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1. TRENDS IN POLICY
DEVELOPMENT
Although the National Health Policy (NHP) in
India was not framed until 1983, India has built up a vast health
infrastructure and initiated several national health programmes over last
five decades in government, voluntary and private sectors under the guidance
and direction of various committees (Bore, Mudaliar,
Kartar Singh, Srivastava), the Constitution, the
Planning Commission, the Central Council of Health and Family Welfare, and
Consultative Committees attached to the Ministry of Health and Family
Welfare. The period after 1983
witnessed several
major developments in the polices impacting the health sector - adoption of
National Health Policy in 1983,
73rdand
74th Constitutional Amendments in
1992, National Nutrition Policy in 1993, National Health Policy in 2002,National Policy on Indian
System of Medicine and Homeopathy in 2002, Drug Policy in 2002, introduction
of Universal Health
Insurance schemes for the poor in 2003, and inclusion of
health in Common Minimum Programme of the UPA Government in 2004.
The first National
Health Policy in 1983 aimed to achieve the goal of `Health for All'
by 2000 AD, through the provision of comprehensive primary healthcare
services. It stressed the creation of an infrastructure for primary
healthcare; close co-ordination with health-related services and activities
(like nutrition, drinking water supply and sanitation); the active
involvement and participation of voluntary organisations; the provision of
essential drugs and vaccines; qualitative improvement in health and family
planning services; the provision of adequate training; and medical research
aimed at the common health problems of the people.
The main objective of the revised National Health Policy, 2002 is to
achieve an acceptable standard of good health among the general population of
the country and has set goals to be achieved by the year 2015. The major
policy prescriptions are as follows:
 Increase public expenditure from
0.9 percent to 2 percent by 2010.
Increase allocation of public
health investment in the order of 55 percent for the primary health sector;
35 percent and 10 percent to secondary and tertiary sectors respectively.
Gradual convergence of all health
programmes, except the ones (such as TB, Malaria, HIV/AIDS, RCH), which need
to be continued till moderate levels of prevalence are reached.
Need to levy user charges for
certain secondary and tertiary public health services, for those who can
afford to pay.
Mandatory two year rural posting
before awarding the graduate medical degree.
Decentralising the implementation
of health programmes to local self governing bodies by 2005.
Setting up of Medical Grants Commission for funding new
Government Medical and Dental colleges.
Promoting public health
discipline.
Establishing two-tier urban
healthcare system - Primary Health Centre for a population of one lakh and Government
General Hospital.
Increase in Government funded
health research to a level of 2 percent of the total health spending by 2010.
Appreciation of the role of
private sector in health, and enactment of legislation by 2003 for regulating
private clinical establishments.
Formulation of procedures for
accreditation of public and private health facilities.
Co-option of NGOs in national
disease control programmes.
Promotion of tele
medicine in tertiary healthcare sector.
Full operationalisation
of National Disease Surveillance Network by 2005.
Notification of contemporary code
of medical ethics by Medical Council of India.
Encouraging setting up of private
insurance instruments to bring secondary and tertiary sectors into its
purview.
Promotion of medical services for
overseas users.
Encouragement and promotion of
Indian System of Medicine.
The first National
Health Policy in 1983 aimed to achieve the goal of ‘Health for All’
by 2000 AD, through the provision of comprehensive primary healthcare
services. It stressed the creation of an infrastructure for primary
healthcare; close co-ordination with health-related services and activities
(like nutrition, drinking water supply and sanitation); active involvement
and participation of voluntary organisations; provision of essential drugs
and vaccines; qualitative improvement in health and family planning services;
provision of adequate training; and medical research aimed at the common
health problems of the people.
Through the 73rdand 74th Constitutional Amendment
Acts (1992), the local bodies (Municipalities and Panchayat)
have been assigned 29 development activities, which have a direct and
indirect bearing on health. These include health and sanitation (covering
hospitals, PHCs and dispensaries), family welfare,
drinking water, women and child development, the public distribution system
and poverty alleviation programmes.
The Common Minimum Programme announced by the UPA government in 2004
has proposed to raise public spending on health to
at least 2-3 percent of the Gross Domestic Product (GDP) over the next five
years, with focus on primary healthcare. The present Government has proposed
to take all steps to ensure availability of life saving drugs at reasonable
prices through revival of Public Sector Units in the manufacture of critical bulk
drugs.
The budget 2004-05 has proposed three major initiatives in the health
sector. They are: (i)
redesigning the Universal Health Insurance scheme introduced in 2003 to make
it exclusive for below poverty level people with a reduced premium (ii) introduction
of Group Health Insurance scheme for members of Self Help Groups and Credit
Link Groups at a premium of Rs 120 per person for
an insurance cover of Rs 10000, and (iii) exemption
of income tax for the hospitals working in rural areas.
Related Links:
Health Policy
India
at glance 
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