The Multiple Flaws in the NRHM Programme

The Multiple Flaws in the NRHM Programme
  • 13

Sheikh Maqbool

The National Rural Health Mission (NRHM) Programme, that New Delhi mooted and the state government accepted a design of introducing a three -and-half year Bachelor of Rural Medicine and surgery diploma course running parallel to the existing 5 years MBBS course. The former is intended to train a large number of Doctors for the rural areas. The attempted justification for this rather indecorous move is that as fresh pass outs of the MBBS course refuse to accept offers and work in villages, there always remains a dearth of Doctors for rural assignments on the medical service. The new course is meant to meet that need.
Obviously, the two courses, namely the existing 5 years MBBS degree course and the new 3-Years diploma course can never be of the same quality and standard. The policymakers also recognize it when they refrain from empowering diploma – holding doctors with all the responsibilities the MBBS doctors bear; nor such diploma holding doctors are allowed to undertake all kinds of treatments.
In effect , the quality and standard of medical education will come down ; even some RTI applications revealed that the verification upon these diplomas were not disclosed by the CMO offices of Kashmir; village people are asked to remain content with the kind of poor health care as rendered by those less equipped medical personnel. Is it because the policymakers consider and look down upon village people as second class citizens, given that they are not able to provide for the money for better treatment?
Such a despicable and condemnable outlook and attitude of the government even smacks of a colonial heritage, where the imperialist rulers advocated lower qualified ‘native doctors ‘to treat natives. It refuses to probe, why doctors refuse to go to villages? Is not it primarily because of the miserable lack of infrastructure in the government hospitals and health centres, in both rural and urban areas and particularly in the former, as well as the lack of minimum support for basic living facilities for the new recruits in the rural areas?.
Had the Government been really serious in finding out a solution to the Health sector’s problems , it would and should have opted for improving the infrastructure and facilities in rural areas and the hospitals and health centres there. In place of setting up rickety institutions as a semblance of health centres, they should have set up well – equipped hospitals. Instead of shifting the onus on to the doctors for refusing offers for rural service, the government should have offered them decent, adequate remuneration and improved living and working conditions free from local political or other types of interference like attachment of Doctors and so on. Skirting these responsibilities , the Government encourages , on the one hand , the setting up a modernised , well equipped privately – run medical institutions in cities where treatment cost is exorbitant and out of the reach of common people, where attitude towards patients is starkly commercial even in the case of emergency treatment or saving a patient’s life, and announces with fanfare , on the other hand, this project to produce second – rung medical practitioners for the less privileged poorer sections of village people.

—The writer is the chief spokesperson of J &K RTI Foundation. He can be reached at: