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        Union Health Minister's comment on the state of government hospitals has not come as a surprise. They were in a deplorable condition, was what he said. Strong words, coming as they do from the Minister himself.

        We ought to be glad that someone in authority is at least aware of the suffering of the multitudes which, unfortunately — that is because they are poor — have no alternative, but go to these institutions. Anbumani Ramdoss has rightly given as examples the plight of maternity hospitals. It will take someone strong willed to step into the verandah of any of the hospitals run by the government. Patients lying on the floors, waiting for hours in queues, unclean wards and filthy toilets, these hospitals are a sorry sight. What quality of doctors are we training in these circumstances?

        The Minister said that some basic features of health programmes would have to be re-examined. Sanitation, nutrition, education, not to forget clean drinking water will get more importance than is now given. The Central government proposes to carry out a survey of hospitals throughout the country to study their functioning and to upgrade facilities. It is true that the quality of service, the range of service in maternal and child care as well as general and preventive services all need immediate attention.

        In India, most sick people have to fend for themselves. Policy-makers must surely be aware of the havoc being wrought by neglecting health care. One would think that this would spur political parties into raising this issue vociferously. It is a misfortune that election manifestos hardly mention healthcare. The sole aim of politicians is to capture power and then hang on to it. By the time the ill-effects of this neglect are seen they will not be in power.

        The government spends only two per cent on health, as opposed to 15 per cent in several developed countries. But defence spending remains high. Which is vital, one may ask. High-tech medical care may be expensive, but can be kept reasonable if services are efficient and equipment is maintained well.

        Government hospitals treating patients free of charge all over the country are in dire straits. Yet people flock there, because most of them have no choice. Doctors working in these conditions are demoralised and cynical. They spend a lot of their time trying to arrange financial help for patients, getting machines repaired and keeping the hospital clean. They must work for poor salaries and in overcrowded outpatient clinics. They see private hospitals have a profusion of expensive equipment which is often underutilised or used when not really necessary. Thus paradoxically there is an inverse relationship between patient need and availability of services.

        This is not to strike a discordant or pessimistic note. What the Minister says is old hat. What the people want is visible improvement. Private hospitals too are no better. They are — at least many of them — are only commercial ventures. There are several shortcomings common to all public sector undertakings. Lack of proper work ethics, lack of discipline and misappropriation of funds are some of them. There has to be an incentive for good work and a punishment for not working. Accountability of employees and transparency of financial deals is essential. The services of voluntary organisations may be sought to assist in keeping things in order, as some private hospitals now do. It must not be forgotten that universal access to health care is a must for any society to progress.