Kerala 2005 - of Planning Commission

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Kerala has maintained a strong tradition of indigenous
health care especially ayurveda. In recent periods there
has been a considerable increase in demand for ayurvedic
system of health care both in the domestic (regional and
national) as well as in the international markets. In fact,
Kerala has successfully factored ayurvedic health care into
its tourism sector that has witnessed a steady increase.
It goes to the credit of the State Government that it has
maintained a public system of health care consisting of
allopathy, ayurveda and homeopathy. Public policy
should now focus on measures to introduce standards
in ayurvedic health care services as well as manufacture
of pharmaceuticals and related commodities. Innovative
approaches to treatment, marketing and other services are
called for. There is a case for initiating high standards
of research and development centres in ayurveda. Since
financial resources are a constraint to any government
initiative, possibilities of a consortium approach
involving public-private partnership need to be explored.
Such an initiative is likely to find favour with the Central
Government as well. Given the size and enthusiasm of the
Kerala diaspora, there is the potential to source resources
from the ‘external’ sector as well. Since such a venture
is unlikely to bring in commercial returns in the near
term, establishment of a foundation for such research and
development activities could be thought of. The highly
experienced and reputed talents available within Kerala
could be tapped for this purpose.
While the private health care sector has now come to
dominate the Kerala scene, one should not underestimate
the important role being played by the public system. In
fact a well functioning public health care sector acts as a
check against the ill effects of a co-existing private sector.
It is here that public policy has to be focused to strengthen
the existing public health care sector. The lower rungs
of this system such as Primary and Community Health
Care Centres have partly been brought under the control
of Village and Block level Panchayats with responsibility
for maintaining the infrastructure and overseeing the
functioning of institutions. The continuing deficit in
physical infrastructure as well as the shortage of qualified
medical personnel (due to a higher opportunity cost of such
specialists) are two areas that need to be taken care of.
Two specific recommendations are put forward here. One,
the creation of panchayat level funds for strengthening the
public health system may be given serious consideration for
supplementing the currently available resources. Second,
vesting panchayats with powers to appoint medical and
related health care personnel in the institutions under their
supervision/control.
3. Linking Human Development
with Growth
A major outcome of this Report is the emerging, as well as
encouraging, scenario in Kerala pointing to the possible
emergence of a virtuous cycle of growth linking human
development with growth. If this link has to be – and should
be – strengthened, several policy initiatives are called for
that are not necessarily focused on human development
per se in a segmented sense. In chalking out the possible
growth scenario, the Report has taken into account the
regional character of the economy, the national context
of economic liberalisation and its international linkages.
The importance of non-traded sectors, where the threat of
competition is relatively less, has been emphasised. The
most critical aspect, both from a short and long-run point
of view, is the management and development of critical
infrastructure. Concerted efforts are therefore called for
to improve and develop such critical infrastructure as the
supply of electric power, water control, road and water
transport and environmental sanitation.
A common factor in the development of critical
infrastructure is the time and cost overruns. The Report
has mentioned this with reference to the irrigation and
power sectors. A thorough review of the time and cost
overruns of all infrastructure projects is called for with a
view to developing a system whereby such overruns are
eliminated for future projects.
An equally urgent area of concern is that of environmental
sanitation. While sanitation facilities of a personal and
household kind are being taken care of, those in the realm
of ‘public bads’ such as waste disposal and treatment
have become subjects of increasing controversy and
public concern during the last one-and-half decades,
if not more. While Local Bodies are charged with the
responsibility of environmental sanitation, they are
not backed by adequate support in terms of resources,
technical assistance and political will. Apart from its
close connection with the quality of human development,
environmental sanitation is also an important factor
in Kerala’s ability to pursue a sustainable growth
strategy that is compatible with the preservation and
augmentation of its ecosystem that has emerged as one
of its ‘assets’ and the natural beauty that attracts so many
visitors. The tourism industry has emerged as one with a
high potential for development in Kerala. However, past
experience in promoting tourism, for instance, the case
of Kovalam, has not been very conducive to enhancing
human development, resulting as it did in a negative