This refers to Prof. Syed Amin Tabish’s article “Challenges and opportunities” about the health sector in Jammu and Kashmir (GK Dec 28). Without challenging the authority of the author to speak on the subject, it seems he has overlooked many issues which merit our attention. Blaming rising population for everything seems illogical. We must know that there have been scholars and researchers like Mahmood Mamdani who have refuted the notion of illiteracy being the cause of bigger families. I agree with Mr Tabish on the issue of providing incentives and facilities to doctors serving in rural areas. Also it is beyond any doubt that district health centres should be made the hub of the health services. However, I could not understand why the author has not made any mention regarding the public health aspect as a whole. There are important bottlenecks that need to be removed while thinking about the health sector development in the state.  The growing problem of the pharmaceutical drug market in Kashmir poses a greater risk to the population at large. Prescription from a doctor should be the sole criteria for getting medicines from the market but in reality it is not like that. Private practice is strengthening the medical industry in Kashmir. The two main characteristics of healthcare which lead to market failure and thus necessitate state intervention are the presence of externalities and information asymmetries (Jayati Ghosh, 2006). There have been studies (Ramesh Bhat, 2005) which have shown that the out of pocket expenditure in India from a patient is about 80% and thus one cannot not understand how come the public private partnership is going to serve the purpose. If we need to increase private investment like the Apollo and Fortis, then the new phenomena of medical tourism will be taking the shape. I feel the urgency of time is that there should be the increase in the health sector spending from the government side and more focus on the public health. The overall spending of the GDP from present levels of 1% should rise to 2-3%. The government health spending of India is already low than many Asian countries. Keeping in view the topography and the nature of conflict, there is need of some innovative ways to deliver health services to people. Policy makers have to look for services like trauma centres, emergency clinics and ambulance services.

Bhat Iqbal Majeed
Research scholar
Centre for Social Medicine and Community Health
JNU
bhat.iqbal@gmail.com

Lastupdate on : Thu, 30 Dec 2010 21:30:00 Makkah time
Lastupdate on : Thu, 30 Dec 2010 18:30:00 GMT
Lastupdate on : Fri, 31 Dec 2010 00:00:00 IST