PUCL Bulletin, 2000

Insaaf International press note:

WB funded Punjab Health System Corporation makes Public Health costlier

Insaaf International has launched a campaign with effect from 22.10.00 against orders of the World Bank Funded Punjab Health Systems Corporation (PHSC), Punjab, to hike the user fee for health services and elimination of subsidized fee structure for low-income group. This order of PHSC is clearly another example of the treacherous World Bank strategy of charging the poor when in fact its mission is to deliver them services they could not otherwise afford. This is being done at a time when even the U.S. Congress is considering legislation that would prevent this practice. The World Bank (WB) is systematically privatizing health in Third World countries by funding commercial health projects in the name of removing poverty. India is a welfare state, and the National Health Policy (NHP) emphasizes the role of the state in providing basic health care. The objectives stated in the project under which PHSC was created, were to improve efficiency in allocation and use of health resources through policy and institutional development, improve the performance of the health care system, increase coverage and effectiveness of services at the primary and secondary levels, and to better serve the neediest sections of the population. But in, practice it is resulting in denial of right to health and undermining state responsibility in providing basic health care to its citizens. Poor and women are worst hit with the increased costs of the treatment. Vide its orders dated 3.10.00, the PHSC has removed monthly income slab for determining user fee. Prior to these orders, according to government notification dated 14.5.1991 (which continued with some variations till date), there were three slabs, up to 1000 Rs per month, from Rs 1001 to 2000 income per month and above Rs 2000 income per month. The income group up to 1000 rupees had subsidized fee and other benefits like free diet and no charges for operation, X-ray, and laboratory tests, dental dressing, tooth filling, fluoride application, tooth extraction, minor dental operation, Intra and extra oral X-ray, etc. And what ever charges this group had to pay was almost one fifth as compared to income group at the third slab with income of more than Rs 2000 per month. The second group from 1001 Rs to 2000 had to pay almost half of the charges.
Now only the rates above Rs 2000/- per month will be applicable, w.e.f 3.10.00, meaning that highest income group slab will not be affected at all. The order of PHSC to eliminate the slab system and hike in the fee structure has adversely affected the poor people most, whom our government and World bank falsely projects to be helping. This move has totally exposed the designs of both, the WB and the government. Still they want us to believe that it is doing every thing to help poor people. All this is being done "Under the process of rationalization of the existing user charges".
Fee for issuing and testing of blood for transfusion has been increased many folds. There is no exemption of blood transfusion charges for childbirth bleeding complications or severely anemic mothers in labor. The delivery charges have also been hiked. So much for Government and WB 's resolve to help women and better mother and child health (MCH) care services.
We strongly condemn PHSC for its anti poor and anti women policies and demand that these orders be reversed immediately.

(Dr. Vineeta Gupta), General Secretary

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