KK Shailaja, Kerala Health Minister – The Hindu
Kerala’s handling of the Covid-19 pandemic has been the subject of international conversation about public health systems. Piloting Kerala’s fight against the pandemic is the State’s Health Minister and CPI(M)’s Central Committee member KK Shailaja who speaks exclusively to BusinessLine about the criticality of publicly-run healthcare and how the need of the hour is to nationalise the system. Excerpts:
What are the lessons to be learnt from the present crisis?
I think there are two major lessons from this pandemic. One, that the country needs proper planning and decentralised implementation mechanisms to improve our health system. And two, there can be no delay in enhancing public investment in healthcare. We spend just one per cent of our GDP on the health sector, it should be increased to at least ten per cent. Countries like Cuba invest much more in healthcare.
What would be your suggestion?
I am a Leftist. I have no say over the health policy of this country at present. But had the Left been in power at the Centre now, we would have nationalised healthcare and education. The Government should have control over healthcare so that everyone — poor or rich — gets equitable treatment.
The ideology of the present Government at the Centre is capitalist. But functioning even within the capitalist policy, they should try to improve the public healthcare system. They should also try to regulate the private healthcare providers so that they do not exploit the poor and vulnerable people.
What are the ideal international models in this context?
The Scandinavian countries, even though I have never been there, provide the best healthcare in the world. But I visited the UK once to see their NHS and GP Surgery. Their primary sector and Cuba’s family doctors system have influenced me when we started the Family Health Centres here in Kerala. Healthcare should be universal, with some regulations at the tertiary healthcare facilities. There should be more investment in health at the primary, secondary and tertiary levels. There should be decentralised planning with regulations. Cuba has achieved a lot because of their centralised planning and decentralised implementation. Their system of healthcare is people-centric and patient-centric. Their egalitarian concept and decentralisation can be emulated here.
What distinguishes Kerala from other States?
When we came to power in 2016, we found that the Primary Health Centres were working only till afternoon. They didn’t have lab facilities. So, people had to go to the cities and tertiary healthcare centres even for a common cold.
I wanted to focus on prevention. Lifestyle diseases are very high in Kerala. People need individual care at primary health centres. We even changed the aesthetic appeal of our PHCs with good buildings, toilets, labs and out-patient rooms. Immunisation rooms were made child-friendly.Local self-governments and KIIFB played an important role in this. We trained Panchayat presidents and medical officers on building this infrastructure. They helped us a lot in this work within the limited availability of the Centre’s plan fund. A lot of people contributed financially too to build this infrastructure.
Out of the 946 PHCs, 617 have new buildings now. It is a public movement. More than 100 of these PHCs have received National Quality Assurance Standards (NQAS) certification. We have improved our secondary level hospitals at the Taluk level. Some hospitals have more facilities than a corporate hospital. Tertiary healthcare too got improved. The medical colleges were modernised. New medical colleges started. Most modern equipment is available in these hospitals now. We also promote research in medicine too.
Till 2016, 37 per cent people were depending on Government hospitals. Now more than 50 per cent of the State’s population opt for Government hospitals without any hesitation. This systemic change helped us in fighting the pandemic. Our policy is that healthcare should be accessible, affordable and friendly.
The major issues the Centre and States confront now are availability of oxygen and vaccines. How do you view this?
The Government at the Centre should have a plan. Kerala cannot remain an island. On the issue of oxygen supply, we could foresee a problem. In May 2020 itself, we held a meeting with the Industries Ministry of the State in availability of oxygen. We decided to open an oxygen plant in Palakkad district. It came as a blessing now. We have sufficient production now. But there are issues in its supply. We are trying to address it by getting more tanks and cylinders.
The meetings convened by the Centre is just to share statistics. But they have not given us any assurance on our demands such as availability of vaccines.
The vaccine policy of the Centre will result in windfall profits to the manufacturers. The Centre should not see this as a profitable venture. States should be allowed to vaccinate people with their own system. The State cannot bargain with a company to protect the lives of its people. Our priority is the health and life of people. The Centre should provide adequate vials of vaccines to States. Kerala has zero wastage of vaccines. I doubt that they are hoarding vaccines now as the vaccine is payable since May 1. The supply of vaccines is inadequate. They should take the States into confidence in this exercise. If we get vaccines, we will control this second wave in one month. We are confident about it.