Inadequate regulations undermine India's health care
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《英国医生杂志》
New Delhi
The private sector dominates health care in India, but inadequate legislation and failure to enforce regulations are contributing to poor quality medical services, says a World Bank publication released in New Delhi last week.
Eighty per cent of spending on health in India is from personal funds, but existing laws do not ensure that private medical services maintain even minimum standards, says the report.
"Powerful medical lobbies have opposed government efforts to regulate the private sector," it says, adding that India's medical councils are not enforcing laws relating to registration and licensing of medical practitioners.
In a section on private healthcare services the report acknowledges problems that consumer health organisations have long complained about: doctors overprescribing drugs, recommending unnecessary investigations and treatment, and failing to provide appropriate information for patients.
It says there are no laws regulating the geographical distribution of healthcare providers and the types of technology to be made available, and it suggests that the influx of technology may have led to unreasonable use of equipment. Yet, despite such problems most people still choose the private sector, because of accessibility and shorter waiting times for diagnosis and treatment.
Health sector analysts say the private healthcare system in India should be segmented so that the relation between quality and prices of services can be examined. "We would probably find that some private sector establishments offer excellent quality at a high price," said Professor Subrata Chakraborty of the Indian Institute of Management, Lucknow, who analysed the private sector in India's largest state, Uttar Pradesh, for the report. "The typical consumer doesn't separate the two issues."
"The Indian Medical Association has consistently opposed any kind of regulation," said Ravi Duggal, coordinator of Mumbai's Centre for Enquiry into Health and Allied Themes, a nongovernmental organisation that has been long been campaigning for minimum standards.
A survey in Mumbai in the mid-1990s showed gross deficiencies in the quality of medical services. "There were clinics operating out of residential flats, with kitchens turned into operating theatres," said Dr Abhay Shukla, project coordinator at the centre.(Ganapati Mudur)
The private sector dominates health care in India, but inadequate legislation and failure to enforce regulations are contributing to poor quality medical services, says a World Bank publication released in New Delhi last week.
Eighty per cent of spending on health in India is from personal funds, but existing laws do not ensure that private medical services maintain even minimum standards, says the report.
"Powerful medical lobbies have opposed government efforts to regulate the private sector," it says, adding that India's medical councils are not enforcing laws relating to registration and licensing of medical practitioners.
In a section on private healthcare services the report acknowledges problems that consumer health organisations have long complained about: doctors overprescribing drugs, recommending unnecessary investigations and treatment, and failing to provide appropriate information for patients.
It says there are no laws regulating the geographical distribution of healthcare providers and the types of technology to be made available, and it suggests that the influx of technology may have led to unreasonable use of equipment. Yet, despite such problems most people still choose the private sector, because of accessibility and shorter waiting times for diagnosis and treatment.
Health sector analysts say the private healthcare system in India should be segmented so that the relation between quality and prices of services can be examined. "We would probably find that some private sector establishments offer excellent quality at a high price," said Professor Subrata Chakraborty of the Indian Institute of Management, Lucknow, who analysed the private sector in India's largest state, Uttar Pradesh, for the report. "The typical consumer doesn't separate the two issues."
"The Indian Medical Association has consistently opposed any kind of regulation," said Ravi Duggal, coordinator of Mumbai's Centre for Enquiry into Health and Allied Themes, a nongovernmental organisation that has been long been campaigning for minimum standards.
A survey in Mumbai in the mid-1990s showed gross deficiencies in the quality of medical services. "There were clinics operating out of residential flats, with kitchens turned into operating theatres," said Dr Abhay Shukla, project coordinator at the centre.(Ganapati Mudur)