The ‘Kerala nurse’ is today an acknowledged prized export from India but unlike the ‘Motel Patel’ of the US, another stereotype, the former does not seem to have risen above circumstances. We are familiar with the reasons for her flight to ‘greener pastures’: better remuneration, dignity of service, better career progression. But her flight is the nation’s loss: today, we have a serious shortage of nursing talent.
There is hope that Health Minister Dr Harsh Vardhan champions these issues at the centre. A proposal forwarded by the Department of Personnel and Training (DoPT) to create a cadre of doctors for government hospitals, called the Indian Medical Service (IMS) is also tipped to be given serious attention by the Health Minister, never mind the fact that it has been gathering dust for the past three decades. The IMS would be designed along the lines of the Indian Administrative Services and other cadres, with similar working conditions, perks and periodic training.
Industry experts say an IMS would be a good move, as it will attract doctors to public hospitals and solve the brain drain problem. A similar solution can be applied to nurses and paramedical staff as well. But these moves also need safeguards, as another section of health policy experts caution. Such measures could merely lead to more bureaucratic layers and red tape rather than making a difference to health care indices.
In this issue of Express Healthcare, an In Imaging special, we focus on paediatric imaging, another sub-speciality that hasn’t got the attention it deserves. As our cover story (‘Waking up to paediatric imaging’, pages 28-31) shows, this neglect will only trip us up as we have the world’s largest child population (400 million) but as one expert estimates it, hardly 10 radiologists who practice pure paediatric radiology. This is a grave gap in diagnostic services and one that will allow many diseases to go undetected in children. This will unfortunately result in a higher disease burden so it is imperative that this gap is addressed in a strategic manner.
Whether it is the shortage of nurses, paediatric radiologists or medicines, the Narendra Modi government has a huge task on its hands. But often it’s not the lack of services or talent, but the lack of efficiency in our healthcare infrastructure. For instance, in spite of India being the third largest producer of generic medicines, we do not have an efficient distribution system to deliver affordable medicines to rural areas. Some states have made a start; Kerala and Tamil Nadu are pioneers in this respect. Plus, there is a fund crunch, with India’s public healthcare spend just 1.2 per cent of GDP. The way ahead is more efficient and transparent partnerships between government and industry as well as overseas partners like governments and regulatory bodies. But it is equally essential that these partners demonstrate and prove that they have no hidden agenda.
Viveka Roychowdhury
Editor