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P LANNING P ARADIGM
made for enabling the representatives
of these professions to infl uence the
health policy of the country;
5. In view of the complexity of modern
medical practice, from the standpoint
of diagnosis and treatment, consultant,
laboratory and institutional facilities of
a varied character, which together con-
stitute “group” practice, should be
made available;
6. Special provision will be required for
certain sections of the population, e.g.
mothers, children, the mentally defi -
cient etc.,
7. No individual should fail to secure ad-
equate medical care, curative and preventive,
because of inability to pay for
it and
8. The creation and maintenance of as
healthy an environment as possible in
the homes of the people as well as in all
places where they congregate for work,
amusement recreation, are essential. 1
It further emphasized a need for a comprehensive
and universal health care
system, and it made recommendations
concerning the
district health scheme and
health organization to provide
integrated health services
— curative, preventive
and promotive — to the entire
population. If implemented,
these measures
would have been India’s fi rst
steps to realize universal access.
The health care facilities
112 THE IIPM THINK TANK
that existed in India at the time of the
Bhore Committee were embarrassingly
inadequate. In fact, most of these were in
urban areas and largely in enclaves of the
British Civil administration and Canton-
ments. 2
The Committee categorically states,
"we are satisfi ed that our requirements
can only be met satisfactorily by the development
and maintenance of a state
Health Service." 3 It recommended that all
services provided by the health organiza-
No individual should fail to secure
adequate medical care, curative and
preventive, because of inability to pay
tion should be free to the population
without distinction and it should be fi -
nanced through tax revenues. 4 It further
recommended that the health service
should be a salaried service with wholetime
doctors who should be prohibited
from private practice. 5
The Bhore Committee
ends its report on a clear
note of urgency for implementation
of the plan
in its full form:
The existing state
of public health in the country is so unsatisfactory
that any attempt to improve the
present position must necessarily involve
administrative measures of such magnitude
as may well seem to be out of all proportion
to what has been conceived and accomplished
in the past. This seems to us inevitable,
especially because health administration
has so far received from governments
but a fraction of the attention that it deserves
in comparison with other branches
of governmental activity. We believe that we
have only been fulfi lling the duty imposed
on us by the Government of India in putting
forward this health programme, which can
in no way be considered as extravagant either
in relation to the standards of health
administration already reached in many
other countries or in relation to the minimum
requirements of any scheme which is
intended to demonstrate an appreciable
improvement in the health of the community.
For reasons already set out, we also
believe that the execution of the scheme
should not be beyond the fi nancial capacity
of governments.
We desire to stress the organic unity of the
component parts of the programme we
have put forward. Large-scale provision
for the training of
health personnel forms an
essential part of the
scheme, because the organization
of a trained
army of fi ghters is the
fi rst requisite for the successful
prosecution of
the campaign against
diseases. Side by side
with such training of
personnel, we have provided
for the establishment
of a health organization
which will bring