Annual Report - National Human Rights Commission

Annexure 8
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and other paramedical staff serve by rotation in difficult areas. During such service in
difficult areas a special package of measures including financial incentives to support
such doctors should be adopted. These two steps are critical to address the problem of
lack of doctors in difficult rural areas.
9. States should have a state drug policy and/or adopt a state drug action plan which
ensures that the states formulate an essential drug list and all the drugs on this list are
available at all public health facilities without interruption, and that the prescription
and use of irrational, expensive drugs and the use of hazardous and banned drugs is
curbed in both the private and public sector. This would also need to specify better
drug information to both the patient and the prescribers.
10. The state should adopt a time bound action plan/road map by which the critical gaps
in the provision of good quality emergency obstetric services, sterilisation services,
safe abortion services, and basic surgical emergency services (burns , accidents) can be
provided in a network of referral centers such that there is at least one such centre per
every 100000 population. This action plan should be a detailed publicly stated
commitment and should have an year by year milestone, so that even if the entire plan
would take ten years to implement, the monitoring committees and the public would
know whether each year, that year’s goals are being achieved.
11. The most immediate measure for closing specialist gaps in the referral center would be
transferring of surgeons and gynaecologists and anaesthetists so that this norm for the
provision of emergency and referral level care is met in as many facilities as possible. In
the absence of a transfer policy well-qualified specialists languish in peripheral centers
losing their skills while key facilities, which needs their services, go without them.
12. The governments may publicly notify what are the services it would be providing at
the level of the habitation, at the level of subcenters, at the level of PHCs, CHCs and
district hospitals along with quality indicators. This should be accompanied by similarly
graded standard treatment protocols. This is essential for public knowledge and for
monitoring. This will also help prevent unreasonable expectations from the public – for
certain services may be available only at the district or block level and not at every
PHC as may be expected. But this needs to be publicly notified.
13. The governments should set up a medical services regulatory authority- analogous to
the telecom regulatory authority- which sanctions what constitutes ethical practice and
sets and monitors quality standards and prices of services – both in the public and even
more importantly in the private sector.
14. A Public Health and Health Services Act that defines the rights of food security, safe
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