Cabinet clears National Health Policy '02

new delhi: the union cabinet has cleared the national health policy for 2002 envisaging a hike in health sector expenditure, mandatory two-year posting in villages for new doctors, revival of primarcy healthcare system and enhancement in spending for public-funded research. the policy, cleared on wednesday night by the cabinet chaired by prime minister atal bihari vajpayee, seeks to increase health sector expenditure to six per cent of gdp, with two per cent of gdp being contributed as public health investment by the year 2010. with the stepping up of the public health investment, the central government''s contribution would rise to 25 per cent from the existing 15 per cent by 2010, it says. the policy envisages kick-starting of the revival of primary health system by providing some essential drugs under central government funding through the decentralised health system. it also recognises the need of levying reasonable user-charges for certain secondary and tertiary public health care services for those who can afford to pay. the policy seeks to enforce a mandatory two-year rural posting before the awarding of the graduate degree. this would not only make trained medical manpower available in under-served areas but would also give valuable experience to the graduating doctors, it says. to enable fresh graduates to contribute effectively to provide primary health services, the policy identifies a need to modify the existing curriculum. a need-based, skill-oriented syllabus, with a more significant component of practical training, would make fresh doctors useful immediately after graduation, it says. the policy envisages an increase in government funded health research to a level of one per cent to the total health spending by 2005 and up to two per cent by 2010. research programmes taken up by the government in drug/vaccine development would be conducted in a mission mode, the policy says adding time-bound applied research for developing operational applications would be undretaken. it aims at regulating minimum infrastructure and quality standards in clinical establishments/medical institutions by 2003. the policy also envisages that creation of additional seats for the postgraduate courses should reflect the need for more manpower in deficient specialities. it envisages progressive implementation of mandatory norms to raise the proportion of postgraduate seats in these disciplines in medical training institutions to reach a stage wherein one-fourth of the seats are earmarked for public health/family medicine. the policy seeks full operationalisation of an integrated disease control network from the lowest rung of public health administration to the central government by 2005. the setting up of this network will include installation of database handling hardware, it inter-connectivity between different tiers of the network and in-house training for data collection, it says. the policy says baseline estimates for the incidence of common diseases - tb, malaria, blindness - would be done by 2005 while the same for non-communicable disease like cancer, diabetes and accidental injuries and communicable disease like hepatitis would also be compiled. with access to such reliable data, the public health system would be closer to the objective of evidence-based policy making, it says. the policy says a social health insurance scheme, funded by the government, and with service delivery through the private sector, would be considered. recognising the contribution of ngos in providing health services, the policy says the disease control programmes would earmark not less than 10 per cent of the budget in respect of identified programme components to be exclusively implemented through these institutions. the policy also aims at expanding the pool of medical practioners by including licentiates of medical practice, indian systems of medicine and homoeopathy practioners. the production and sale of irrational combinations of drugs would be prohibited through the drug standards statute, it says adding not less than 50 per cent of the required vaccines/sera would be sourced from public sector instituitons so that the country is not dependent on imports. the policy contemplates setting up of a two-tiered organised urban primary health care structure.