The Bill, which is expected to be passed by the end of this month, is the culmination of a series of steps that the State Government had been taking over the last few years to make medical treatment more affordable to more people, especially in the rural areas. A scheme has already been introduced as a pilot project to issue insurance cards to the people under which an expenditure up to Rs. 25,000 for medical treatment will be borne by the Government. The aim is to cover the entire population in as short a time as possible.

The State Government is already bearing the cost of medicines supplied to the tea garden hospitals, especially in Upper Assam where, till a couple of years ago, gastro-enteritis was taking a heavy toll of lives, not only of the labourers but also of the people in the surrounding villages. With the Government taking on the responsibility, medicines are no longer in short supply. Though run by the garden management, these hospitals are no longer restricted to the tea employees only. Anyone can walk into any tea garden hospital for treatment. To the doctors, who now have to bear the extra burden of treating non-tea people as well, the Government is giving a monthly “impetus bonus”.

The State Government is giving an annual grant of Rs. 2.5 lakh each to all tea garden hospitals. There are about eighty of them. The grant goes to meet the cost of equipment, beds and allied facilities.

The condition of the Government hospitals in Assam (there are twenty-two) has “immensely improved” in the past couple of years, says Dr D. P. Bora, Principal of the Jorhat Medical College and an executive member of the Medical Council of India (MCI). The survival rate has gone up perceptibly, according to him. Benefits have also percolated down in the form of mass immunization campaigns. “While the State has, in recent years, taken major strides forward into the health care sector in States like Assam, West Bengal, Kerala and Tripura, the reverse has been the case in States like UP, Bihar, MP and parts of Rajasthan, where the State has practically retreated from the health sector”, he laments.

Taking advantage of the steady deterioration in the conditions of the Government hospitals, there has been a mushrooming of private hospitals over the last two decades. They have all the state-of-the-art equipment and other facilities, but it is only the rich and the affluent who can afford the “luxury” of being treated there. The poor just cannot think of going there while the middle class people are often compelled to get admitted knowing full well they will be fleeced. “With the improvement in the working of the Government hospitals, more and more people will be coming to us,” says a senior health department official.

The Public Health Bill, after being passed by the State Assembly, will become operational only with the framing of Rules and Procedures under it. The Bill makes it mandatory for all hospitals, government or private, to provide free health care service to patients admitted in emergency wards for the first 24 hours. The cost will be borne by the State Government. The rules and procedures will fix the amount of cost.

Another feature of the Bill is that it makes it mandatory to conduct a health impact assessment before giving permission for starting any new industry. Some social workers feel this provision should be made applicable to existing industries also. For example, in stone-crushing industry, the cloud of dust raised by crushers affects not only the labourers who are directly engaged in the work but also the people of surrounding areas. The long-term effect is various pulmonary diseases like bronchitis.

Cancer, particularly oral cancer, has been taking a heavy toll of lives in Assam. Decades ago, Dr S. N. Sarmah, former Principal of the Guwahati Medical College, found out through painstaking research carried on for long years that an alkaloid in the green areca nut which the Assamese are very fond of chewing along with betel leaves contains a carcinogen which is responsible for the high incidence of oral cancer. The State now has only one cancer hospital at Guwahati which can do with a lot of improvement.

Social activists feel that a modern specialty hospital for cancer patients should be set up immediately in Assam so that patients from the entire north-eastern region can get treatment near at home instead of having to go to far distant places like Mumbai or Vellore, adding greatly to the cost of the treatment. (IPA)