The recently enacted Right to Health Act of Rajasthan has become a subject of hot debate with many renowned health activists welcoming it but at the same time some professional medical organizations and private health care providers opposing it. To clarify the issue, the Jan Swasthya Abhiyan (JSA), a joint platform of hundreds of health organizations and networks, has recently issued a statement which welcomes this legislation but at the time also draws attention to the potential and need for further improvements.
This statement says, “ Jan Swasthya Abhiyan welcomes the Rajasthan Right to Health Act passed in the State Legislative Assembly on 21st March 2023, and congratulates the State government of Rajasthan for achieving an important milestone in the history of Health policy in India. Rajasthan has initiated the process of making basic health services a justiciable right, based on providing legal guarantee of public health services and emergency healthcare in the state, setting a historical example for the rest of the country. JSA criticises the misinformation being spread by certain lobbies which are claiming that the act is anti-private sector, linked with their politically motivated demand that the Act should be withdrawn. At the same time, Jan Swasthya Abhiyan is also concerned that despite several strengths, some provisions in this Act need clarifications or modifications to ensure optimally effective implementation of this Act. This would ensure realization of health rights for people of the state, while also being fair to healthcare providers.”
In particular the JSA has recommended that the following issues should be addressed by the State government:
- Greater clarity and specificity are required regarding the definition of “emergency care”, keeping in view the complexities of emergency management, and the limited set of first aid measures which can be offered by most healthcare providers
- Larger private hospitals (those having over 50 beds) should have broader provisions for providing emergency services, while smaller health care providers and clinics should have restricted obligations in this regard, in keeping with their limited capacities
- Ensuring that reimbursement to private providers for providing emergency healthcare would be transparent, hassle-free, corruption free and time-bound
- Increasing the State health budget, to provide the substantial additional resources whichmust accompany expansion and strengthening of public health services in the state, required for fulfilling all the provisions under this Act
- Strengthening mechanisms to ensure accountability of regulatory authorities to people as well as involved healthcare providers
Further the JSA has expressed satisfaction that the Rajasthan Government has agreed to address many of these issues on the floor of the State Legislative Assembly, or in their other public communications. At the same time it has expressed concern certain entities have have been engaging in agitations aimed at pulling down the Act itself, perhaps without realizing the fact that such a stand goes against the ethos of the medical profession, and the duties of healthcare providers to fulfill people’s right to health care. The JSA has urged such organizations to reconsider their position, and to positively engage with, support the further rolling out of the Act and its Rules.
The JSA has expressed appreciation that the Government has been consultative in the process of developing this legislation and has already accommodated many suggestions from associations of private doctors. After the State Government first introduced the draft bill in the Legislative Assembly in September 2022, it was sent to a Select Committee of the Assembly, keeping in view concerns of private doctors’ associations. Then there were several rounds of discussions with various groups, leading to a series of amendments to the earlier draft of the bill. Given this background of consultations, JSA has expressed regret at the “the misleading campaigning by certain lobbies which claim that doctors’ concerns have not been considered.”
While strongly welcoming the current Act as a major step forward for ensuring the right to health services for people in the state, the JSA has urges the State government to address the following issues in further processes, to ensure the full effectiveness of this initiative:
- The current Act mainly ensures Right to healthcare; to move towards comprehensive Right to Health, further concrete steps are needed by the state to ensure entitlements to determinants of health (such as food security and nutrition, water supply and sanitation, healthy environmental conditions etc.);
- Provisions for helpline and web-based grievance redressal systems for patients which were made in earlier versions of the Act need to be restored;
- The Act must ensure health rights for all persons present in the state, not only permanent residents but also migrants, nomadic persons, visitors from others states etc.
* Set up strong oversight and accountability bodies so that the services to ordinary people are guaranteed to be provided with dignity, while reimbursements to the private sector providers are ensured in a transparent corruption free environment, within stipulated time frame;
* Adopt a well-defined plan for substantially enhancing the State health budget in line with theobligations and enhanced requirements being generated through this Act, in order to ensure overall
expansion and strengthening of government provided health services in the state;
Jan Swasthya Abhiyan’s National Coordination Committee and JSA Rajasthan state unit have concluded this statement by offering offer their full support and solidarity to the Government of Rajasthan towards realizing health rights for all people of the state.
The writer has specialized in development issues.