India needs a National Health Service like in Britain to combat the coronavirus pandemic

0


The question needs to be asked: If we could follow the Westminster style of democracy, why couldn’t we have emulated the British National Health Service (NHS), the United Kingdom’s publicly funded health-care system whose 75th anniversary is being observed this year? Founded in 1946 a year after World War Two ended, the NHS was the brainchild of the Labour government’s minister for health Aneurin Bevan who, at the age of 13, had to work in the coal mines in Wales due to poverty before he became an activist and a full-time Labour Party member. Born in 1897 in Tredegar in Wales, Bevan was inspired by the Tredegar Medical Aid Society which had a system where, in return for contributions from its members, health-care was provided free at the point of use to everyone in the town, including those who could not afford to contribute.
.
When Labour won the first post-war election on July 5, 1945, Clement Attlee appointed Bevan as the minister for health. The first thing Bevan did was to `Tredegarise’ health services for the UK through the National Health Service Act, 1946. There was a lot of resistance, not just from the opposition Conservative Party but from a section of doctors who saw their profession not as a service but as a way of minting money in a post-war Britain where the supply-demand ratio was heavily tilted in favour of those providing medical services. However, Bevan stood firm. “No society,” he said, “can legitimately call itself civilized if a sick person is denied medical aid because of a lack of means.”

Primarily funded by the government from general taxation, the NHS provides healthcare to all legal UK residents, with most services free at the point of use. Emergency treatment and treatment of infectious diseases are free for most people, including visitors. Today, the NHS is a lasting legacy to the vision of Bevan who was far ahead of his time and ideologically opposed to the colonial, imperialist policies propagated by the likes of Winston Churchill. It was the Labour Party government which insisted on Independence for India, much against the wishes of the then Leader of the Opposition, Wnston Chuchill. The NHS may have started off as a British concept but much of it today is Indian in implementation. Many of the doctors and nurses are Indians who have either migrated or are the children and grandchildren of immigrants.

Today, if the UK has a much better Covid vaccination-rate than not just its European neighbours but many countries throughout the world, it is because of the crucial contribution of the NHS. Only 12 to 14 months ago, it looked as if the UK was being overwhelmed by the coronavirus, with even the British Prime Minister Boris Johnson being infected and admitted, when his condition worsened, to the ICU of London’s St Thomas Hospital, with the health secretary Matt Hancock (who also tested positive and was in home isolation) stating that “I know he (Johnson) will receive the best possible care from the amazing NHS.” Both Johnson and Hancock recovered but the situation was particularly grim towards the end of 2020 and the beginning of 2021.On January 20, 2021, the UK posted a record high of 1,823 deaths, the most for a single day since the pandemic began. On January 8, 2021, the number of new cases for a single day in the UK, touched a record high of 67,841. By January 31, 2021, the cumulative figure for active cases in the UK was 2,027,232. Boris Johnson acknowledged that there were oxygen-shortages in some places, and reports emerged of hospital mortuaries reaching full capacity.

Which was when the UK embarked on a two-pronged strategy of containing the infection through preemptive action (lockdowns) while simultaneously launching a mass-vaccination programme–the first western country to do so. Stocks of more than the required amount of vaccines were pre-booked a year in advance. All of which paid off. The latest figures indicate that the UAE, Israel, the USA and the UK lead other countries when it comes to vaccinating the biggest proportion of their population. Israel has fully vaccinated 57% of its population, (with 60% getting one dose). The US has fully vaccinated 41% of its population (51% one dose),. and the UK 40% fully (60% one dose).

Compared with them, India has so far fully vaccinated 3.3% (13% one dose). In terms of the actual number of doses.(whether full-vaccination or one dose), India is second to the USA. However, the population of India is over 20 times that of the UK and over four times that of the US. Again, India did not pre-book vaccines like the US and the UK and was caught napping when the second wave hit the country like a tsunami, resulting in a daily surge of new cases from 8,587 on February 1 to 409,3000 on May 8, with the number of daily deaths shooting up from 76 on March 8 to 4,525 on May 18. India’s number of daily new cases has now come down onJune 5 to 121,476 and the figure for daily deaths has dropped to 2,683. While India is now targeting 2 billion vaccine-doses between August and December, that seems highly improbable, going by the fact that the daily average for vaccinations has dropped by almost 50% from 30,24,362 in April to 16,22,087 in May.

The vax-drive in the UK targeted people in three main ways, through GP (general physician) practices and community pharmacies, through hospital hubs, and through major vaccination-sites across the UK, like the Etihad Tennis Centre in Manchester, the International Centre in Bournemouth and the ExCel Centre in London. The mass-vaccination drive in the UK has been so successful that the number of daily new cases has dropped from a high of 67,840 on January 8, 2021, to 5,765 on June 5. The cumulative number of active cases has dropped from 2,027,232 by February 1 to 111,136 by June 5. The number of daily deaths has dropped from a high of 1,823 on January 20 to, believe it or not, just 13 by June 5. While the figures for the coronavirus have been volatile in the past and have tended to go up and down, it is the success of the vaccination-drive that has given the government, the policy makers and the NHS the confidence that the situation can only improve from now on.

Hence, many of the pandemic restrictions are now being lifted in the UK. The pubs are open, provided there is no crowding at the bar, with one customer being allowed in for each person leaving. The programme of “Coventry UK City of Culture 2021” has been activated. The English Premier League football season has just concluded and the cricket is on. The World Test Championship Final between India and New Zealand is to be staged from June 18 at the Ageas Bowl cricket stadium in Southampton, the city from where the Titanic set out on its first and last journey on April 10, 1912.

Unlike the United Kingdom, India does not have one single omnibus nation-wide health service like the NHS in which treatment is assured for not just all British citizens but also foreigners who are either working or studying in the UK, many of them again from India. India has the CGHS (Central Government Health Service) which provides treatment for both working and retired government employees. The Defence Services have a chain of command hospitals in different parts of the country. During his last illness, the late president Pranab Mukherjee was being treated in the army’s referral hospital in New Delhi. The Indian Railways, perhaps the biggest employer in the country, has hospitals across the length and breadth of the nation and, as a college student, I was treated in the one in Chakradharpur (in Jharkhand) where my father, a railway employee, was then posted. In the rural areas, there are the primary health centres and the anganwadis. On September 23, 2018, Prime Minister Modi launched the Ayushman Bharat national health-insurance scheme, whose objective is to provide access to health services for the low-income earners.

Where the NHS has scored is that it has successfully withstood the onslaught of the ongoing pandemic, the world’s worst medical crisis since the Great Flu of 1919-1920. Last year in 2020, for a brief while it looked as if the NHS would be overwhelmed by the pandemic, with the UK constantly recording the highest daily number of cases and deaths. That was the time the UK’s deputy chief medical officer Jenny Harris announced at a press-briefing that someone in her family (her daughter) had just received ventilator-training. What enabled the NHS to combat the coronavirus is that it had 75 years of experience to fall back on.

India, of course, is a much bigger country than the UK. India’s population is between four to five times bigger than that of the UK. However, the one thing demonstrated by the horrendous wave of deaths in April and May in not just India’s urban centres but in the rural hinterland is that the existing system had collapsed, whether we blame it on a shortage of oxygen-cylinders, medicines, infrastructure, logistics, or policy formulation and coordination. Who can forget the haunting image of the TV journalist Preeti Choudhry beseeching the night-watchman of Delhi’s Lok Nayak Jaiprakash Hospital to allow patients gasping for breath to enter? Who can forget the telecast images of bodies floating down the Ganga? Who can forget the image of a teacher in the rural district of Agra converting his village primary-school into a treatment centre and of patients lying under trees and being put on IV, with the tube attached to the branch above, and all this because the primary health centre had been locked and there was no doctor?

It is apparent that a drastic change in policy is needed. However, any change in policy would take time to formulate and implement, given the number of stakeholders involved in a country where health is a state subject and where different states are run by different political parties.

Vaccination, we are told, is the immediate need of the hour to stop the spread of the virus. In the rural areas where the majority of the people live and where it may not be easy to log on to CoWin, well-planned vaccination drives could be a solution, especially if the local officials and elected representatives at the grassroots work in tandem with the primary health centres and the anganwadis. The experience gained from the mass-vaccination programmes like the one for the eradication of polio should be utilised.

For the urbanites (those living in the metros, the Tier-2 towns or the mofussil centres), there are three points for vaccination. The first is, of course, the hospital where you have been registered for years. That hospital, which has the computerised record of all your ailments over the years, should logically be the best place for vaccination. The second would be the health centres and medical clinics run by the municipal authority. These would be greater in number and possibly located in the ward close to your home but they would also be more crowded, entailing a risk of exposure to an asymptomatic carrier of the coronavirus. The third option is to register for a vax-drive

In my case, what worked was a combination of the first and third options. CoWin had promised that, from March 1, senior citizens and those above 45 with comorbidities could register for the hospital of one’s choice and at the time of one’s preference. However, I could get nowhere on CoWin despite several attempts. And so I rang up the Bangalore hospital where I was registered for a decade (Manipal). After innumerable attempts, I got through to someone called Vinod whom I had never met and he told me that there was not much of a rush early in the morning and I could get jabbed if I brought along my Aadhaar card and hospital-registration card. And so I had my first jab of Covishield at the hospital on March 11. The final jab was supposed to be after four weeks on April 8. However, on March 23, the Central government recommended a six to eight week gap (42 to 56 days) between the first and second dose of Covishield to ensure optimum efficacy of the vaccine. And so I decided to wait.

By the time my 42 days were over in the third week of April, a rigid lockdown had been enforced on Bangalore. There were reports of vehicles being seized by the cops after 10 in the morning unless one had a confirmed CoWin booking for a jab. However, each time I clicked on Cowin, the response was one of “no vaccination-centre available for booking”. That could have been due to a glitch or because registration had also been opened first from April 1 for those above 45, and then from May 1 for those in the age-group of 18 to 44. I rang up Vinod, who had helped me with the first jab at my hospital. He told me he had been transferred and that I should drop by the next morning and ask for one Bhumika. There was a rush on the hospital lawns and I was told to look for a lady in a pink dress. Fortunately there was only one lady in a pink dress and she told me that no stocks of Covishield were available and that I should text her on her mobile after 6.30 pm on May 11. I did so on May 11 but there was no response.

On May 13, a Central government notification recommended a 12 to 16 week gap (84 to 112 days) between the first and second dose of Covishield for greater ‘efficacy’. However, Maharashtra and Delhi maintained that they had to close their vax-centres for a few days due to a shortage of vaccines. .

On Sunday, May 30, my cook Mohana informed me that a vax-drive was being organised in the immediate neighbourhood on May 31 for the benefit of those living in nearby apartment blocks. My BSNL-based internet was down again but a kind neighbour Vishwesh did the needful by way of booking and payment, even dropping by to check out the OTP on my mobile. For a few hours, I was on Cloud Nine (coincidentally, the name of the maternity-hospital chain which had organised the vax-drive). However, I was brought back to earth with a thud when I was informed that I had been knocked off the final list because there had to be 84 days between the first and second jab of Covishied while I had ‘only’ completed 81 days.

On June 2, I got an email saying that the same hospital was organising a vax-drive in another part of Bangalore and that I would not have to wait in a queue if I reported to a Dr Cheryl by 10 am on June 3, by which date I would have completed 84 days. I am now in the 3.3% of India’s fully vaccinated population.

The experience has left me with a profound admiration for Aneurin Bevan, the teenaged coal-miner who subsequently became an activist and who, as the youngest minister in Clement Attlee’s post-war cabinet, launched the National Health Service whose legacy endures today. Some 67 years after the NHS was founded, a 2013 opinion poll conducted on behalf of the think tank British Future found that the NHS was more popular than at the time of its creation, and more popular than the monarchy, the BBC and the military.

“I do not,” Bevan once told the House of Commons, “represent the big bosses at the top. I represent the people at the bottom, the individual men and women.”



Linkedin


Disclaimer

Views expressed above are the author’s own.



END OF ARTICLE





Source link

Leave A Reply

Your email address will not be published.

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More

Privacy & Cookies Policy