CHAPTER - 1
INTRODUCTION
“Should medicine ever fulfil its great ends, it must enter into the larger political and social life of our time; it must indicate the barriers which obstruct the normal completion of the life cycle and remove them. Should it ever come to pass, Medicine, whatever it may then be, will become the common good of all."
(Rudolf Virchow, c.1850)
Right to life includes ‘Right to health’. Right to health cannot be confined to particular bureaucrats, Government, health experts or doctors but it should be accessed by every human being and specially the most marginalized must be assured of basic health care service and can demand access to this right without any fear. Looking at the issue of health under the equity regime, it is clear that the massive burden of morbidity and mortality suffered by the deprived majority is not just an unfortunate accident, but a denial of a healthy life because of structural injustice within the health sector. To achieve a decent standard of healthy life, it requires a range of far reaching social, economic, environmental and health system changes. To change the whole system we have to transform everything into shape within and beyond the health care sector which would ensure an adequate standard of health for all.
It is now established and recognized that right to health is a basic human rights and along with the basic human care is needed to a population for sustainable and equitable economic growth. The ‘Economic Growth above all’ by Dr. Amartya Sen says,
'Among the different forms of intervention that can contribute to the provision of social security, the role of health care deserves forceful emphasis. A well developed system of public health is an essential contribution to the fulfilment of social security objectives. We have every reason to pay full attention to the importance of human capabilities also as instruments for economic and social performance. Basic education, good health and other human attainments are not only directly valuable. These capabilities can also help in generating economic success of a more standard kind.”[1]
The right to basic health care is recognised internationally as a human right and India is a signatory to the International Covenant on Economic, Social and Cultural Rights which states in its Article 12. The States Parties to the present Covenant recognise the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. There are various steps that can be taken which include those necessary for the creation of conditions which would assure to all medical service and medical attention in the event of sickness. There are other similar International Conventions, wherein the Government of India has committed itself to providing various services and conditions related to the right to health, e.g. the Alma Ata declaration of ‘Health for all by 2000’. The National Human Rights Commission has also concerned itself with the issue of 'Public health and human rights' with one of the areas of discussion being 'Access to health care'. The need of the hour is to ensure the action in realistic manner, time-bound and accountable framework.
The term ‘deficiency’ in medical services should extend beyond the doctrinal definition for the term given under the consumer protection act 1986, for the purpose of promoting human rights. The foundation of this term in fact stems from the concern expressed by the International Organisation for Consumer Unions[2] (IOCU) and the United Nations Guidelines on Consumer Protection[3]. If deficiency in medical services is examined in the light of the principles projected by these bodies, the following circumstances can be identified as leading to deficiency in medical services.
- Denial to access health services which include access to basic medical services.
- Advanced medical treatment which may be life saving procedures, cosmetic procedures, or procedures for satisfying desirable human needs.
Failure to provide safety of products used in health care services, experimental medicines and clinical trials on human beings and abuse of diagnostics and curative procedures can also lead to human right violation. India urgently needs to spend more on healthcare and save its poor population from poverty and hunger or face the risk of slower economic growth and sustainable development which is very much important to meet the millennium development goals. It is worth saying that a sick and vulnerable population which cannot act at par with healthy population, will not contribute much to the economic development of our country. “It is a hard fact to digest that the Government spends only 1% of its gross domestic product on healthcare facilities, forcing millions to struggle to get and access healthcare services in India. Indian authorities themselves admit of corruptions and inefficiency in the government system, especially in villages where health centres do not have medicines or doctors. After calculations it is said that to meet the success of millennium development goals by 2015, India needs to spend 3% of its GDP on health sector. The crucial fact is that India’s maternal mortality rate (MMR) stands at 450 per 100,000 live births against 540 in the 1998-99 period - and way behind the MDGs which call for a reduction to 109 by 2015. To improve this poor condition, India needs to increase public expenditure and ensure better healthcare facilities.”[4]
Agreed. But who is going to act ?
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