Right to Health as Fundamental Right in India

This presentation is on inclusion of Health as Fundamental Right in the Constitution of India, the issue raised by Dr Anamika Ray Memorial Trust under its Stop Medical Terrorism Campaign.

1. Dr. Ankuran Dutta Head, Dept. of Communication & Journalism, Gauhati University, India Managing Trustee, Dr. Anamika Ray Memorial Trust Right to Health as Fundamental Right in India

2. this presentation is dedicated to Dr Anamika Ray 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 2 Do not let the tentacles of medical terrorism wipe away a precious life

3. What we need? The right to health/healthcare as fundamental right in the Constitution of India (to ensure quality and transparent healthcare services in India with more staff, space and system). Right to freedom of healthcare (to be healthy is a kind of freedom, freedom from diseases) 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 3

4. Why we need Right to Health? We need a separate Right to Health as a fundamental right to have a transparent and quality health care service in the country Eradicate dubious health services address health crisis, alleviation of the standard of living list-out problems associated with medical terrorism transform India into a welfare state in real sense Harness an affordable and uniform medical treatment for all 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 4

5. Why we need Right to Health? 57.57% out-of-pocket expenditure on health in India Over 63 million people are faced with poverty every year due to overburdening health care cost National Health Policy, 2015 No financial protection for the vast majority of health care needs. We need the citizen of the country to be protected under national health insurance . 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 5

6. Why we need Right to Health? India has one of the highest disease burdens in the world. India is a laggard in health outcomes not just by OECD standards, but also by the standards of the developing world. In 2012, India witnessed 253 deaths per 100,000 population due to communicable diseases alone which is much higher than the global average of 178. India faces a higher disease burden than many emerging economies such as China, Brazil, Indonesia, Mexico and Sri Lanka. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 6

7. Why we need Right to Health? More than hundred children under the age of five die every hour in the country. A global disease burden study revealed that in 2016, 0.9 million children under the age of five died in India. The less than five years mortality rate in India stands at fifty per one thousand live births in 2015-16 which has decreased from 74 in 2005-2006. This children mortality rate is more than the rate of under developed countries like Nigeria, Congo. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 7

8. Why we need Right to Health? The maternal mortality ratio per 100,000 life births is 167 in 2011-13 Assam stands at the top with 300 mortality rates. NITI Aayog , Government of India 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 8

9. Why we need Right to Health? One allopathic doctor for every 10,189 people One government hospital bed for every 2,046 people One state run hospital for every 90,343 people. The National Health Profile, 2017 India has 1 million of allopathic doctors to treat its 1.3 billion populations Just 1.1 lakh work in the public health sector. i.e. only 11 percent, to whom India’s nine hundred million rural population turn for treatment. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 9

10. Why we need Right to Health? In Russia, 98% population of the lower income classes have access to the free public health services, in comparison, only 17.33% lower income classes get public health facilities in India. India doesn’t have enough hospital, doctors, nurses and health workers and since health is a state subject, disparities and inequalities in the quality of care and access to health varies widely not just between states, but also between urban and rural areas. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 10

11. Why we need Right to Health? One in five doctors in rural India are qualified to practice medicine. 31.4 % of those calling themselves allopathic doctors were educated only upto class 12 57.3 % doctors didn’t have a medical qualification. In India, self styled doctors without formal training provide up to 75% of primary care visits. 58% of the doctors in urban areas had a medical degree only 19%of those in rural areas had such a qualification. WHO report published in 2016 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 11

12. Why we need Right to Health? 462 medical colleges that teach 56,748 doctors 3,123 Institution that prepared 1,25,764 nurses each year India’s population increasing annually by 26 million. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 12

13. Why we need Right to Health? There is a shortage of 27.21 % for clinical equipment 56.33 % for non clinical equipments, of which Oxygen supply is a part. Critical medical equipment had not been used for more than five years because there was no AMC. Comptroller and Auditor General (CAG) report,June 2017 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 13

14. Why we need Right to Health? Nearly 2 million slum children die every year in India, 1 every 15 seconds. The highest number anywhere in the world where, more than half die in the month after birth and 400,000 in the first 24 hours. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 14

15. Why we need Right to Health? 5.2 million medical injuries are recorded in India A round 98,000 people lose their lives every year due to negligence and error Approximately 3 million years of healthy life are lost in the country each year due to medical negligence 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 15

16. Why we need Right to Health? WHO figure says India ranks at 171st out of 175 countries on public health spending. The state expenditure on health is only 1.4% of the GDP According to a 2010 World Bank estimate, India loses 6% of its GDP annually because of premature deaths and preventable illness. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 16

17. Why we need Right to Health? Articles 38, 39(e), 41, 42, 47 of the Constitution of India do not guarantee the Right to Health enforceable by court of law. And Article 21 of the Constitution doesn’t clarify about what is meant by “life”. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 17

18. How? Patients’ Rights The right to get the best possible medical care without discrimination Right to prompt, life-saving treatment Right to take part in all decisions relating to a patient’s health care Right to privacy Right to know the identity and role of people Right to dignity and to have caregivers respect Right to appropriate assessment and management of the pain of the patients R ight to receive visitors R ight to refuse treatment and to leave the medical center R ight to get necessary information related to the line of treatment as well as all health records. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 18

19. How? Patients’ Responsibilities The responsibility to refrain from misconduct and misbehaving with any medical service providers from physical assault of any healthcare personnel or damage to property be truthful provide the complete and accurate medical history cooperate with the agreed line of treatment meet the financial obligations refrain from initiating, participating or supporting fraudulent and illegal health care practices report illegal or unethical behaviour get a post-mortem done of unnatural death discuss end of life decisions. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 19

20. How? Stop Medical Terrorism For a quality and transparent healthcare services in India CCTV surveillance in the hospital premises ICU monitoring facility Availability of the bed head ticket at the time of discharge Recording of surgery P rompt action towards negligence issues Prevention of laboratory nexus Prescription of generic medicine I ncorporation of a course on medical ethics and communication between doctor-patients in the medical programme Development of the skills of paramedical staff Development of record-keeping mechanism on the cases pertaining to medical error and negligence, etc. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 20

21. What it is? The World Health Organisation (WHO) says, ‘The highest attainable standard of health as a fundamental right of every human being’. The right to health is the economic, social and cultural right to a universal minimum standard of health to which all individuals are entitled. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 21

22. Is it a UN Fundamental Right? Article 25 of the United Nations Universal Declaration of Human Rights, 1948 defines that everyone has the right to a standard of living adequate for the health and well-being of himself and of his family including food, clothing, housing and medical care and necessary social services. The United Nation’s International Convention on the Elimination of All Forms of Racial Discrimination, 1965 addresses the provisions of the right to public health, medical care, social security and social services. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 22

23. The right to health is also defined in the article 12 of the United Nation’s International Covenant on Economic, Social and Cultural Rights, 1966, which says the right of everyone to the enjoyment of the highest attainable standards of physical and mental health. The Convention on the Rights of Persons with Disabilities also says about the right to health. 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 23

24. Then? Need to amend the Constitution of India Incorporation of a new Fundamental Right Or amendment in the Article 21 Amendment in the Part IV- DPSP Amendment in the Fundamental Duties Or a separate Act 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 24

25. The Way forward…. Right to Education guarantees free and compulsory education for children in the age group of 6- 14 years. As a fundamental right under Article 21 (A) the 86 th Amendment act 2002, a new article 21 (A) for Right to Education was incorporated as a fundamental right. This act also led to the amendment of Article 45 in DPSP and Article 51 (A) on Fundamental Duties where after clause (j), the clause (k) was added to provide enough opportunity to continue compulsory education in the country. After this amendment which came in to force in 2010, this right became enforceable by court of law With this Right to Education Act, a welcome change in the State’s position in the primary and secondary educational architecture has been noticed. In the same direction, there is a tremendous need to amend the Article 21 to incorporate Right to Health as fundamental right . 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 25

26. Please visit: armt.in Contact [email protected] www.comcomm.org Ph- 91-9910115696 06 January 2018 © ARMT, 2017 [CC-BY-SA]:: http://armt.in 26