core sector communique

PM’s Speech at the third convocation of JIPMER, Puducherry

Following is the text of the Prime Minister, Dr. Manmohan Singh’s speech at the third convocation of the Jawaharlal Institute of Postgraduate Medical Education and Research, in Puducherry today: “I am truly delighted to be here at this very prestigious campus. I wish all the graduating students a life of professional fulfillment and commitment to the values that have guided health care-givers from time immemorial. The Hippocratic Oath that you are enjoined to take commits you to the idea that you will practice the art and science of your profession in order to secure the “respect of all humanity, at all times”. This is an onerous commitment but I am confident that each one of you will live up to this cherished ideal. The Jawaharlal Institute for Post-graduate Medical Education and Research has established itself as a premier institution with a worldwide reputation. JIPMER occupies a very important place as a premier Institute among medical colleges in our country and it is recognized for its excellent quality of medical education both at undergraduate and postgraduate levels. It is a matter of pride for all of us that the Institute is in the forefront of driving change and innovation in the health-care sector. I compliment the many generations of staff and students whose hard works have led to earning this reputation for this great Institute. It is often said that the health of a nation depends on the health of its people. We face serious challenges in assuring the health and well-being of our people. Our health indicators continue to be poor and high mortality rates of infants and pregnant women have been a cause of serious concern. Despite decades of implementing health and family welfare programmes, we are still faced with a situation where two thirds of health expenditure is borne by people from out of their pockets. A very large proportion of this expenditure is on purchase of drugs. Seven years ago we launched the National Rural Health Mission to deal with some of these challenges. There was a massive infusion of human resources at the cutting-edge levels with the induction of several lakh health workers and accredited social health activists (ASHA) across the country. My esteemed friend Shri Ghulam Nabi Azad has mentioned the widespread changes that have been introduced in the infrastructure providing health-care in our country in the last three years. I compliment Shri Ghulam Nabi Azad for these achievements. The NRHM has shown that health indicators can be improved with concerted focus on public health systems at primary and secondary levels. Infant and maternal mortality rates have fallen and institutional deliveries have increased. But much more needs to be done and there is a large unfinished agenda of providing affordable healthcare for all our people. Our Government has decided to continue the National Rural Health Mission for the next five years. We are now proposing a new National Urban Health Mission in order to focus on the health challenges in our towns and our cities. The challenge for policy makers in India is to ensure proper development of the various segments of our health care system. Traditionally, the debate in the West has been between public and private provisioning of health-care. But, in India we have had both public and private sectors in health-care. Much of the media attention tends to focus on the corporate sector. However, in terms of reach and affordability, the non-corporate private sector has played a significant role in complementing the public health system. Eventually I do hope that we will be able to launch a unified National Health Mission. The scarcity of doctors, nurses, health workers, public health professionals is emerging as one of the most important impediments to providing universal health coverage for all. This shortage is acute in our rural areas and in particular, in the northern, central and eastern regions of the country. Against a desirable rate of 1 doctor per 1000 population we have one doctor per 2000 people. Against a norm of 3 nurses per doctor, we have 3 nurses for every 2 doctors. The centre and the state governments, particularly state governments of the under-served regions, need to put their heads together, prepare strategies and implement urgent measures to remedy the situation. I am very happy that under the guidance of Shri Ghulam Nabi Azad, the Ministry of Health and Family Welfare is paying increasing attention to filling up these gaps in our health system. The quality of medical education is another concern. There is a perception of deteriorating quality. We cannot allow this situation to continue or to persist. We must put in place a credible regulatory and institutional mechanism to help develop standards in our medical education. We also need to take a serious look at the curriculum for medical education so that doctors are trained to look at health in a truly holistic manner, and that it goes beyond a narrow clinical and technology-driven approach. Students training to be doctors have to be prepared to work with local communities and in our villages. They should be sensitised to the social determinants of health and be as willing to contribute to preventive healthcare and its management as the more lucrative curative systems. As science and society evolve rapidly in the 21st century, the education of health professionals too must be transformed in precept and practice. Interdisciplinary learning and health system connectivity should, therefore, become the hallmarks of contemporary medical education. Apart from the study of health and disease, knowledge of health economics, ethics, patient rights, behaviour change communication and information technology should inform and influence the design and delivery of our health care systems. Effective health care involves a truly multi-layered workforce working cohesively as a team rather than as individuals acting in a disconnected manner. Doctors, nurses, allied health professionals such as paramedics and technicians as well as community health workers should, therefore, acquire, even during their training, the skills of working together in community or hospital settings. Medical education should accordingly be reconfigured to produce a technically competent, socially sensitive, ethically correct and ready to serve health professional who can respond to the diverse demands of India's growing health needs. False hierarchies should be shunned. Mutual respect and a sense of shared responsibility should form the basis of effective team work. I am sure that an institution such as JIPMER will lead and show us the way in developing innovative models of inter-professional education and non-hierarchical medical practice. I understand our Health Ministry is focusing on many of these areas. The Medical Council of India is in the process of revising the MBBS curriculum and incorporating training in Community Medicine at all levels. The Central Government has taken several steps to strengthen medical education in our country. The number of undergraduate and post graduate seats has been greatly increased in the last three years. The Medical Council of India norms have been rationalised and new medical colleges have been opened all over the country. The Union Health Ministry is taking measures to set up new medical colleges particularly in under-served regions. Under the Pradhan Mantri Swasthya Suraksha Yojana, construction of 6 AIIMS-like institutions at Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur and Rishikesh is in full swing. The medical colleges are expected to be functional from the academic session 2012-13 and the hospitals by 2013-14. Being a ‘window of French culture’, if I may use Jawaharlal Nehru’s famous words, Puducherry occupies a special place in our country. I am truly delighted to come to this historic city which became the home of one of India’s great spiritual thinkers Shri Aurobindo. I am very happy that Puducherry is keenly pursuing an agenda of all round development, with emphasis on education and health. I understand Puducherry has implemented a scheme for providing free ambulance services through the “108 Ambulance Service”. I compliment the Government for this. The Government of India will help Puducherry develop into a hub for higher and professional education in our country. I would also urge the Government of Puducherry to work with our Tourism Ministry and explore the possibilities of developing responsible and eco-friendly tourism. I once again wish you all well. I hope and trust you will serve your patients with competence and compassion. I trust you will keep the flag of our Motherland flying high in whatever you may choose to do.”