Issues with Medical Education

Background:

  • The serious shortage of health workers, especially doctors, in some northern States is a major impediment for achieving the health-related Sustainable Development Goals.
  • Health workers are critical not just for the functioning of health systems but also for the preparedness of health systems in preventing, detecting and responding to threats posed by diseases such as COVID-19.
  • The workforce crisis has been aggravated by the imbalances within the country.
  • For instance, the doctor-population ratio in northern States is far short of the required norm, while the southern States, barring Telangana, have enough doctors in possession.
  • There is also a general lack of adequate staffing in rural areas.

NITI Aayog’s proposal:

  • The NITI Aayog has proposed allowing private entities to take over district hospitals for converting them into teaching hospitals with at least 150 MBBS seats. There are some concerns associated with this proposal.
  • This would encourage the private sector in medical education directly aiding the corporatisation processes of healthcare provisioning while the under-resourced public health system will be a collateral damage. The corporatisation will make the services of district hospitals very costly.
  • Even from the perspective of producing more doctors to meet the shortages in under-served areas, this is unlikely to yield the desired result. This proposal is not aligned with India’s national health policy goals like achieving universal health care and health equity. It could widen health inequalities further.

Solutions:

  • The government should learn from previous cases of public-private partnerships (PPPs).
  • In the past, contrary to the expectation that markets would help increasing access to primary and tertiary care for the poor through private players, the evidence supporting their effectiveness is very limited.
  • In fact, many PPPs had to be shelved owing to the non-compliance of the agreement conditions by the private sector under which they were also supposed to cater to the non-paying patients.
  • There should be a substantial step-up in public investment in medical education. By establishing new medical colleges, the government can increase student intake as well as enhance equitable access to medical education. Besides, it must allocate adequate financial resources to strengthen the overall capacity of existing medical colleges to enrich student learning and improve output.