Responsibility of Health Care

Responsibility of Health Care

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“The health of people is the foundation upon which all their happiness and all their powers as a state depend”
Benjamin Disraeli, British Prime Minister


Dr. Srikant Sharma, MBBS, MD (Medicine), Senior Consultant medicine, MCKR Hospital, New Delhi, published many national and international papers and chapters in books.

Dr. Sharma, an eminent medicine specialist with decades of experience in health care management with a holistic perspective having researched on sub systems of health care presents an outline for building a responsible healthcare system with responsibility of all stakeholders including patients, doctors, health organization, government and other support professionals like nurses etc.

A global approach in the health field is required from all the aspects. The quality of medicine lies in its capacity to integrate,what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator.

Health is the level of functional and metabolic efficiency of a living organism. In human beings it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.

The World Health Organization (WHO) defined health in its broader sense in its 1948 constitution as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” This definition however has been subject to controversy, in particular as lacking operational value because of the problem created by use of the word “complete”.

Hence Health and Health Care itself holds a great importance in our society. As a whole, responsibility of health care comprises of not only patients and physicians, but also of Government, Corporate institutions, Health care workers, NGOs and general public.

PATIENTS: Patients make up one of the most important pillar of Health Care Industry. They are accountable to health care in every regard. This includes attending all medical appointments without fail, prebooking appointment for regular checkups and actively participating in the treatment. Patients have an ethical responsibility towards their own health. Healthier living would lead to lower healthcare costs, following this, even some companies such as Wal-Mart and the WHO have stopped hiring employees that smoke in order to reduce healthcare related costs.

As technology is increasing patients want the newest, most advanced, and expensive treatments through Medical insurance and do not realize expensive treatments are not necessarily the best. The patient has a duty to participate with the physician in making reasonable and cost-effective choices.

It is the responsibility of an individual to realise the importance of Emergency Department and they should make sure to make use of it when it’s duly required. Thus protecting the resources (emergency services etc.) in a broader aspect.

As a patient and health care consumer, it is ones responsibility to stay involved, informed, and educated about ones health and the care one receives. One should not be afraid to ask the doctor questions about the care. One needs to fully understand medication instructions and follow the medical advice and orders given by the doctor.

PHYSICIAN: Physicians play a key role in ensuring that their patients receive adequate healthcare. They help by finding a balance and act as a gatekeeper for the insurance companies and being an advocate for the patient. Physician should know the values of compassion, service and trustworthiness in terms of their patients. Physician has to report the administration in respect to notifiable diseases which includes various communicable disease like Pertussis, Tuberculosis, Chickenpox, Diphtheria, Influenza, Smallpox, Measles, sexually transmitted disease like HIV, disease outbreak in a particular area or community including food borne, vector borne diseases like Dengue, Malaria, Plague, Cholera etc.

Physician’s duty includes prescribing the right medication, emphasizing on advantages, disadvantages, risks and alternatives regarding a proposed treatment/operation with respect to adequate follow up to the patient in reasonable amount of time.Role of information and consent plays a great regard. Also duty to respect the confidentiality plays a root ground in forming a Doctor-Patient relationship.

HEALTHCARE W0RKERS: Many healthcare professionals have codes of ethics to which practitioners are expected to adhere. For example, the nursing Code of Ethics is a lengthy document that covers ethical expectations in detail. Healthcare workers have a legal and ethical responsibility to protect the patients they care for. In complete harmony with many physicians, healthcare workers improve the functioning of the health system.

GOVERNMENT: A good system of regulation is fundamental to successful public health outcomes and it is the Government who is solely responsible for strengthening the health care systems and their enforcement. It includes wider strata ranging from health research system, promotion of health and health care policies, human resource development to enable intersectorial coordination towards basic public health issues. Government has played a key role from preclinical development to post licensure monitoring, in making polio, small pox abolished because of vaccination strategy.

The NRHM (National Rural Health Mission) is launched by Government of India in order to establish effective integration and convergence of health services. The Integrated Disease Surveillance Project is also set up to establish information relating to disease occurrence required for prevention and containment at the community level.

Education is an essential step to acknowledge and strengthen the healthcare policy.Elementary education has received a major push through the SarvaSikshaAbhiyan. Right of children to Free and Compulsory education Bill 2009 seeks to provide education to children aged between 6 and 14 years, and is a right step forward in improving the literacy of the Indian population. The RashtriyaSwasthiyaBimaYojana, AamAdmiBimaYojana are social security measures for the unorganized sector (91% of India’s workforce). The National Old Age Pension scheme has provided social and income security to the elderly population.

Government also plays a pivotal role through enforcement of sanitary codes, e.g., water quality monitoring, slaughterhouse hygiene and food safety. FSSAI (Food Safety and Standard Authority Of India), an autonomous body established under the Ministry of Health and Family Welfare, Government of India is promoting public health through the regulation and supervision of food safety. Stopping the spread of STDs and HIV/AIDS, helping youth recognize the dangers of tobacco smoking and promoting advantages of physical activity is another step.

These are a few examples of behaviour change communication that focus on ways that encourage people to make healthy choices. Observing days like Diabetes day,”Tuberculosis day” and Heart day etc. even in villages is a Government initiative to create awareness at the grassroots level. The Ministry of Health, in coordination with other ministries, provides technical assistance in implementing disaster management and emergency preparedness measures. Implementation of Disaster Management Act, 2005 is essential for establishing institutional mechanisms for disaster management.

PUBLIC HEALTH SECTORS FOR HEALTH CARE: There is a need for effective addressing of public health challenges with cooperation of private sectors (public-private partnership), civil societies, national health leaders, health workers, communities, other relevant sectors and international health agencies (WHO, UNICEF, Bill and Melinda Gates foundation, World Bank).

INTERNATIONAL AGENCIES: World Health Organization (WHO) is the United Nations’ specialized agency for Health. It is an inter-governmental organization and works in collaboration with its member states usually through the Ministries of Health. The WHO is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. The WHO Country Office for India is headquartered in Delhi with country-wide presence.

Country Cooperation Strategy (CCS) 2012-2017 The WHO Country Cooperation Strategy India (2012-2017) has been jointly developed by the Ministry of Health and Family Welfare (MoH&FW) of the Government of India and the WHO Country Office for India (WCO). Its key aim is to contribute to improving health and equity in India. It addresses the challenges in solving long-standing health and health service delivery problems internally.

A global approach in the health field is required from all the aspects. The quality of medicine lies in its capacity to integrate,what science says is appropriate and to be recommended, what can be reconciled with human rights and the self determination of the patient and what can be achieved by optimising available resources. In this complex context, the doctor could take on both the role of the person who decides on the use of resources and the one of social mediator.

It was a glorious past in having Expanded Program of Immunization in 1974, Eradication of smallpox 1988, FCTC ratification( Framework Convention on Tobacco Control) in 2004 and COTPA Act (cigarettes and other Tobacco products Act) 2005, to name a few. Future of healthy INDIA lies in streamlining the public health agenda in the framework of sustainable development. The goal of a nation would be one where health care of rural and urban divide has reduced to a thin line, with adequate access to clean energy, safe water, non polluted environment and healthy food, where best of health care is available to one and all, where governance is responsive, transparent, where poverty and illiteracy have been eradicated—-a healthy nation that is one of the best place to live in.

About the author

CSR VISION is India's (probably World's) first monthly magazine in print devoted to CSR and Sustainable Development for bringing together all stakeholders of SUSTAINABLE DEVELOPMENT at a global and local levels and act as a platform for promoting strategic CSR and sustainable development practices through dissemination of information and knowledge.