The Ashok Gehlot-led Rajasthan government on Thursday introduced the Right to Health Bill in the Rajasthan assembly. The bill claims to establish legal rights and entitlement of citizens to avail themselves the best health services.?
Health rights experts say Rajasthan’s bill lacks a guarantee of the accessibility of basic health services and mentions no specific financial allocation.
The Ashok Gehlot-led Rajasthan government on Thursday introduced the Right to Health Bill in the Rajasthan assembly. The bill claims to establish legal rights and entitlement of citizens to avail themselves the best health services.?
After its introduction in the assembly, the bill was sent to the select committee the next day. It shall now be passed after the committee gives its nod.?
Rajasthan would be the first in the country to have such a law when this bill is passed. However, it has received a mixed response from various stakeholders, including health experts, who have demanded certain revisions. Even the bill received protest by the Doctor Association of Rajasthan —both private and government— which demanded certain amendments to be made before it is passed.
Rajasthan Health Minister Prasadi Lal Meena, who introduced the Bill in the assembly, said, “The bill has been brought to enhance the effectiveness and implementation of the Rajasthan Model of Public Health and the bill commits to safeguard the right to health of residents.”
Calling the bill as first of its kind, Meena said, “The Bill also ensures grievance redressal mechanism. Besides this the Bill aims to establish a strong state health authority and the district health authority.”
The recurring expenditure for the Bill will be Rs 14.50 crore. While Rs 14 crore have been allotted for human resources, around Rs 5 lakh have been kept for as allowances to be made to the nominated members of the state health authority and district health authorities.
As soon as the bill was introduced, a group of NGOs working in the health sector released a joint press release highlighting the ‘flaws’ and ‘missing’ portions in the bill. As per the health rights experts, the bill lacks a guarantee of the accessibility of basic health services and has no specific financial allocation mentioned.
Healthcare activists have demanded the availability of government-funded healthcare services as per distance or geographical area or considering population density which includes health care institutions, free medicine, test and diagnostics of notified items, and ambulance services as per standards as may be prescribed.
Pavitra Mohan, a health activist associated with Basic Healthcare Services (BHS), told Outlook, “The Bill is a good initiative but at the same time, as it has no guarantee for basic health services and there is no extra budget allocated for the Bill. It should clearly mention that in how many kilometres one can get guaranteed access. We had demanded it should be a minimum of 3 kilometres. People now walk even 100 kilometres to reach a nearby health care service in villages.
“Besides this, the Bill mentions that the ‘Social Audit’ will be conducted by the community using the social dimension. But it should also be conducted as per the Auditing Standards of Social Audit as laid down by the Comptroller and Auditor General.”
Mohan also demanded that around 8-10 per cent of the state budget should go to healthcare. At the moment, allocation to health services is just around 5 per cent of the total budget.
The Bill has received criticism for Section 14 which says: “No civil court shall have jurisdiction to entertain any suit or proceeding in respect of any matter which the State Health Authority or District Health Authority, as the case may be, constituted under this Act is empowered by or under this Act to determine.”
The health activists have demanded that completely barring the jurisdiction of civil courts is neither desirable nor realistic as the State Health Authority or District Health Authority would not have the authority or resources to deal with the range of disputes or issues that may arise.
Rajasthan-based health activist Dr Narendra Gupta of Jan Swasthya Abhiyan (JSA) told Outlook “It is a good step and this Bill is a much awaited one. It has gone through a long process since 2018 after Congress came to power. The Act which is presently called the Rajasthan Right to Health Act, 2022, maybe retitled as ‘Right to Health Care Act’ as its contents largely account for healthcare aspects.”
The Bill started getting shape in late 2018 after the Congress government came to the power in Rajasthan. However, the bill despite being one of the promises mentioned in the election manifesto of Congress took four years to get introduced.
“The government started working on it immediately after it came to power, but Covid-19 delayed it. ?Later we [the health NGOs] of the state were asked to form a draft which we submitted to the health minister. After this, the draft was put on the government website and public opinions were sought. However, what is more disappointing is that none of those suggestions have been carried in the bill,” added Gupta, who has examined the Bill.
Reacting to the comments, Rajasthan Health Minister Prasadi Lal Meena said, "The Bill was made keeping in mind the opinions of people, non-government organisations, and other stakeholders. And it shall be passed after a thorough discussion.”
Meena added that the Bill is a part of the state government’s bid to expand and strengthen medical services. Steps in this regard include Mukhyamantri Chiranjeevi Swasthya Bima Yojana, which provides health security for every family by providing free treatment up to Rs 10 lakh, and the Rajasthan Government Health Scheme (RGHS), which gives insurance of up to Rs 5 lakh to families registered in the scheme.