India needs a holistic care system that is universally accessible, affordable and effective and drastically reduces the out of pocket spending on health. NRHM has failed to meet the objectives and will be radically reformed. BJP accords high priority to health sector, which is crucial for securing the economy.
The overarching goal of healthcare would be to provide, ‘Health Assurance to all Indians and to reduce the out of pocket spending on health care’, with the help of state governments.
The current situation calls for radical reforms in the healthcare system with regards to national healthcare programs and delivery, medical education and training and financing of healthcare. Our government would focus on the following reforms in healthcare:
- the last healthcare policy dates back to 2002. India now needs a comprehensive healthcare policy to address the complex healthcare challenges, keeping in view the developments in the healthcare sector and the changing demographics. BJP will initiate the New Health Policy.
- initiate the ‘National Health Assurance Mission’, with a clear mandate to provide universal healthcare that is not only accessible and affordable, but also effective, and reduces the OOP spending for the common man.
- Education and Training – Will review the role of various professional regulatory bodies in healthcare and consider setting up an overarching lean body for healthcare. High priority will be given to address the shortfall of healthcare professionals.
- Modernize Government hospitals, upgrading infrastructure and latest technologies.
- Reorganize Ministry of Health and Family Welfare in order to converge various departments dealing in healthcare, food and nutrition and pharmaceuticals, for effective delivery of healthcare services.
- Increase the number of medical and para-medical colleges to make India self sufficient in human resources, and set up an AIIMS like institute in every state.
- Yoga and Ayurveda are the gifts of ancient Indian civilization to humanity and we will increase the public investment to promote Yoga and AYUSH. We will start integrated courses for Indian System of Medicine (ISM) and modern science and Ayurgenomics. We will set up institutions and launch a vigorous program to standardize and validate the Ayurvedic medicine.
- Move to pre-emptive care model where the focus and thrust will be on child health and prevention.
- School health program would be a major focus area, and health and hygiene will be made a part of the school curriculum.
- Focus on Rural Health care delivery.
- Senior Citizens healthcare would be a special focus area.
- Give high priority to chronic diseases, and will invest in research and development of solutions for chronic diseases like obesity, diabetes, cancer, CVD etc.
- Occupational health programs will be pursued aggressively.
- Utilize the ubiquitous platform of mobile phones for healthcare delivery and set up the “National eHealth Authority” to leverage telemedicine and mobile healthcare for expanding reach and coverage and to define the standards and legal framework for technology driven care.
- Universalization of emergency medical services-108.
- Re-orientation of herbal plants board to encourage farming of herbal plants.
- Population stabilization would be a major thrust area and would be pursued as a mission mode program.
- Programme for Women Healthcare with emphasis on rural, SC, ST and OBC in a mission mode.
- Mission mode project to eradicate malnutrition.
- Launch National Mosquito Control mission.
Poor Hygiene and Sanitation have a far reaching, cascading impact. We will ensure a “Swachh Bharat” by Gandhi ji’s 150th birth anniversary in 2019, taking it up in mission mode by converging resources and building around jan bhagidari:
- Create an open defecation free India by awareness campaign and enabling people to build toilets in their home as well as in schools and public places.
- Set up modern, scientific sewage and waste management systems.
- We will introduce Sanitation Ratings measuring and ranking our cities and towns on ‘sanitation’; and rewarding the best performers.
- Make potable drinking water available to all thus reducing water–borne diseases, which will automatically translate into Diarrhoea–free India.
Rajendra Pratap Gupta
Authored the BJP Election Manifesto 2014 under the Chairmanship of Dr.Murli Manohar Joshi
Rajendra Pratap Gupta
President & Member
Board of Directors
October 27, 2013
Shri Keshav Desiraju
Secretary to the Government of India
Ministry of Health & Family Welfare
Nirman Bhawan, New Delhi – 110108.
Reference: Need for a National Health Policy – NHP
Dear Shri Keshav ji,
I am writing on behalf of the Disease Management Association of India – The Population Health Improvement Alliance. We have been proactively taking up issues with regards to healthcare policy & reforms in India.
On February 01, 2013, when you were appointed as the Health Secretary, people involved with the health sector felt happy that the nation had got its best health secretary! Expectations are running high!
This communiqué is about the need for setting up a team to draft the National Health Policy. Since the last National Health Policy was drafted more than 10 years ago in 2002, a lot of things have changed, like;
- NRHM was launched in 2005 as a flagship program focused on rural health
- RSBY was launched
- Pandemic outbreaks like H1N1 (Swine Flu) have been a surprise and have shaken the world
- Rise of MDR – T.B.
- Increase in the incidence of chronic diseases & the issues related to child health
- Occupational hazards
- High IMR/MMR & MDGs deadline approaching in 2015
Besides, a lot of other developments have taken place, like;
- UID –Aadhaar number for the entire population have been initiated
- Emergence of mHealth & telemedicine
- Newer technological interventions for diagnostics and treatment
- Emergence of Big Data Analytics
- Also that, India is focusing on transitioning the healthcare system to Universal Coverage
- Emergence of innovative concepts, like Disease Management, ACOs (Accountable Care Organizations), HMOs (Health Management Organizations) & Meaningful use.
- Emergence of the prominent role of civil society organizations in healthcare delivery
- Role of social media
The 12th five year plan has often been referred to as the plan for health, and I believe, that it is the right time to set up a committee to draft the new National Health Policy by 2015. Even if the committee is set up in early 2014, it will take at least a year to do the survey and complete the policy and so, most likely, the NHP would be tabled by 2015 and would cover a period of next 10 years (2015-2025).
We are sure that you will consider our request seriously and initiate the process for the new National Health Policy
With best wishes and with warm regards
Rajendra Pratap Gupta
Dr.Manmohan Singh, Prime Minister, Government of India.
Shri. Ghulam Nabi Azad, Union Minister for Health & Family Welfare
Dr.Syeda Hameed, Member, Planning Commission, Government of India
Presidents of all the National Political Parties
Rajendra Pratap Gupta
July 08, 2013
Hindustan Unilever / Colgate Palmolive / The Himalaya Drug Co. / GlaxoSmithKline
Ref: Failure to display properly important information related to potentially poisonous effects of toothpastes / tooth powder on children
I am writing this note on behalf of ‘The Disease Management Association of India – The Population Health Improvement Alliance’.
We have come across a glaring lapse in the manner in which the important information related to the quantity of toothpaste / toothpowder to be used by children is not displayed by your company. The correct quantity should be used and the over usage could be detrimental to the health of the population has not been properly displayed on the packaging. This is a serious issue and cause of immediate concern in the interest of millions of children across the country. I am putting here the message displayed on most of the toothpastes/toothpowders sold in India. It is important to quote here that majority of the toothpastes / powders sold are have fluoride as an ingredient.
- ‘For children under the age of six; use a pea sized amount under adult supervision. Do not swallow. (Printed on Pepsodent made by HUL).
- Keep out of reach of children under 6 years of age. If you accidently swallow more than used for brushing, get medical help or contact poison control. Children under 2 years ask a dentist or physicians (Printed on Aquafresh made by GSK. Of course, I brought this particular pack from U.K. but I guess it would be same for India as well).
- Children under 6 years of age should have adult supervision and use only a pea size amount. Do not swallow (Printed on Colgate made by Colgate-Palmolive).
- Children 6 years and below should have adult supervision and use only a pea-sized amount. Do not swallow. Spit and rinse thoroughly after brushing (Printed on Active Fresh Gel by Himalaya Drug Co.)
It is evident that brushing of teeth daily twice is a message blasted on various media platforms i.e. TV, Radio & magazines every day, but the message (using the right quantity & the potential poisonous effects on the health of children if used more than the size of a pea), which should ideally be put as a warning in bold & red colored alphabets or read out aloud in the TV / Radio is completely ignored in these media blasts.
Also, the message to use ‘pea size’ is put in small alphabets and that too, in English only, It is important to consider, how many Indians would understand ‘size of pea’ keeping in mind the rural & non-English speaking population? This is a serious issue, and I am quite surprised that this has not been raised till date by anyone, and this would have already harmed millions of children across the country.
This amounts to a serious ethical lapse on your company’s part, and conveys lack of seriousness towards the health of the country’s innocent children who are coerced into using tooth paste daily without understanding the harmful effects based on the numerous advertisements blasted on various media platforms.
I also must quote the annual report of the Ministry of Health & Family Welfare, Government of India; “Excess intake of fluoride over a long period of time leads to major health disorders like Dental Fluorosis, Skeletal Fluorosis and Non-Skeletal Fluorosis besides inducing ageing. The harmful effects being permanent and irreversible in nature are detrimental to the health of an individual and the community which in turn has an impact on growth development economy and human resources development of the country” and the Government has started a national programme for prevention and control of Fluorosis (NPPF).
Clearly, business interests of your company have ignored the health issues related to children of this country and this has to be addressed without any further delay.
I would like to hear from you about the action taken in this regard in terms of;
- Immediate warnings to be issued on radio, newspapers and television about the quantity of tooth paste to be used by children and harmful / poisonous side effects.
- Mentioning this warning prominently and highlighting it in local language in red color on the packing and the toothpaste tube.
- Withdrawing the old stocks from the market and replacing them with the new stocks with proper warning.
I am also marking this note to Shri Keshav Desiraju, Secretary- Health, Ministry of Health & Family Welfare, Government of India, for actions that might be needed on an urgent basis & how medical associations like IMA (Indian Medical Association) & IDA (Indian Dental Association) have been endorsing some of these brands might need to be looked into.
In hope of the needful at the earliest possible.
Rajendra Pratap Gupta
Shri. Desiraju, Secretary to the Government of India, MOHFW.
Rajendra Pratap Gupta
President & Board Member
February 13, 2013.
Dr. M.M. Pallam Raju
Union Minister for Human Resource Development
Government of India
Shastri Bhawan, C- Wing, Dr.Rajendra Prasad road.
New Delhi- 110001
Subject: Implementing strategies focusing on Child Health through Ministry of Human Resource Development
I am sure this finds you doing well.
This note is a follow up on my earlier communications on including health education in school / college curriculum. Please refer
- Communication regarding Child Health dated 11th Feb,11 http://dmai.org.in/sites/default/files/Unhealthy_Promotions_MOHFW.pdf
- Communication dated July 11, 2011 on the UN High level summit for Heads of States. http://dmai.org.in/sites/default/files/Note%20to%20PMO%20for%20UN%20Summit%20on%20NCD’s%20%20September’11.pdf
- Communication dated 8th August 2011 regarding, Right to Preventive Care & child health . http://dmai.org.in/sites/default/files/Right%20to%20Preventive%20Care.pdf
- Communication to Shri Kapil Sibal, Former HRD Minister, for including health in the school curriculum. http://dmai.org.in/sites/default/files/Healthcare%20in%20School%20Curriculam.pdf
- Communication dated October 10th, 2012 to Shri Ghulam Nabi Azad, Union Minister of Health & Family Welfare on ‘Pre-emptive care’ focused on child health. http://dmai.org.in/Pre-emptive-Care-A-new-model-of-care.pdf
- My address at the United Nations, on why we need to focus on Child Health? http://www.youtube.com/watch?v=qCTKC4ndjsc
Implementing strategies to ensure good heath among children would require collaborative working between the
Ministry of Human Resource Development along with Ministry of Health & Family Welfare & the Ministry of
Women & Child Development & the Ministry of IT & Communications . We have been following this issue very
closely, and have sent numerous proposals and met up with various officials from time to time.
The following, if not yet implemented, would be a good step to promote child health ;
1. Start a chapter on hygiene & oral care from class 1 onwards
2. Create animated pictures and videos for children’s health that could be multilingual, and can be screened nationally in classes or using mobile health as a medium to disseminate the audio visuals .
3. Have a chapter and subject called ‘Essentials of health’ , which is exam based
4. Define child health and check-up guidelines on the lines of vaccination charts till the age of 15 years. This can
be done by the Ministry of Health & Family Welfare and incorporated in the school curriculum.
5. Child obesity is a serious issue, and this can be addressed by giving right knowledge about ‘Calorie exchanges’. Since parents teach the children, they will also get educated on the same and impact the family’s health. This must be added in school curriculum from class 3 onwards
6. Work outs or Yoga / mediation must be introduced in all schools
- All schools must have ideal height / weight / age charts in all classes, and every 6 months these must be reported in the half-yearly and annual report card. The same way as attendance, neatness , punctuality etc. are reported in class report cards at the PTMs (Parents Teachers meetings)
- It would be a great move if we start giving out 3 %marks or give a grading of A, B or C ( A for being fit for standards , B for borderline & needs improvement & C for being much below the child health metrics ), for various health indicators like dental hygiene, height and weight (BMI – Body Mass Index ), hemoglobin, Vitamin B & D etc.
- Each school / college should have a full-time doctor / health educator
- Junk foods & associated calorific intake needs adequate attention in school level awareness campaigns
- Children do not realize the importance of having adequate quantity of water, and since, in school, they are sometimes restricted to go to toilets, it is high time that the guidelines are issued to all schools for adequate water consumption & availability of drinking water & toilets in school (It might sound trivial, but it is very
Hope this issue will be given the highest priority and attended at the highest level. We will be raising this issue in parliament though members of Parliament from different political parties
For this generation, we are already too late, but we must ensure that the next generation is a healthy one.
In hope of the needful
Rajendra Pratap Gupta
Shri. Ghulam Nabi Azad, Union Minister for Health & Family Welfare.
Shri Kapil Sibal, Minister for Communications & IT
Smt.Krishna Tirath, Minister of state (I/C) for Women & Child Development
Dr.Syeda Hameed, Member, Planning Commission, GOI.
Shri. T.K.A. Nair, Advisor to the Prime Minister.
Shri Keshav Desiraju, Health Secretary, GOI.
Shri Ashok Thakur, Secretary, Min. of HRD.
Shri Prem Narain, Secretary, Min. for Women & Child Development.
Dr.Jagdish Prasad, DGHS, MOHFW
Dr.K.Srinath Reddy, President, PHFI.
Rajendra Pratap Gupta spoke at the United Nations General Assembly Hall on the issue of NCDs ( Chronic Diseases). This was for the Heads of State Summit on NCDs.
Yesterday, i participated in the meeting of what the United Nations must do to the MDG’s ( millenium Development Goals ) post 2015 , when the MDG’s comes to an end in terms of the timeline .
I have suggested that ‘ without sustainable livelihoods for a family’ , MDG’s could never be achieved , so this must come at the forefront .
Access to ICT’s should be made a MDG
Improving life expectancy makes sense seeing the infant mortality and maternal mortality
Further , the MDG’s related to health be ‘clubbed’ and the definition be expanded to provide access to ‘ Preventive health’ as a MDG
Multi-skilling along with education needs to be put than the universal primary education as a MDG
Also, private sector needs to be involved in conceptualization , planning and execution . I further added , that , if the private sector was involved as a partner in MNAREGA and MRHM , things would have been different
Charity is as deep as profits …… time to work as a TEAM ( PPP), else ‘laudable’ goals will become ‘laughable’
Rajendra Pratap Gupta
Rajendra Pratap Gupta
President & Board member
December 27th, 2012
Dr. Murli Manohar Joshi
Public Accounts Committee
6, Raisina road, New Delhi 110001
Ref: Auditing of the unused budgetary allocations for Healthcare sector
Dear Dr. Joshi,
Greetings from the Disease Management Association of India (DMAI).
This has reference to the meeting at your residence on 25th December 2012, and the discussions that we had on the Public Accounts Committee report on NRHM (PAC NO. 1939). I have gone through the PAC report submitted by your good self to the Parliament. I wish to draw attention to the following references in your report;
Page 9: Mission Steering Group (MSG) was required to periodically monitor progress of the mission and to meet twice a year. Audit scrutiny revealed that MSG met only four times in four years instead of 8 times as per the laid guidelines.
The delegation of powers to the MSG and EPC (Empowered Programme Committee) was subject to the condition that a progress report regarding NRHM, also indicating deviation from the financial norms and modifications in ongoing schemes, would be placed before the cabinet on an annual basis. However, during the past four years, the Mission had submitted a progress report to the Cabinet only once in August 2008 (as per the PAC report).
Page 12: Public Private Partnerships (PPP) in RCH services is not up to the expected levels
Page 18: Regarding composition & functioning of the VHSC (Village Health & Sanitation Committee)
Secretary Health’s statement,
“To be very honest with you, we have got a survey done recently by the Institute of Population Sciences, and yesterday they gave us a presentation. It is not a very happy picture on the village health societies. In many of them, people did not know if they existed; they did not know who the members are; they did not know if they are functioning; that was the finding of the planning Commission’s mid-term review also, when they had gone round the country and seen… that is VHND. There is certainly a vision in the NRHM when it was designed. That has not been fructified……….
“ Our experience with Panchayat raj is not good. They also complained about it. Half of the fund is not spent because he is the co-signatory – either he is not living in the village or if he is, he harasses her and why should she sign? The entire Panchayat raj system, with due respect, has not really worked; the ideal is one thing, but practically it is not; those who take interest, have got excellent experience, but those who are not interested, it is not good. It is very difficult for these people; it has not worked out well”.
Page 19: Health Secretary’s response on, “how the ministry ensures that the disbursal of funds by the state health societies to VHSCs is monitored”?
“This is a huge task for the states. They are finding it very difficult to keep a track of so many small accounts. But we have given them accountant at every block level. In a block there will be some 100 VHSCs. He should have been able to get these accounts and see what they have spent on and do the auditing. We will have to streamline it further and get them to do the auditing. But we suspect about Rs.100-200 Crore lying unspent. That is our present assessment”
Page 20: Table 3 highlights the gap between the funds released and expenditure.
Page 23: Point 55, “ However, the Ministry have clarified that actual utilization of the funds allocated shall depend upon a number of factors in particular the absorptive capacity of the system. In fact, one of the argument put forward by many is that while the actual allocation in the Eleventh Plan was lower than the original plan allocation, the actual expenditure has still been lower i.e. the system has not been able to utilize the curtailed outlay”
Page 28: “It may be observed that rural households account for around 55 % of the total out of pocket expenditure within the country”
Page 31: Audit examination revealed that 71 PHCs (11 per cent) in 15 states were functioning without an allopathic doctor. In 518 PHCs (86 per cent) of 28 States / UTs, an AYUSH doctor had never been appointed. 69 test checked PHCs were functioning without an allopathic doctor or an AYUSH doctor. This meant that population residing in their sphere of coverage had no doctor available at all in the public domain. In Andhra Pradesh, Haryana, Himachal Pradesh, Kerala, Madhya Pradesh, Mizoram, Punjab, Sikkim, Tripura and Lakshadweep, none of the test checked centres had an AYUSH doctor.
Page 33: “As per norms, Specialists are appointed only at CHCs level and not at PHCs level. As per the data available in Bulletin on Rural Health Statistics in India (Updated up to March 09), a total of 5789 specialists are in a position at CHCs across the country, as against the sanctioned posts of 9028 specialists…………”
Dr. Joshi, as discussed during our meeting, it is imperative that the PAC / CAG, or any competent independent regulator, starts the audit of unspent funds allocated for each social sector so that the benefit of the plan reaches the targeted population. As DMAI, we would be interested in pursuing this issue further with the concerned authorities. Also, a clear and enabling policy framework is required, so that the bureaucrats can take decisions without fear on fund allocation utilization, and the absorptive capacity of the system increases to 100 %.
I have been visiting the rural sub-centres and have been gathering first hand information about the impact of NRHM. This communiqué is marked to the PMO and MOHFW for information. Will meet you shortly with more details
Thanks for your continued support
Best wishes for a great year ahead, & tons of good wishes for your birthday, in advance. Wish you good health & long life.
With best regards
Rajendra Pratap Gupta
CC: Dr.Manmohan Singh, Prime Minister,
Shri Ghulam Nabi Azad, MOHFW
Dr.Syeda Hameed, Member, Planning Commission
Secretary – MOHFW
President , PHFI