Trust deficit exists between citizens and healthcare system: former IAS officer

Former IAS officer Jayaprakash Narayan highlights trust deficit in Indian healthcare system, emphasising need for reform.

Despite India’s status as a global pharmaceutical and vaccine hub, a trust deficit exists between citizens and the healthcare system, observed former IAS officer Jayaprakash Narayan at the IMA TGSCON conference held at AIG Hospital on Sunday.

“Every year, five crore Indians fall into poverty due to unaffordable healthcare costs,” Dr. Narayan noted, adding that in the states of Telangana and Andhra Pradesh alone, around 45 lakh people are pushed below the poverty line due to healthcare expenses. He highlighted that a majority of healthcare spending, between 58% and 60% comes directly from individuals’ pockets, making it an unsustainable model.

“There was a time when Akkineni Nageswara Rao had to travel to the U.S. for a coronary bypass. Today, in Hyderabad alone, doctors perform 100 such procedures daily. Similarly, when former Prime Minister Atal Bihari Vajpayee needed knee surgery, specialists had to fly in from the U.K. Now, Hyderabad performs 150 knee surgeries each day. While we have indeed made previously inaccessible treatments available domestically, there remains another side to this reality,” he added.

Dr. Narayan pointed out that AIIMS-New Delhi handles a daily outpatient load of 10,000 patients, an international record for any medical institution, though not one to be proud of. Similarly, Telangana hospitals linked to Osmania General Hospital see around 6,000 outpatients daily, with Gandhi Hospital handling approximately 4,000. “These figures are staggering by global standards and reflect a massive breakdown in healthcare below the tertiary level.”

Dr. Narayan also raised concerns about rural healthcare, where unqualified Rural Medical Practitioners (RMPs) often serve as the first point of contact for patients, given the scarcity of qualified doctors. This, he said, further underlines the need for an effective primary healthcare system.

Despite government programs like Ayushman Bharat and Aarogyasri, Dr. Narayan observed, healthcare outcomes have shown little tangible improvement. “While these initiatives have eased some financial burden, outcomes have not significantly improved,” he said, calling for healthcare to become a central pillar of political discourse in India.