Why has Bahutva Karnataka failed Karnataka's healthcare system in their report? What are the concerns that need to be addressed soon?
The Bahutva Karnataka has 'Failed' Karnataka's healthcare system in its report card. (Wikimedia Commons)
The Government of Karnataka has received a failing grade in the state’s health sector evaluation by Bahutva Karnataka, a forum for justice, harmony, and solidarity. The assessment revealed that the government has fallen short of meeting its stated goals and has, in fact, failed to ensure health as a fundamental right.
A report card on the state of healthcare in Karnataka was released at a webinar on Thursday, 13 April. The report revealed a range of issues that are a cause for concern for the public and, if not addressed, could be dangerous to public healthcare entirely.
The webinar, which had members from civil right organisations as well as doctors, nutritionists, health activists, and political leaders, spoke of the failure of the government to fulfill its own promises made in the last eight years to provide adequate healthcare to the people of Karnataka.
The experts at the webinar argued that when the state government came into power, a series of promises and announcements were made to offer comprehensive healthcare that is accessible to all.
Karnataka government has reduced access to education and is openly promoting casteism and communalism in the education system.#fail
Press conference by #bahutvakarnataka today to share the report card https://t.co/0OvlR8IgNm pic.twitter.com/TmLU8RydOb
— Bahutva Karnataka ಬಹುತ್ವ ಕರ್ನಾಟಕ (@BahutvaKtka) April 12, 2023
“It was all unfortunately only on paper. The Covid-19 pandemic brought to light the inadequacies and inequalities of the public healthcare system, which is under-resourced and overwhelmed. Private facilities are unregulated and costly, leaving the state’s residents at the mercy of corporate players,” said Dr Sylvia Karpagam, a public health doctor.
The report also highlighted the discrimination within and by the healthcare system, particularly during the Covid-19 pandemic. The marginalised communities, including garment workers, those living in the slums, and in rural areas, are particularly affected by the inadequacies of the healthcare system.
Speaking about the sad state of Employees’ State Insurance (ESI) hospitals in Karnataka, Dr Pratibha, president, Garment And Textile Workers Union (GATWU), highlighted how the ESI is a responsibility of both state and the Centre, but the state has been consistently underfunding the scheme.
Representational pic of ESI Hospital
“Garment workers, many of whom are from marginalised communities, are unable to benefit from the scheme and neither are their occupational health issues addressed,” she said.
Dr Pratibha explained that the state government has even failed to ensure that the timings of the functioning of the ESI is in tandem with the workers’ working hours.
The hospitals that are meant to provide affordable and quality healthcare to the employees in the organised sector are plagued with issues such as inadequate infrastructure, shortage of staff, lack of equipment, and poor maintenance.
Patients have been complaining about long waiting periods, dirty wards, and unavailability of essential medicines.
“Several rural areas do not even have access to the health facilities of ESI. They have no option but go to private hospitals for care. Funding to the ESI has been steadily coming down and contribution from the employer has come down too. This itself can break down the ESI system and open the door for privatisation. This affects the informal sector workers in a very bad way,” explained Dr Pratibha.
Strongly condemning the state of women’s health in the state, Dr Akhila Vasan from Karnataka Janarogya Chaluvali — an organisation fighting for health rights — questioned the recent celebration by the Karnataka Health Ministry on the reduction in the maternal mortality rate (MMR) in the state.
“Over the last few years, the state government has been celebrating the dip in maternal mortality rate. But what they are not telling people is that Karnataka has the worst indicator for women’s health. The MMR of 69 is actually worse than Jharkhand. So what are they celebrating? This is an indicator of gross inequality,” she opined.
She added that despite being less resourceful than Karnataka, the neighbouring state of Telangana has better health indicators. While Kerala’s MMR is 19 and Telangana’s is 43, Karnataka’s is 69.
Women in Karnataka also face numerous challenges, including a lack of awareness, social stigma, and inadequate support systems, she noted.
It is crucial for the state government to prioritise women’s health and take urgent steps to address these issues. Unless the state takes concrete measures to improve women’s health outcomes, it will continue to lag behind in terms of healthcare indicators, said Dr Akhila.
The report and also the experts at the webinar highlighted the danger of privatisation of district hospitals. Calling it a “crime”, the experts said that the state government is snatching basic rights of healthcare by handing over district hospitals to private establishments.
Going into the details, Dr Akhila said that the public health system is broken and all essential facilities are getting auctioned off by the government to the private sector.
Chitradurga District Hospital is among those district hospitals chosen to run under PPP model. (Supplied)
Handing over district hospitals to private players has been done without any process of consultation or approval from communities that are most affected by these decisions and this is a sure sign of a failing democracy, she said.
She added that medical education is already unaffordable. When medical colleges are handed over to private sector, there is no social justice and principles of reservation will not operate. “This leads to exclusion of marginalised communities in the healthcare sector. Even bureaucracy is not involved in decision making about public-private partnership and this will have a huge effect on people’s access to healthcare. In fact, international and financial investment firms are going to benefit the most,” she said.
Dr Veena Shatrugna, retired deputy director, National Institute of Nutrition (NIN) said that every individual in districts and villages should fight for their health rights and must not let the government handover the district hospitals to private establishments.
She said, “Rajasthan’s passing of the Right To Health Bill is a great move and, similarly, we must fight for our rights. We must not let the government hand over the district hospitals. Villagers must come forward and fight for this.”
Terming the establishment of “Namma Clinics” by the BJP government an “election gimmick”, many of the speakers mentioned that these clinics were inadequate and not functioning properly. Instead, the same resources could have been used to upgrade existing urban health facilities that face shortage of skilled staff and basic facilities, they said.
Namma Clinics are an initiative by the Karnataka government (Supplied)
A Narsimhamurthy, Slum Janandolana Karnataka, endorsed the report card of Bahutva Karnataka and said that the “Namma Clinics” in slum or urban-deprived areas are still not functional.
Healthcare is largely unaffordable to the people living in slums. Even they are forced to access private healthcare, he stated.
Many political parties mention health in their manifesto but there is no serious commitment towards it and he urged that this be done on priority basis. He said that while the Muslim community faced one kind of discrimination during the Covid pandemic, those residing in slums faced another kind of discrimination.
Meanwhile, Nataraja Gowda of the KPCC appreciated the report card initiative. He said that the BJP government never put focus on services like health or education.
If the government has not even learnt its lessons during the Covid pandemic, the deaths in Chamarajanagar, and the deaths in hospitals and makeshift facilities, then it is a serious concern, he noted.
“Children are malnourished and this is mentioned in the report, but there is resistance and objection to eggs in the Mid-Day Meal Scheme. Milk powder has not been given for the last four months. Most of the facilities are only in the cities and there is an urgent need for decentralisation,” he explained.
Adding to this, Fr Anil Dsouza, Loyola Vikasa Kendra Mundgod, said that there is a shortage of doctors and other staff in their local primary health centres. Nurses manage two to three sub-centres and, therefore, antenatal cases or pregnant women are not getting adequate care.
File pic of Karnataka State Health and Medical Education Department Contractual and Outsourced Employees Association (KSHCOEA) who protested seeking abolition of contractual employee system in Karnataka. (Supplied)
“People have to travel long distances to Hubballi or Dharwad for emergency care. Most public facilities refer people to the private sector. There is a need for emergency services close to where people live. He asks why are rural people being cheated of good health facilities,” he added.
CPI(ML) Liberation party’s Appanna said that they have been working with pourakarmikas and other informal sector workers and that this government doesn’t talk about health, water, etc. but only fills people’s minds with non-essential services.
CPI(M) party Comrade Lakshmi said that the government came to power claiming sabka saath sabka vikas, however their lack of vikas became evident during the Covid pandemic.
“The health sector is very unequal. The BJP government says that it stands for health goals, but most of these have not been implemented or seen the light of day. Sustainable development goals (SDG) have just become an advertisement without anything actually being done on the ground. The Oxfam report says that chief secretaries do not have adequate knowledge of SDGs. Although the BJP makes tall claims that they will achieve SDGs by 2030, even 20 percent of these have not been reached,” said Lakshmi.
Dr Veena Shatrugna asked if Karnataka can lead the way in ensuring that all migrant workers get access to healthcare without needing to go back to their own states.
She said that if the government is serious about healthcare, they should appoint people to understand what is happening with the health system. She also reiterated that there is no commitment to data generation by the Centre.
The state should take responsibility to generate data on health, mortality, and nutrition indicators (not Hindu-Muslim data), she quipped.
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