2 Oct 2008, 0046 hrs IST, Dhananjay Mahapatra,TNN
NEW DELHI: In a strong indictment of the country's rural healthcare infrastructure, the Supreme Court on Wednesday said that primary health centres (PHCs), conceived as the pillar of the system providing medical care in the countryside, had become totally defunct.
''In rural areas, there are no doctors. They (PHCs) are functioning only on paper. There is no facility at PHCs. Hospitals function without any doctor,'' a bench comprising Chief Justice K G Balakrishnan and Justices Ashok Bhan and P Sathasivam, said.
The remarks came as the bench was approving plans of the health ministry headed by Anbumani Ramadoss for fresh initiatives on AIDS. The new AIDS control programme, largely authored by additional solicitor general Gopal Subramaniam and adopted by National Aids Control Organisation (NACO), was cleared after the ASG himself gave a power-point presentation. The programme would go a long way in containing AIDS.
But the government's satisfaction was marred by the bench's observations on the poor state of India's the healthcare system.
As Subramaniam pointed out that PHCs in rural areas would be linked with the ART (anti-retroviral treatment) centres so as to widen the net of the AIDS combat programme, the bench asked the health ministry to carry out a reality check on facilities available at PHCs.
Interrupting Subramaniam as he offered an explanation, the bench asked: ''What to talk of PHCs, the state of affairs in government hospitals in the cities is no better. Go to Delhi's Safadarjung Hospital. What is happening there and what is the status of healthcare facilities there?''
The bench added: ''If you want to get a real picture of the rural healthcare system, go to Bihar and Uttar Pradesh. You will realise the ground reality. Now you are linking this scheme with PHCs. But have you noticed that certain areas of the country have more people living with HIV/AIDS compared to others. You should focus your attention to those areas.''
Sensing an exit route from a sticky situation, Subramaniam grabbed it and said the government had precisely done that and established more ART centres in areas where there were higher rates of HIV/AIDS prevalence.
Though the health ministry has already issued an office memorandum to all players concerned, the ASG urged the bench to put the apex court's stamp of approval so that it could be effectively enforced.
The court directed the states and Union territories to implement the 14-point scheme for ''Comprehensive Care for People Living With HIV/AIDS (PLAHAs) at Anti-Retroviral Therapy (ART) Centres'' and asked National AIDS Control Organisation (NACO) to submit status reports on the implementation every four months.