ALL INDIA CONGRESS COMMITTEE
24, AKBAR ROAD, NEW DELHI
Highlights of CP interaction with Health Professionals: 15 March, 2019
Congress President Shri Rahul Gandhi interacted with Health Professionals in Raipur, Chhattisgarh.
Shri Rahul Gandhi said- Mr. Punia, Chief Minister Bhupesh Baghel Ji, T.S. Singh Deo Ji, Charan Das Mahant Ji, Lalit Surjan Ji, Dr. Yogesh Jain Ji, Dr. T. Sundar Raman Ji, all ministers and health care professionals and experts, thank you very much for coming here. It is an honor and pleasure for me to have a discussion with you.
I think, format was that we would have a bit of an interaction. So, we can begin that. I have got a slight issue with timing now, so, we will have to keep it a bit short. At the end of that I can give you my views.
On a question regarding to the commitment of the Congress Party to strengthening the Public Health System, Shri Gandhi said- India is transitioning from a rural system to an urban system and it is a massive shift that is taking place and it is a painful shift, it is not an easy shift, it is a traumatic shift. There are three things that any Government in the 21st Century have to do to protect India’s citizens. Number 1, we have to fix the unemployment and job problem, Number 2, we have to give low cost-high quality education to our youngsters, Number 3, we have to ensure that they are protected as far as their health care is concerned; these are in my mind non-negotiable things. If we don’t do one of these, if we don’t do all of these, we are not going to be successful, so, that is point number 1.
Number 2, the biggest cause of falling back into poverty is health care, everybody knows that, it is being said numerous times. So, health care is in a sense a foundation and we have to ensure the that foundation is built firmly. So, the first response to your question is; A Government in 2019, a Congress Government in 2019 is dramatically going to increase the amount of money we put into the health care and education and we are not going to put money in ways that allow limited number of people to make massive amounts of money, that is how I view the Ayushman Bharat Scheme. If I want to be kind to it, I see it as a limited scheme that is targeting very limited number of health care issues and if I want to be frank, I think it is a hand out to the 15-20 richest businessmen in India. So, that is not the type of scheme we are going to run, I am absolutely convinced that you need public expenditure in health care and in education, not only, private, but, public.
There is of course a role for private institutions, there is a role for big businesses , there is a role for insurance. There is a role even for private providers of health care, but, the foundation in my view, has to be government and public sector and I don’t think this is an impossible goal, there are couple of very interesting models, there is Rajasthan’s model, there is some of the work being done in Chattisgarh, these are I think places where we can look to find some of the solutions. But, I am committed and aggressively committed to taking the expenditure on education to 5-6% and taking the expenditure on health care to about 3%. That is my view. So, I think that would be broadly, how I would answer your question. I think, I find the work done in Rajasthan particularly with the medicines to be very-very interesting.
एक प्रश्न पर कि सरकार अस्पतालों और मेडिकल कॉलेजेज की दुर्दशा के बारे में, ड्रग डिलीवरी सिस्टम, जो आम व्यक्ति को जरुरत पड़ती है, ओपीडी मे, इमरजेंसी मे जो ट्रौमा और बड़े उपचार में दिल की बीमारियों के लिए होती है, जो चिकित्सा शिक्षा में उदारीकरण आना चाहिए था, 30-35 साल पहले देश में, उसके लिए, देश के लिए आप क्या करने जा रहे हैं, श्री गांधी ने कहा कि जैसा मैंने अभी बताया, सबसे पहले अगर आप पब्लिक हैल्थ केयर सिस्टम बनाना चाहते हैं, तो आपको सरकार को बजट में पैसा डालना पड़ेगा, तो पहला स्टेप वो है। दूसरा स्टेप बिना एक नेटवर्क के जैसे आयुष्मान भारत का, मेरा एक क्रिटिसिजम है, कि आप इंश्योरेंस दे रहे हो, पर आपके पास अस्पतालों का, मेडिकल प्रोफेशनल्स का जो स्ट्रक्चर है, वो उस इंश्योरेंस को सपोर्ट ही नहीं कर सकता है। बिहार मे जाईए, यूपी में जाईए, आपने इंश्योरेंस दे भी दिया तो कौन से अस्पताल में जाकर इलाज कराया जाए, that is the fundamental question, तो उसके बिना आपका कोई भी इंश्योरेंस सिस्टम नहीं सकता है, without capacity to deliver medical care. तो मुझे लगता है कि ये पूरा का पूरा नेटवर्क सिस्टमेटिकली हर स्टेट में बनाना पड़ेगा। मेरी स्टाइल, फ्रैंकली, आपको बताने की नहीं है । मैं यहाँ इस एटिट्यूड से नहीं आया हूँ कि मेरे पास सब सवालों के जवाब है, I am not a medical health care professional, you are, so I have come here to give you one particular type of message, that my style of working is to listen to you and work with you. कि मैं आपसे सुनकर, समझकर सोल्यूशन निकालना चाहता हूँ, क्योंकि मैं स्टेज से डायरेक्टली कह देता हूँ कि हैल्थ केयर के बारे में आप मुझसे ज्यादा जानते हो। अगर आप मुझे पॉलिटिक्स के बारे में पूछना चाहते हो तो मैं पॉलिटिक्स के बारे में आपसे ज्यादा जानता हूँ, मुझे लगता है, but, about हैल्थ केयर के बारे में I am convinced that you are more knowledgeable then me. So, who am I to come here and tell you what I think your solution should be. You have to tell me, what you think the solutions are, I have to go and implement the solutions that you believe in. वो फर्क है हममें और भाजपा में और हमने ये राजस्थान में किया और जो यहाँ पर छत्तीसगढ़ में हमारा काम हो रहा है, that is the approach that our Chief Minister and Singh Deo Ji are following. We could not have built a manifesto simply between the 3 of us. हम कर ही नहीं सकते उस को । तो जो मैनिफेस्टो में बनाया है वो आपकी आवाज है और मैं यहाँ आपसे बात करने इसलिए आया हूँ कि मैं आपको ये मैसेज देना चाहता हूँ कि हम आपकी आवाज सुनना चाहते हैं और जो आप हमें एडवाइज दोगे मेडिकल सिस्टम के बारे में, इंश्योरेंस के बारे में, अस्पतालों के बारे में उस एडवाइज को लेकर हम काम करेंगे।that is the difference. Broadly मेरे पास व्यूज हैं, जो मैंने पहले बोले I don’t believe in rampant privatization. I don’t believe that every solution in India is going to come from the same 20-30 individuals. I don’t believe that, they have a role to play but so does everybody else. So, my aim is to go to stakeholders, whether in health care and education and say to you, okay, what do you think and then work together to bring a solution.
नेशनल लेवल के मैनिफेस्टो में I will tell you 2 or 3 things that we are considering. Number 1, we are looking at a Right to Healthcare Act, where we guarantee certain minimum healthcare to all Indians. Number 2, we are looking at increasing our expenditure to about 3% of GDP and Number 3, we are thinking about increasing the number of Doctors, number of professionals we train in the country dramatically, those are three directions that we are taking at the national budget level.
On a question related to the private sector strengthening the public health system how do you regulate the private sector, Shri Gandhi said-I think, it is a complex problem and I don’t think you are going to get a solution from any one stakeholder. I think, private players have a role to play but so does everybody else and what we would like to do and we would like to bring everybody together to solve the issue. I don’t think that simply giving sort of healthcare insurance, entire health insurance to big private players is going to solve India’s healthcare problem. Also, one another thing, when you look at insurance there is an experience that I have on the agricultural side. What is also very important is what the contracts look like? So, for example, in Agriculture, the insurance contracts divide the country up among businesses. So, businesses don’t actually compete for insurance. They are allocated certain number of districts, where they are the kings and they decide everything. So, when you are looking at private insurance, you also have to look at the nature of the contracts that has been designed, which is fundamental.
On another question that there has been a complete denial and complete breakdown of public health system in tribal dominated areas and how do you propose to look at it from a particularly tribal people’s problems, Shri Gandhi said- in my entire campaign in Chhattisgarh and now at the national level that is what I have been saying. I have been saying that there is a dramatic failure on education and health care on the basic needs in the state. So, absolutely I do think, there has been a terrible failure here and it is hugely because of the way that the BJP thinks about development and the RSS thinks about development. The question, I raise here is one of voice, the reason tribal’s do not get a fair deal is because their voice is not heard and their voice is not as well organized, as the voice of certain other institutions or communities. So, I think what I am pushing the Chief Minister and other members in the Cabinet to do, is to be sensitive about listening to people, to be sensitive about listening to tribals and try and understand in detail what their requirements are and work with them to fulfil them. So, we are pretty empathetic and I feel that we have to give a lot of space and do a lot of listening towards the weakest people in society in society in Chhattisgarh, that is just how do I politics.
On another question would you like to include animal health in your vision of universal health care, Shri Gandhi said- One step at a time, I mean I understand your sensitivity and I agree with it and there is a connection between animal health and human health and I take all that but let’s solve one problem first, I think let’s solve the universal healthcare for humans first and then once we solve that problem, let’s go to the universal health care for animals. Though I think it is a commendable idea and I think it is a, there is subtlety in what you are saying because there is linkage between animal health and human health, but, we are at a stage here, where we are trying to solve the first one.
On another question related to the Asha Workers and front line workers in Congress agenda, Shri Gandhi said- I view health care provision as something that is done by a large number of stakeholders, so, there are Asha workers, there are doctors, there are other professionals, there is big business, there are a whole set of stakeholders, my approach is that each one of those stakeholders should have a role to play and each one of those stakeholders their territory should be defended. So, it shouldn’t be that Asha workers are just crushed and wiped out and that space is left empty because we are focusing on just one stakeholder. One of my complaints about what the BJP does, is they only look at one or two stakeholders. So, when you are talking about agriculture, or you are talking about health care, they just keep going to back to those same 50 people and I do agree those 50 people have a role, but, they are not the only people with a role. And I am sensitive about voice so I want to know who are all the other stakeholders and each one of those people should be heard. So, absolutely I would be for training Asha workers, supporting Asha workers, increasing their salaries, 100%.
On another question in our country at present a lot of discussions are going on. I heard that private sector has a role to play and the truth is that at present 70% of the care is taken by the private sector. So, any scheme cannot ignore private sector to be given in work, but, what the Government’s plans in long run that will take a very long view, so, initially, every stakeholder has to be taken account including the private sector and as you reiterated we are involving all the stakeholders, but I think there is some lack in that every stack holder is not being properly looked into, Shri Gandhi said- Yes, No, I would agree with what you are saying. I am not saying in any way that the private sector does not have a role in solving the health care problem in India. They absolutely do, but, so does government and we have to work together, private sector and Government to ensure a proper solution.
Shri Gandhi said- I have a tour in Orissa, and I am having a time constraint now, because the programme has gone much longer than it was planned. So, I would like to thank all of you for coming here and it has been a pleasure for me to listen to you. I just want to tell you that the doors of our Government in Chhattisgarh and my doors are open to you any time you want to discuss any of these issues, we don’t think of this as a one time interaction or a one time conversation. जब भी आप आना चाहें, जब भी आप सुझाव देना चाहें, हैल्थ केयर की प्रोसेस में हम आपके साथ चलना चाहते हैं और आपके पास एक्सपर्टीज है, हम इसको मानते हैं, कि जानकारी आपके पास है और हम आपके साथ मिलकर हिंदुस्तान का, छत्तीसगढ का, जो हैल्थ केयर प्रॉब्लम है, उसको रिजॉल्व करना चाहते हैं।
आप सबको बहुत-बहुत धन्यवाद, नमस्कार।