Patients from across the world now come to India for healthcare that is cheap and of high quality. The government even claims to promote this “medical tourism”. But what the world seeks out here, it seems, isn’t good enough for our IAS and IPS officers. Adding to the considerable privileges of this select band of some 8,4000, the government notified in the first week of September that they will be entitled to reimbursement for medical treatment abroad. The notification also allows for air-fare and the expenses of an attendant. Reimbursement for treatment abroad was earlier restricted to MPs and IFS officers working abroad. The new notification modifies rules that have been in force for 30 years. There are checks—treatment abroad must only be for complex procedures cleared by a medical panel—but even so the notification is drawing much flak.
Even IAS and IPS officers smell a fish. Many officers say they know of nobody in their batches who needed treatment abroad. “The rule,” they say, “is almost certainly meant to oblige one or two officers.” T.S.R. Subramanian, a former cabinet secretary who underwent minor surgery at Delhi’s Apollo Hospital earlier this month, says he was amazed to see patients from Russia, Africa and West Asia thronging the hospital. “Remember,” he says, “even Atal Behari Vajpayee had his knee replacement done in India. There’s little justification for spending one or two crores on a single officer.” He also describes the move as discriminatory, for the Central Government Health Services or CGHS rules naturally cover all government servants; favouring some will definitely increase the scope for misuse. The Centre may allow only a few to go abroad, but it’s a matter of time before officers in the states raise the demand and soon thousands will be lining up for permission. A post by Harsh Taneja on kafila.org described the new privilege as “unfair, undemocratic” and amounting to institutionalised corruption.
Senior doctors say there is virtually nothing that cannot be done in India today. A decade ago, medical technology would take a few years to travel to India. No longer. Medical breakthroughs are mostly available in India as soon as they are abroad—the lag now is no more than a month or two, says Dr Rajiv Sood, a urologist at a prominent Delhi hospital. The last time he advised a patient to go abroad was eight years ago—for robotic surgery, not available here then.
The tide has actually turned. Patients now travel to India for treatment. An Assocham study this year claimed a 40 per cent jump in medical tourism since March this year and put the current market size at Rs 7,500 crore. Basic neurological surgeries, say doctors, are now conducted in an estimated 2,000 hospitals in the country. Over 200 hospitals even carry out complex neurological procedures. Dr A.K. Dhar, an oncologist, does not remember any of his patients travelling abroad for medical treatment. “Besides being costly, there is no need to travel abroad because we in India have the equipment required for even the most complex procedures,” he says.
Another reason Indian doctors, especially surgeons, are at par with those abroad, and even better in many cases, is due to the sheer volume of the patients they attend to, says Dr Sood. Credible training programmes, many of them initiated by the government, have also added to the skill level of Indian doctors. “Even when you go abroad, chances are that you will be treated by Indian or Asian doctors,” he added.
Critics also say the decision could undermine the public health service in the country: politicians and bureaucrats will have little incentive to improve conditions in government hospitals! But did they care in the first place?
Why Go Abroad?
What some major treatments cost
Coronary artery bypass surgery
Apropos the new benefits that our civil servants have won for themselves (The Line is Reversed, Sep 30), it’s getting to be more like Animal Farm, where a few selected animals are more equal than the others. They need to realise that they are not the new maharajas, but public servants in a democracy. They fix the poverty line at Rs 28 a day, then allow for themselves perks unheard of in a modern democracy. If anything, since they are the ones responsible for infrastructure, they should be made to get treatment at government hospitals.
Tejinder, St Louis
Shame on our government. It hasn’t been able to ensure the availability of rabies vaccine, which costs just a few hundred rupees, in every government health centre but it will now spend crores on corrupt and rich members of the ias and ips.
Naveen Singhal, Rohtak
As long as we have a predatory bureaucracy, such things are never going to stop.
Navin Malhotra, Delhi
Thanks to judicial activism, the bureaucracy is autonomous now. The courts have also ruled that bureaucrats are accountable to committees made of bureaucrats. Political executives have far less control now. This is what they must have wanted from the beginning!
Rajesh, Phoenix, US
Apropos of The Line is Reversed (Sept 30) on babus being allowed foreign medical treatment, there's a comment that even “A.B. Vajpayee did his knee replacement in India”. True, but he got the doctor and a whole unit here from abroad. Didn't that undermine our Indian doctors?
According to reports, Government over ruled recommendation to restrict petrol pump operations from 8 AM to 8 PM from round the clock as of now; reason given,avoid creating a bad impression abroad on our prosperity grading! Opening foreign medical facilities to our bureaucrats, in a way, may highlight our prosperity- never mind if the sheen of our Medical facilities is rubbed off.
There will now be a flow of reverse "medical tourism" of IAS and IPS 'burra sahibs' and their kith and kin to countries like the USA, UK, and Canada. What's more, in getting immediate treatment abroad at the expense of the Indian exchequer, they will be more privileged than the citizens of these countries who have to face endless months in the queue under their own public health schemes.
Shame on our government. The government which has not been able to ensure availability of even rabies vaccine in every primary health center to treat victims of dog and monkey bites, which only costs a few hundred rupees per head, will spend crore of rupees on corrupt and rich members of IAS and IPS who will not leave their posts even if government starts charging them a few lakh rupees every month instead of paying salaries to them. It shows why our country is going to dogs with each passing day. If only we can get rid of IAS and IPS from our country we would be able to manage ourselves better.
The shortage of specialists ( and doctors in general ) makes them money, and keeps them busy, though they may not necessarily be excellent.
That is why rulers go to foreign countries for treatment.
When are such moves going to stop? It's high time these folks learnt and are also told that they are public servants and not rulers and masters! (De facto they are!)
As long as we have a predatorial and parasitical bureaucracy - nobody can sort this country out!
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