Ayushman Bharat: Modi govt hasn’t released a single paisa to Bihar under the scheme

Source: nationalheraldindia.com

After slashing the budget for as many as 18 welfare schemes funded by the Central government, it has come to the fore that the Modi government has not released fund to the Bihar government under the Ayushman Bharat-PM Jan Arogya Yojana (AB-PMJAY) in this financial year.

A source privy to the development told National Herald that the Centre has not released a single paisa to the BJP backed Nitish Kumar government in this financial year.

Although the obvious reason for not allocating a single paisa under the scheme is being cited as the “worst performance” of the state, health experts and leaders of Opposition parties believe responsibility for the implementation of the scheme lies with the ruling party.

“They cannot blame others for the poor performance of the state as BJP-JDU government has been at the helm for several years. They cannot escape the responsibility,” said a whistleblower and an expert who was involved in the formulation of the policies for Ayushman Bharat.

We tried to contact JD(U) spokespersons for their response but they either refused to comment or evaded the question saying, “It is an issue related with the governance”.

We were referred to talk to the Bihar health minister Mangal Pandey. But when we tried to reach out to the minister, we were told that “he is busy and he will get back to us as and when he gets time.”

“Health minister himself has admitted that his ministry has no expertise in carrying out such schemes. ‬‪It shows the apathy and lack of seriousness on part of the NDA government. The dysfunctional and broken healthcare system in Bihar is a glaring example of how Nitish Kumar led NDA government failed people of Bihar,” said Sanjay Yadav,” an RJD leader and political advisor to Tejashwi Yadav.

It is important to mention here that out of ₹1,699 crore released by the Centre under AB-PMJAY this year to various states, Bihar got no grant despite having over one crore intended beneficiary families.

According to the data released by the health ministry, Bihar registered just around 156,000 hospital admissions under the scheme since its launch about 17 months ago, and only about 40 lakh individual e-cards have been issued in Bihar so far.

“Three large states (Uttar Pradesh, Madhya Pradesh and Bihar) which account for 30% of the beneficiary population are implementing the scheme for the first time and hence their demand is still picking up,” the Union Health Ministry told Parliament last week.

Experts believe that the poor performance of UP and Bihar has had a sharp impact on the scheme, whose allocation in the revised budget of 2019-20 has been halved to ₹ 3,200 crore from an initial allocation of ₹ 6,400 crore.

According to the government’s own submission, just ₹100 crores have been allocated to the BJP-ruled UP so far owing to its poor performance. Even out of the revised allocation of ₹3,200 crores, the Centre has been able to spend only ₹1,699 crore which is just over half of the total allocation.

Raghubar Das vows to make New Jharkhand

Source: telegraphindia.com

Chief minister Raghubar Das stressed his commitment to “New Jharkhand” after unfurling the Indian Tricolour at Morabadi grounds here on Thursday, the 73rd Independence Day.

Addressing around 5,000 people, including dignitaries, Das said: “Naya Jharkhand banana hai, yeh mera sankalp hai, yeh meri akansha hai (We have to make a New Jharkhand, that’s my promise and my dream).”

He urged people from all strata — farmers, workers, professionals, youths, craftspersons, mothers and sisters — to work for a happy and prosperous Jharkhand.

Das praised the Centre for removing Article 370 and 35A of the Constitution, and recalled late Prime Minister Atal Bihari Vajpayee’s doctrine of Insaniyat, Jamhooriyat, Kashmiriyat (humanity, democracy and Kashmir’s legacy of amity).

But the bulk of his 30-minute speech was centred around the achievements of his government. This is the last Independence Day before Assembly polls later this year.

Das reeled off statistics to highlight how Jharkhand had grown under his governance. He said: “Growth rate in the last three years is 14.2 per cent and rate of increasing per capita income is 9.1 per cent. During the last five years growth in forestry has been 31.2 per cent, fisheries 15.9 per cent, and agriculture 19 per cent.”

He added: “Jharkhand is the first state to give Rs 5,000 per acre as grant to farmers and Rs 3,000 per month as pension to labourers of the unorganised sector. From next month, the government will start a pension for journalists.”

“So far, 2 lakh people have been helped by the Pradhan Mantri Jan Arogya Yojana (Ayushman Bharat) in the state under which 57 lakh of 68 lakh families are covered. The government aims to give gold cards to all beneficiaries of this scheme by September 25. This apart, 100 mohalla clinics will be opened by September 25 for the urban poor.”

He spoke about big strides made in higher education, including new medical colleges in Dumka, Palamau and Hazaribagh, women’s colleges in 12 district, model colleges in 13 districts and 27 degree colleges and 13 polytechnic colleges.

Das also inspected the Independence Day parade in which platoons of the CRPF, CISF, Jharkhand Jaguar, JAP, NCC, Jharkhand Home Guard and Raksha Shakti Vishawvidyalaya participated.

Cops felicitated

In Jamshedpur, food minister Saryu Roy, who hoisted the national flag at Gopal Maidan, also felicitated Parsudih OC Animesh Gupta and Azadnagar OC Vishnu Rout for their good work. In Ranchi, SSP Anish Gupta gave a cash award of Rs 15,000 to Chutia OC Ravi Thakur for nabbing three snatchers wanted in 30 cases.

Jharkhand ensuring last-mile public healthcare delivery

Source: ehealth.eletsonline.com

With healthcare becoming a focus point, as reflected through Narendra Modi Government’s game-changer Ayushman Bharat scheme, the Government of Jharkhand has gone out of its way to evolve the State’s healthcare delivery system, enabling people of all strata of the society better patient care in terms of accessibility and affordability.

One must have vivid memory of last year’s incident when Prime Minister Narendra Modi had launched the scheme from the soil of Jharkhand, providing much needed succor to poor and vulnerable section of the society. Taking a leaf from the Centre, the Jharkhand Government is taking all measures to improve care delivery system to ensure wellbeing of each and every citizen of the State.

Our latest cover story titled ‘Jharkhand Making Giant Leap to Ensure Inclusive, Affordable Healthcare’ thus touches upon various aspects of this all-important healthcare sector.

It highlights how the State has come a long way since its inception in 2000 and has made tremendous progress in every sectors including healthcare.

Despite having lots of challenges in terms of hilly terrain and a large swathe of tribal population, the State has improved its rank in healthcare index and recent Niti Aayog report vouches for the same. The story encapsulates how the State Government has leveraged Public Private Partnership (PPP) model to fill infrastructural gaps on many fronts.

The latest issue also features insightful interview of Dr Nitin Madan Kulkarni, Secretary, Department of Health, Medical Education & Family Welfare, Government of Jharkhand, who sheds lights on various initiatives of the Government undertaken to improve healthcare delivery to the last mile.

We also have a special feature on Emergency Medical Services which takes into account various aspect of emergency care and its significance in providing immediate care in critical situations.

The magazine has also insightful articles on Public Private Partnership model which plays a pivotal role to resuscitate healthcare infrastructure.

The articles on behalf of Medall, Ziqitza HealthCare, Apollo Tele Health Services, Healthmap, and Tata Motors present comparative accounts of their contribution to bolster patient care across length and breadth of India. With such a bouquet of articles, interviews and stories, we hope this edition will evoke an invaluable response from our esteemed readers.

Ranchi doc performs 246 surgeries under Ayushman Bharat

Source: dailypioneer.com/

While the State Government is consistently seeking the support of doctors and hospitals in making the ambitious Ayushman Bharat Yojana a success in Jharkhand, a cardiac surgeon in Ranchi has gone out of his way to support Prime Minister Narendra Modi’s vision of providing accessibility of expensive medical facilities to the poor.

Meet 54-year-old Dr Kunal Hazari, MS, MCh, who has successfully completed as many as 246 open heart surgeries in less than a year under the Ayushman Bharat Yojana.

Hazari, the Vice Chairman of Medica Superspecialty Hospital near Booty More, believes that every doctor should be accountable for the health of people living in the country. 

“We are all accountable for the health of our citizens – the government, the hospitals and the doctors,” Hazari said. The 246 surgeries that he performed includes Bypass Grafting, Valve replacements, Tetrology under Ayushman Bharat till now, Dr. Hazari started operating cases under this scheme from October 2018. Since then the graph of patients getting treatment under this scheme has just gone up. Today, out of every 40 patients he operates monthly, at least 35 are covered under this programme.

The scheme provides a cover of Rs 5 lakh per family annually for 10 crore poor and vulnerable families.

The beneficiary under this programme can undertake cashless benefits from public and private hospitals across the country. While Private versus Public Hospitals spark an endless debate in terms of facilities and also the eligibility to cover Ayushman Bharat patients, all the hospitals in the nation are accountable to treat patients under this scheme,said Hazari.

“If you are to provide healthcare facility, all the government hospitals need to be strengthened and equipped. Healthcare of its people is the liability of the Government,”he said.

The system or the chain of procedures for getting covered under the scheme is simple and requires the patients to have a ration card which in turn is needed to generate golden cards —  a facility available at the hospitals.

“The procedure and paper work involved has become so systematic and mechanised that now as doctors we can really focus on treating the patients. It also saves time. Talking about cardiac surgeries, time loss is equivalent to muscle loss,” said Dr Hazari.

The golden cards can be generated within half an hour after producing the ration cards meanwhile the patients can be admitted and the treatment procedures can start, he said.

The hospitals are known to receive funds from the Government within the stipulated time.

“Ayushman Bharat is much simpler for both patients and hospitals compared to the earlier BPL healthcare programme. The simple paperwork, systematic checking of facts post treatment, clearing of payments have all cumulatively built trust among private hospitals and doctors. The trend shows that they are taking it up now,” told Dr Hazari on the current scenario of the programme in the State Capital.

The programme cannot be fully crowned as a success as it has its own set of lacunas. Regularised price slabs for a certain type of medical procedure is one of the major issues that has to be resolved.

“With patients the treatment gets customised according to their body response, one patient can take five days to get discharged while others may take up to 10 days and one price bar cannot accommodate both. We are constantly trying to find solution to this gap,” said Dr Hazari who is also a member of Ayushman Bharat board for the state of Jharkhand.

There is a motion to increase the flexibility of the amount by 10 to 15 per cent.

“The satisfaction I get after treating the needy patients is the prime incentive for being an active force in this scheme by the PM for a healthy nation. Finance always comes secondary,” said Hazari.

The enthusiasm of government, doctors and the public is required for this scheme to be a success, government’s feedback and check system being the major drivers of the movement, he added.

After Bihar, a public health agenda for India

Source: thehindubusinessline.com

Global experience shows that building a robust health system takes decades. However, the government has made systematic efforts towards impacting the multiple determinants of health over the last five years. The second term of the Narendra Modi-led government will be crucial for ensuring full implementation of recently launched initiatives in the health sector.

First, a greater push is needed for supporting the development of dedicated public health cadres in States. Whether it is combating a Nipah virus outbreak in Kerala or preventing the death of children due to the Acute Encephalitis Syndrome in Bihar, a strong public health system is crucial. In fact, in a rapidly urbanising and densely populated India, the risk of disease outbreaks and spreading of contagion is much higher.

It took a significant human cost and socio-political crisis after the Severe Acute Respiratory Syndrome (SARS) outbreak for China to boost investments in public health. We must make the recent deaths in Bihar a turning point for prioritising public health in India.

Expanding Ayushman Bharat

In 2018, the government announced the flagship Ayushman Bharat programme which seeks to comprehensively strengthen the health system from the primary level through to tertiary care. With respect to primary care, emphasis will need to be placed not only on accelerating the establishment of Health and Wellness Centres (HWCs) but also ensuring that they are fully functional and delivering comprehensive services, including in areas like mental health and geriatrics.

A strong referral system for those identified to be at risk of non-communicable diseases will also need to be put in place. Further, suitable models for delivery of primary care in urban areas will need to be prioritised as historically sub-centres and primary health centres have not worked as effectively in large, dynamic urban agglomerations.

Over 26 lakh beneficiaries have received treatment thus far under the Pradhan Mantri Jan Arogya Yojana (PM-JAY). The supply of services under PM-JAY will need to be enhanced through the creation of multi-speciality hospitals in the private sector. This will also boost job creation as every additional hospital bed generates an estimated 3-4 jobs. The government can also build on the platform of PM-JAY to expand insurance coverage to a larger section of the population. For instance, a contributory health insurance scheme could be launched for various categories of professionals who are not covered under PM-JAY and can afford to pay a contribution.

A long-standing challenge for India’s health system has been the existence of patient health records in manual or disparate IT systems with little standardisation. This limits interoperability and sharing of information. A key component of the HWCs is the creation of patient health records at the community-level. Further, PM-JAY emphasises electronic records for all patient transactions. What is needed now is an entity that can create a common health data vocabulary and specify minimum data standards. NITI Aayog has put out a strategy paper on the National Health Stack.

Another area in which the government has intervened significantly is enabling access to drugs and medical devices at affordable prices by setting up over 5,000 Jan Aushadhi stores and adopting price control. Going forward, the government would need to iron out any challenges with the business model of Jan Aushadhi stores as well as take steps to boost the domestic production of raw materials for drugs, thereby reducing the country’s dependence on imports.

During the first term of the Modi government several efforts were made to reform medical education in the country. The National Medical Commission Bill, 2017 must be implemented expeditiously. Reforms should also be undertaken along similar lines in AYUSH, nursing, dental and pharmacy education. To boost medical education infrastructure, private partners may be encouraged to establish new medical colleges, linked with district hospitals. I Developing other cadres of health professionals such as AYUSH and nurse practitioners as well as allied health professionals, should be prioritised.

Of course, a key enabler for implementing these reforms and programmes is an increase in government health expenditure to at least 2.5 per cent of GDP by, if not before, 2025. State governments also have a key role to play in ensuring that they spend at least 8 per cent of their budget on the health sector. The government can consider innovative sources of raising funds for health including earmarking revenues from tobacco and alcohol sales, earmarking taxes on sugar-sweetened beverages and utilising social impact bonds.