains with nearly a dozen passengers dying every week on its suburban system, the city seriously needs a healthcare overhaul.

In contrast with OECD countries, the population to bed ratio is particularly low in India. In Mumbai it’s dismal. With the probability of closure of the 800 bed Wadia hospital for children, there will be a further reduction in the number of affordable hospital beds for the population who needs it the most.

In the previous decade, China invested significantly in its front-line health services, to create capacity and improve the quality of healthcare delivered and the results are evident. The infant mortality rate in China (IMR) is at 7 in India it is 30 per thousand births as per the United Nations Inter-agency Group for Child Mortality Estimation. In 2018, an estimated 882,000 children under five died in India, which is highest in the world, whereas the Central government in this health budget has only nominally increased the allocation to healthcare spending by 10 percent. Considering the nominal inflation of 7.5 % what is this government trying to achieve?

Traditionally, the maximum city has been neglected in terms of allocation for health resources. In comparison to any similar financial center in the world, the ratio of population to publicly available beds is dismal. This leads to the vulnerable class of the population, the marginalized slum dweller, who is already struggling to meet his basic necessities grapple with the situation.

Facilities for the relatives of the visiting patients is yet another area of disparity. Seeing intubated patients along with their relatives living on the payments opposite major hospitals in makeshift shanties is all to familiar site. Even though there are a significant number of NGOs working towards creating some facilities to them, in the wake of lack of systemic action from the local government, they are woefully inadequate.

Most tertiary care centers are medical colleges, which are best in class in the entire country. Admission in these institutes is most competitive and attracts the best talent in the country. Yet, the accommodation facilities are extremely sub-par. It is a common sight to find a number of students crammed up in poorly maintained rooms with very basic facilities. The cases of medical students contacting transmissible diseases because of a lack of adequate facilities are not uncommon.

 

Mumbai needs a much larger share of central investment in its health services. The creation of AIIMS like hospital with provision of various tertiary specialties under one roof will save inconvenience and hassle to a large number of its residents. Instead of spending enormous sums of money on memorials, it’s about time that the government looks into this lacuna.

Nearly all major government hospitals are located in the city, with very few in the Suburbs. That is where the population growth is high, yet the facilities at these institutes are inferior to the ones in the city. With the BMC being the largest grossing municipal corporation in the city, and Maharashtra being the richest state in India in terms of revenue, its about time that Mumbai gets its fair share in healthcare allocation.

Dr. Aniruddh Bhaidkar is a master’s in Healthcare Management from the University of Manchester, UK.

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