Minister of State for Health and Family Welfare Ashwini Kumar Choubey says a pilot project of ‘Chikitsa, Chikitsak Aapke Dwar’ will be launched in some districts of UP, Jharkhand and Bihar.
New Delhi: In an exclusive interaction with The Sunday Guardian, Ashwini Kumar Choubey, senior Bharatiya Janata Party leader and Minister of State for Health and Family Welfare (MoHFW), spoke about the targets that the ministry has set for itself under the Narendra Modi 2.0 government.
Choubey said that the government was going to launch the “Chikitsa, Chikitsak Aapke Dwar” scheme under which doctors will be available to the common people at their doorstep, the pilot project for which is going to begin soon. The government is also working to bring the population belonging to the lower income group under the much successful Ayushman Bharat scheme. The ministry is also working on the goal to eradicate tuberculosis (TB) from India by 2025. Excerpts from the interview:
Q: The phenomenon of overcharging by private hospitals, especially by the “big” ones, is an old issue that has refused to subside. Is the government looking into this problem faced by the common man virtually every day?
A: Health is a state subject; however, whenever we get any such complaints, we take proactive actions as much as we can to stop such incidents and deter such practices.
We take it up with the state governments to look into such complaints and take quick action. We already have the Clinical Establishments (Registration and Regulation) Act, 2010 to tackle such issues. Many states have adopted the Act. Those who have not adopted it, we are asking them to do it as soon as possible as it will make the working of the medical establishment across the country more transparent. We do not want to take away the independence of medical establishments, but patients’ interest is paramount for us and we cannot let that be ignored.
Any such incidents (of fleecing, overcharging) lead to questions being raised not just against the private hospitals, but also against the government, both state and Central, and the health department. Please be assured that we are intervening wherever we can. We have been sending advisory notes and following them up. Many hospitals are doing great service, but there are a few that are indulging in malpractice and we will not let them go unpunished if they indulge in wrongful practice. There cannot be any compromise on health and fleecing of patients will not be tolerated.
Q: The number of patients from rural areas who are coming to hospitals in the cities because of lack of medical facilities in their region is increasing every year. How do you intend to address this issue?
A: We are working on a scheme where doctors and laboratory specialists will be available at the doorstep of the common people. This scheme, “Chikitsa, Chikitsak Aapke Dwar (treatment, doctor at your doorstep)” is at an advanced level of finalisation. This will initially be launched as a pilot project in some of the districts of Uttar Pradesh, Jharkhand and Bihar. Doctors and paramedics will be moving around on mobile vans and bikes which will also have laboratory facility that will be able to test around 75 health parameters and give the results then and there. This is going to be executed very soon. Once the results of the pilot project come out, we will accordingly execute it across the country phase-wise. This will greatly reduce the pressure on hospitals.
Similarly, we are working in a very focused way on the aspect of “prevention” and “awareness” that play a huge role in stopping the spread and occurrence of disease and ailments.
When I was the health minister of Bihar, I had undertaken a Swachhata (cleanliness) yatra in 2008-2010, which was called Bihar Gram Gaurav Yatra. I got the inspiration for this yatra when I went to Gujarat when Modiji was the Chief Minister and saw how focused he was on maintaining cleanliness and hygiene. After coming back, I decided to visit villages of Bihar and spend time there and conduct awareness camps during which we also did two hours of shramdan (labour intensive work) every morning, in which, from the lowest ranked government officer to the district collector, everyone took part.
In these camps, which were held in those villages where the state of hygiene was not good, we focused on building toilets and in the three years of this yatra, we were able to build 300,000 toilets in villages of Bihar.
Later, we carried out the Jan Swasthya Chetna Yatra, where we worked on the idea of “Chikitsa, Chikitsak Aapke Dwar, Tabhie Hoga Bihar Evam Desh ka Udaar”.
Since there was a shortage of doctors, we decided to hold “health fairs” in villages, during which 11,000 such fairs were held in one year and 33,000 such fairs were held in three years. As a part of this initiative, top doctors would come to villages and treat patients and identify diseases and ailments at the first stage itself. In three years, 3 crore people were checked. During these three years, we spread a lot of awareness on health-related issues, due to which we witnessed a drop in the number of many diseases in the coming years. Awareness is a very important part of disease prevention and we are working on it in a very focused manner.
Q: What has been the response to the Ayushman Bharat scheme, which is one of your government’s flagship programmes?
A: As you must be aware, under Ayushman Bharat, around 10.5 crore families, which adds up to more than 50 crore individuals, are eligible for free treatment.
In India, annually 6 crore people were entering into the poverty trap due to health problems as they would have to take loans, spend their life savings if they were diagnosed with a disease. The Ayushman Bharat scheme has made a huge impact in stopping people from falling into that trap.
It was with the intention of stopping the common man from falling into this trap that Prime Minister Narendra Modi decided to bring this so that we can give affordable treatment to the last person who is at the economic level.
No one would have imagined few years ago that a poor person of a rural, remote district would be able to get his treatment done at the “big corporate hospitals”; we made that possible. As of today, more than 40 lakh individuals have availed treatment under this scheme and these people were able to save more than Rs 12,000 crore of their life savings, as the government paid for their treatment. Ayushman Bharat is totally cashless and perhaps the biggest example of the success of the Digital India initiative.
Q: There is a concern that many of the needy and those who are eligible are not able to take benefits of Ayushman Bharat because their names are not in the socio-economic census 2011 that is used to determine the beneficiaries.
A: Around 80% to 90% of the intended beneficiaries have been covered. For the rest who have been left out, we are aware of their situation and we are bringing in other methods to identify them. Our goal is health for all and we will leave no one out of that umbrella.
We also aim to bring the lower middle class population under the Ayushman Bharat scheme and we are working very seriously towards it. This reach of this scheme will become broader once we have covered the lowest income strata population. The PM is personally monitoring the implementation of the Ayushman Bharat scheme, and this shows how serious we are about the health of our people.
Q: The situation of health-related establishments at the rural level is still not satisfactory. What is the government doing about that?
A: A large number of the 1.5 lakh health centres and sub-centres in rural India are not in good shape, especially in states like Odisha, Uttar Pradesh and Bihar. In response to that, we are on our path to convert them into “wellness centres” by 2022. This year, our target was that we will convert 15,000 such centres into wellness centres; we have crossed that and are now at 19,000. In these wellness centres, 12 kind of medical facilities will be provided. We want the wellness centres to emerge as the first point interaction for ailments and non-communicable diseases like diabetes, cancer of different types and leprosy so that they can be contained at the primary stage itself.
We are giving specialised training to health providers who will man these centres, so that they can handle it at the ground level. For that, we are putting a lot of effort on bringing tele-medicine and mobile medicine at every such centres. This is making a big impact on reducing the burden on hospitals in the cities as now rural patients are getting basic treatment of high quality in their area.
Earlier, even for a small ailment, people had to rush to divisional hospitals. Now with the upgradation of these wellness centres, this will stop. The villager had to take his relatives, spend money on travelling and lodging at cities for minor ailments; this is reducing now. The economic aspect, too, is being addressed by this thought process that we are following. We are working on a war-footing to increase the infrastructure at sub-centres and government hospitals.
Q: Tuberculosis (TB) and cancer continue to remain areas of concern for doctors and patients alike. How do you intend to tackle them?
A: Our aim is to make India TB free by 2030; however Prime Minister Modi is pushing for ending it by 2025, so we are working on it very seriously and are sure that we will be able to eliminate it by 2025.
We are going to start a big pan-India revolution towards achieving this objective; very soon that will be coordinated by the health ministry under the guidance of PM Modi, which will be called “TB Harega, Desh Bachega”.
Cancer is a concern which I have focused on even when I was the health minister of Bihar.
Cancer is a potent problem because it affects not just the patient physically, but also hurts him or her economically. It also has a very demoralising impact on society. We have to tackle that. To achieve that, we are also taking people’s help, from those who can help by way of donation.
We want religious places to keep donation box for cancer patients, so that the money, through trusts, can go into helping cancer patients. To tackle something like cancer, people’s participation is very much needed, apart from what the government is doing.
We are seeking participation from those who can donate generously. And I have personally experienced that people want to donate generously for cancer patients. So we are planning to build some kind of platform through which cancer patients can get help through private donations. Cancer, if detected and treated at the first stage, can be completely cured, especially in children. IIT Chennai is working on a India-specific cancer genome data so that India-specific medicine is developed. This is a very important step that we are working on with the IIT to tackle cancer in India. They are doing very good work.
We are also working very closely with the Tata Memorial Hospital on how to tackle cancer. We are going to enter into an MoU with Tata Memorial Hospital so that doctors from this institute can go to the rural areas and detect cancer at the very first stage so that it can be treated. We are starting this by initiating a pilot project in Buxar, Bihar.