India’s National Human Rights Commission (NHRC) has asked the Madhya Pradesh chief secretary to provide a report on the death of at least 11 patients, including two children, at a state-run hospital in Indore. The patients are alleged to have died after the sudden failure of oxygen supplies at Maharajah Yaswanth (MY) Hospital in the early hours of June 21.
The NHRC said that if press reports about the deaths were true, it indicated “gross negligence” by hospital authorities and amounted to a violation of the right to life of patients. It requested the Madhya Pradesh state government to complete the report within four weeks.
The incident, however, goes beyond MY Hospital. It exposes the parlous state of India’s entire public health sector. Successive governments at the national and state levels have refused to provide adequate funds, while promoting highly profitable private hospitals. MY Hospital is the largest state-run health facility in central India.
MY Hospital authorities denied any problem with oxygen supplies. Divisional commissioner Sanjay Dubey, who is also affiliated with MGM Medical College, to which MY Hospital is attached, rejected allegations of “medical negligence.” He said legal action was being considered against a newspaper that published what he claimed was wrong information about the deaths.
“There is no negligence. I have been to every ward of the hospital and there was no break in oxygen supply,” Dubey said. “It is a tertiary sector hospital with 1,400 beds and on an average, there are 10–12 deaths every day.” Sixty to seventy patients are placed on oxygen every day, he continued, and if “the oxygen supply had been cut off, the rest of the patients should also have died.”
A Times of India report, however, quoted an anonymous senior hospital official who confirmed there was a “disruption” in oxygen supplies at around 3 a.m. “The [oxygen] supply was cut off for nearly 15 minutes. Those who could survive the duration survived,” the official said. “The critical ones died.”
While MY hospital authorities continue to deny any oxygen disruption they have refused to offer any reason for the deaths. Hospital authorities have also seized all the death records of patients from the wards, intensive care units (ICU) and neonatal ICUs.
Hospital superintendent Dr. V. S. Pal admitted to the media that 11 patients died on June 21, yet refused to provide any information. “I can assure that no medical negligence has taken place,” he said, but “I am not at liberty to disclose details.”
Questions about oxygen supply at MY Hospital are not new. In late May 2016, two children died at the facility when they were accidentally given nitrogen gas, instead of oxygen in a paediatric operating theatre.
Total government expenditure on health in India is currently about 1.3 percent of gross domestic product (GDP), among the lowest levels in the world. In 2011 the Indian government’s Planning Commission and High Level Expert Group Report on Universal Health Coverage for India said public health expenditure should be increased to 2.5–3 percent of GDP. Six years later, spending has not reached even half of this target.
Public health expenditure per capita is also among the lowest internationally, with China spending 5.6 times more per person than India and the US 125 times more. As a result, Indians have to personally fund more than 62 percent of their health expenses, compared to 13.4 percent in the US, 10 percent in the UK and 54 percent in China.
Due to meagre government allocations, India’s public health care is both under-financed and short-staffed, with the situation in rural areas far worse than in urban centres. There is an 81 percent shortage of specialists at rural community health centres. About 31 percent of the country’s rural population has to travel over 30 kilometres to get much-needed medical care.
Under these conditions, private hospitals increasingly dominate, reaping massive profits from Indian patients and others in the region. In 2013, India’s private health care sector was worth $US81.3 billion annually and that figure is expected to increase by 17 percent by 2020. According to official figures, the private health sector accounts for 63 percent of hospital beds and over 134,000 patients travelled to India seeking treatment in private hospitals last year.
The vast majority of working people and rural toilers cannot afford the high costs of private health care or health insurance. According to recent data from the Insurance Regulatory and Development Authority, 76 percent of Indians have no health insurance. Indian government contributions to health insurance total around 32 percent, compared to 83.5 percent in the UK.
By contrast, the political and business elite have access to high-quality private health care at home and abroad. Last month, Union Minister of Consumer Affairs, Food and Public Distribution Ram Vilas Paswan flew to London for heart surgery. Early this year, Sonia Gandhi, president of the opposition Congress Party, flew abroad for medical tests and treatment.
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