Kerala’s storied public health system comes under strain

Thiruvananthapuram: All is not well with Kerala’s storied public health system. The poor state of government hospitals, including Medical College Hospitals (MCHs), has sparked massive protests by the opposition Congress-led United Democratic Front (UDF) and the BJP.

A social media post by a senior doctor of the government MCH in the state capital and the collapse of an old building block in Kottayam MCH recently exposed chinks in the LDF government’s claim that Kerala stands first in public health care in the country.

A woman died in the building collapse at Kottayam MCH, prompting the UDF and BJP workers to hit the streets. They are demanding the resignation of Health Minister Veena George, a demand rejected outright by the ruling front.

Amid the turbulence, Chief Minister Pinarayi Vijayan left for the US this weekend for a specialised health check-up and treatment—an almost annual feature over the last few years.

“If the state’s public health system is in the pink of health, why should the Chief Minister fly to America for treatment?” This question from the opposition is rankling in the air, causing great discomfiture to the ruling dispensation.

The current round of rage was sparked by a candid social media post by the head of the Urology Department at Thiruvananthapuram MCH. Though a left-leaning surgeon, he brought to light the pathetic state of his department, where surgeries are being delayed for want of equipment.

Even though the doctor later withdrew his post, he clarified that he had raised the issue with positive intent and was not concerned about the personal consequences.

It was against this backdrop that an old building block in Kottayam MCH collapsed amid heavy rains, killing a middle-aged woman. Though the collapsed block was not used to house patients, it did contain a washroom used by patients and bystanders.

A preliminary inquiry by the district collector was immediately ordered, and the government promised that a detailed probe would follow.

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Such instant responses, however, have failed to contain the opposition and widespread public concern. The opposition parties mobilised their cadres across the state to stage protests, defying barricades and water cannons unleashed by the police.

The ruling front has rallied behind the health minister, accusing the opposition of trying to gain political mileage as the state heads for assembly polls in less than a year and civic elections barely six months away.

Political blame games aside, the issue has triggered a heated debate among healthcare and policy experts. At the centre of the conversation is the question: how reliable is the once-fabled state-run health system now?

Millions depend on government hospitals for medical care, as the cost of services at private hospitals continues to rise. The state-supported public health schemes for low-income categories are entirely delivered through the government system.

Have successive governments been able to consolidate the gains and scale up the state’s public health system, once known for its commendable achievements in key health and human development indices? It is often claimed that Kerala’s public health system is comparable to those of advanced Western countries.

Though the foundations of the system remain strong, many feel it is time for a reality check to assess whether it is still capable of delivering the services expected of it.

Restoring the health of the system is critical, given the state’s high disease burden, the increasing elderly population, and the spiralling fees charged by private hospitals.