THE recommendations of the health reforms commission, formed on November 18, 2024, in a report submitted to the government on May 5 after missing out its extended deadline of April 30, appear good steps towards ensuring health care as a fundamental right and improving the health services that have so far been in a deplorable condition. The prime among the recommendations is treating primary health care, as defined by the World Health Organisation, as a fundamental right of citizens and making it free. The recommendations also include unique health identity cards for all, which will enable patients to services at local health centres or tertiary hospitals in a functional referral system, the establishment of primary health centres at all wards, no value-added tax on certain medicines used to treat non-communicable diseases, the allocation of 15 per cent of the national budget, or 5 per cent of the gross domestic product, for the health sector, setting aside 1 per cent for health research, round-the-clock access to chemists鈥�, autonomy for medical education institutions and a special police wing to prevent violence in health centres.
The chief adviser to the interim government is reported to have already instructed officials to implement short-term recommendations. The commission chief says that it is possible to make primary health care free, despite limited funding, with a better coordination and resource management. The commission has also proposed that tertiary hospitals should be established in all divisional headquarters, based on public-private partnership schemes and foreign investment. The commission seeks no value-added tax on medicines for the treatment of cancer, diabetes, high blood pressure and some antibiotics keeping to a list and free access to essential drugs at all primary health centres. The commission stressed the need for the enforcement of the Government Servants鈥� (Conduct) Rules 1979 to stop political activism in health services. It has also sought a ban on gifts and medicine samples for physicians, noting that the marketing of drugs should only be allowed via e-mail or postal communications, so as to limit the influence of pharmaceutical companies on physicians. The commission also rallies for competence-based, community-oriented medical education and a strict oversight of the institutions in keeping with the World Federation for Medical Education standards. The commission has also sought the institution of a permanent, independent health commission and of a separate public service commission for the health sector to manage recruitment in the health sector. It has also sought strict government oversight on hospitals and diagnostic centres in the private sector.
Whilst the recommendations appear a good start to improve the health sector, the issue that remains pressing for the government is to show the will, rising above any partisan or commercial interests.
