|Year : 2021 | Volume
| Issue : 6 | Page : 602-603
Need for Indian medical services – Time to learn and unlearn
Harshal Tukaram Pandve1, Swetha Rajeshwari2
1 Department of Community Medicine, PCMC's Yashwantrao Chavan Memorial Hospital & Postgraduate Medical Institute (YCMH-PGI), Pimpri, Pune, Maharashtra, India
2 Department of Community Medicine, ESIC Medical College, Sanathnagar, Hyderabad, Telangana, India
|Date of Submission||29-Jul-2020|
|Date of Decision||15-Sep-2020|
|Date of Acceptance||25-Sep-2020|
|Date of Web Publication||29-Jun-2021|
Harshal Tukaram Pandve
Department of Community Medicine, PCMC's Yashwantrao Chavan Memorial Hospital & Postgraduate Medical Institute (YCMH-PGI), Pimpri, Pune
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pandve HT, Rajeshwari S. Need for Indian medical services – Time to learn and unlearn. Med J DY Patil Vidyapeeth 2021;14:602-3
Medicine has gradually evolved into matters beyond patients and diseases to involve families and the community as a whole. This shift becomes imperative in building a healthier nation and is in consensus with the statement made by Bhore committee, “the doctor of the future should be a social physician protecting the people and guiding them through healthier and happier lives.”
Medical authority is not merely showing knowledge acquired or planning treatments within four walls of any health center; it is way beyond that. It is by and large a social authority, which includes decision-making for the district, town, and institution or even a regulation. It is not only restricted to preventive and promotive aspects of health, but also organizing primary, secondary, and tertiary health-care services. This strategic position needs expertise in all key components of health systems, be it community participation, human resource management, coordination with other sectors related to health, technologies and adapting those that are affordable for health, financing, governance, and management in line with equitable distribution and above all organizing health-care services in the community. This authority should be grounded to the community, its behaviors, culture, and societal norms along with having sound knowledge and practical skills on clinical, epidemiology, and administrative aspects of health care.
In the late 19th and 20th century Indian Medical Service (IMS) had flourished to become this social authority as a situation then demanded so. Accordingly, they did show dramatic improvements in medical and sanitary conditions and could efficiently cope up with deadly epidemics like the plague and cholera. Almost all the diseases prevalent at that time in India like smallpox, leprosy, and malaria were controlled successfully. There were very few epidemics in later years, and many of the diseases were almost eradicated. Officers and researchers of IMSs contributed a lot to the study and prevention of diseases.
Post-independence, the abolition of IMS was one in the major health sector reform that took place. This bridge of co-ordinated action in between the center and states was lost and so did the most important aspects of public health, epidemiology and statistics weaken. This dearth was recognized and reported almost five decades ago by the Mudaliar committee in the year 1962 and recommended to set up All India Medical Service for Health administration. Ever since then, this has remained to be a recommendation to the government by various committees that came later.
When unforeseen events like the COVID-19 pandemic toppled the world, leaders across the globe are introspecting the technical and administrative capabilities of their own country health systems on handling such pandemics. India is no different; we have paid heavily in terms of lost lives and fallen economy. Emergency advisory boards and committees have been formed with experts in various fields, including doctors, epidemiologists, administrators, economists, to assess, collate and advice the government on ways to respond to the national emergency. At times like this, the need for an able health administrator with strong medical background becomes much more evident, especially with national guidelines changing every day to meet the demand in different geographies. This pandemic has once again proved that health cannot be seen as an independent entity and is interlaced with other sectors like food, infrastructure, sanitation, etc. It is also deeply entangled within social, behavioral, and cultural aspects of the community.
This only emphasizes on the fact that Public health competencies and tools are crucial for health care administrators to facilitate a better understanding of the needs of the population, prioritizing activities according to epidemiological, organizational, and economic trends. Its time the government prioritizes setting up of IMS or All India Health Cadre on par with other all India services to enhance the quality of health care in the country, this also ensures a uniform standard of administration across states and union territories. These officers should be posted at various administrative units of districts, states, and national levels to make it more efficient. This restructuring of the health sector should also include the establishment of parallel units like public health engineering departments in the states that will work in coordination with the health department. The benefits of this reform can be better appreciated when the National programs and projects will be better implemented, yielding optimal public health benefits.
To conclude, it is time for introspection, time to learn, and unlearn and take initiatives for the long run. One of these initiatives is to start IMSs for better health care services.
| References|| |
Mushtaq MU. Public health in British India: A brief account of the history of medical services and disease prevention in colonial India. Indian J Community Med 2009;34:6-14.
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