A Right to Health bill at the central level may still be in the works, but a draft bill in Rajasthan that proposes to hold the government accountable for providing affordable and easily accessible healthcare for all citizens has garnered attention across the country.
The draft bill promises free consultation, drugs, diagnostics and emergency care at all government hospitals to Rajasthan’s 80 million people. It makes Rajasthan the first state in India to propose a guaranteed right to healthcare to its residents.
The bill was placed in the public domain recently for stakeholder comments and feedback, which are being incorporated in the draft before it is presented in the state assembly.
Rajasthan chief minister Ashok Gehlot had promised the right to healthcare ahead of the state assembly elections in 2018. Extensive consultations for the draft bill started soon after he was elected. After disruptions caused by the Covid-19 pandemic, the draft bill was published on March 8 and stakeholders were invited to share their feedback.
“While on the one hand, the pandemic delayed the work on the draft bill, on the other, it also necessitated its progress as this massive public health emergency exposed the chinks in the healthcare system nationally,” said a senior official who was instrumental in drafting the Rajasthan bill. At the heart of the draft bill, according to state authorities, is the government’s intent to commit to quality and affordable healthcare services through fully functional and easily accessible government and private healthcare providers.At the heart of the draft bill, according to state authorities, is the government’s intent to commit to quality and affordable healthcare services through fully functional and easily accessible government and private healthcare providers. healthcare services and shows how committed the government is to make healthcare accessible and affordable,” a state health department official said.
The first draft of the bill has seven chapters that include the rights and duties of citizens, obligations of the government, and constitution of state and district health authorities and grievance redressal mechanisms.
“This bill is important because even though it may not be sufficient in itself to bring about changes in the healthcare landscape without filling gaps in resources, at least it makes the government accountable,” said a specialist attached with the World Health Organization in India.
In practice, the specialist added, citizens can enforce that accountability and take the government to court if it fails to fulfil its obligations.
“To my mind, there are many lessons in the Rajasthan bill for other states as well as the Union government,” the specialist said.In a country with high dependence on the private sector for health services, the draft bill may have come as a breather.
However, Chhaya Pachauli, director of voluntary group Prayas, pointed out that many clauses in the draft bill were open ended and vague. The proposal to make healthcare “accessible to all” lacks specifics, she said.
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“Basic primary care should be available within half an hour of walking distance, comprehensive primary care within 12 km, secondary level care within an hour’s distance by motorised vehicle and tertiary care within 150 km,” she said. “Without specifications to all the rights proposed, the bill won’t be able to lead to any substantial improvements in healthcare delivery.”
Prayas, which participated in the consultative process ahead of the drafting of the bill, has sent a 30-page document with suggested changes to the state health department.
“We are aware of the changes being demanded, but all those can be incorporated in the rules and descriptions after the enactment,” the official said.
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