Times of India
17 March 2010

With the National Health Bill, 2009 still open to public debate, Assam – with the country’s highest maternal mortality rate and an infant mortality rate higher than the national average – was first off the block in tabling a right to health Bill in the state assembly. State health minister Himanta Biswa Sarma tells Prabin Kalita that with the central government taking the health sector more seriously than ever, it is the right time for states to act:
What led you to take the plunge?
The implementation of the right to health requires a huge amount of money. When the Centre is pumping in more funds through successful schemes like NRHM (National Rural Health Mission) and other health schemes and with the financial position in my state better than before, i thought we should go for it now – or we might not be able to do it at all in future.

How much would you require, annually?
Initial estimates suggest about Rs 7,000 crore to Rs 10,000 crore. And the right to health Bill does not limit itself to just health and family welfare departments, but to a host of departments like public health engineering and social welfare, among others, whose fund allocation would be taken into account. This year alone, the NRHM allocation for Assam has been hiked from Rs 600 crore to Rs 1,000 crore and i strongly believe that when we have taken such a big step, the Centre will not hesitate to assist us.

What, at present, is the ground reality in the health sector?
The government and the private sector are doing their bit to provide health care, but there is no direction. At present, when we talk of health, we ignore core issues like essential nutritious food, safe drinking water, proper sanitation or even basic housing. Unless there is good housing, safe water to drink and appropriate sewerage to ensure proper sanitation or access to nutritious food, there is no health and wellbeing in the true sense. The health department has always been kept in isolation – limited only to doctors and hospitals.

The high point of the Bill is the mandatory health impact assessment by any new development project coming up in the state. We have had only environment impact studies so far, but we have always completely overlooked the impact industries have on the health of citizens.

Are you apprehensive of any obstacles while implementing the right to health?
There are bound to be obstacles. I feel there would be obstacles from bureaucracy and administrators because of the clause of fixing responsibility and accountability in the Bill for repeated outbreaks or recurrence of communicable diseases in one particular area. The bureaucracy is also likely to oppose legislation on the grounds that providing funds would now be mandatory.

But is the state’s health infrastructure in place?
Four years back, i would have said no. Today we are in a better position. The Bill makes it binding on the government to attain the Indian Public Health Standards for both government and private health institutes.

How will you financially help the poor to enjoy their right to health?
Health insurance is an individual right and the government, too, has a responsibility. We are working on some kind of a premium-sharing model. The government might take over the premium entirely or share a percentage of it.