Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Crime, health-worker safety, and a self-examination 

Explained | Indian Society | Mains Paper 2: Health & Education
Note4Students

From UPSC perspective, the following things are important :

Mains level: Issues in the healthcare sector;

Why in the News?

  • The recent brutal rape and murder case in Kolkata has sparked widespread calls for the death penalty for the accused.
    • The Justice J.S. Verma Committee, formed in response to the 2012 Delhi gang rape, recommended against the death penalty for rape, even in the rarest of rare cases, arguing that it would be a regressive step.

Deeper problem in the Health Care Sector: 

  • Healthcare Violence: The protests by resident doctors stem from a series of violent attacks against medical personnel. This violence often arises from disgruntled patients and their families who perceive poor healthcare services.
  • Corruption in Healthcare: The World Health Organization estimates that corruption claims nearly $455 billion annually, which could otherwise extend universal health coverage globally.
    • In India, this corruption manifests in various forms, including bribery and sextortion, further undermining the healthcare system’s integrity.
  • Ineffective Responses: Traditional responses to healthcare violence, such as enhancing security and legal measures, have proven inadequate. These knee-jerk reactions fail to address the root causes of the violence.

What does the Justice K. Hema Committee report say on the Culture of Assault?

  • On Sexual Assault and Consent: Instances of sexual assault are not isolated events but are rooted in societal practices that undermine women’s autonomy and consent.
    • The National Crime Records Bureau reported 31,516 cases of rape in India in 2022, indicating a significant prevalence of sexual violence against women.
    • The Justice Hema Committee report emphasizes that rape is a manifestation of a culture that views women as objects rather than individuals with rights.
  • On Workplace Harassment: The Vishaka guidelines established in 1997 aimed to protect women from workplace harassment, leading to the Sexual Harassment of Women at Workplace Act, 2013, which mandates the formation of Internal Complaints Committees (ICC).
    • The report argues that ICCs are inadequate for the film industry due to potential biases and influence from abusers, advocating for an independent government forum to address these issues.

Need to Rethink Violence in Healthcare:  

  • Understanding the Multi-faceted Nature of Violence: Violence in healthcare settings is not limited to patient assaults on healthcare workers, it also includes institutional and managerial violence. This encompasses horizontal violence among healthcare providers and the systemic issues that create a hostile work environment.
  • Implementing Comprehensive Safety Measures: While immediate responses such as improving security and legal protections are necessary, they must be part of a broader strategy that includes training healthcare workers on conflict resolution, mental health support, and creating a culture of safety within healthcare institutions.

About Justice J.S. Verma Committee Recommendations

Recommendations on

Explanation
Rape • It recognized rape as a Crime of Power, not just passion.
• Expand definition to include all forms of non-consensual penetration.
• Remove marital rape exception; marriage should not imply automatic consent. (European Commission of Human Rights in C.R. vs U.K)
Sexual Assault • Broaden definition to include all non-consensual, non-penetrative sexual acts.
• Penalty: Up to 5 years of imprisonment or fines.
Verbal Sexual Assault • Criminalize unwelcome sexual threats.
• Punishable by up to 1 year in prison or fines.
Sexual Harassment at Workplace • Include domestic workers under protections.
• Replace internal complaint committees with Employment Tribunals.
• Employers to compensate victims of sexual harassment.
Acid Attacks • Propose a 10-year minimum punishment, separate from grievous hurt.
• Establish a compensation fund for victims.
Women in Conflict Areas • Review AFSPA; exclude government sanction for prosecuting sexual offenses by armed forces.
• Appoint special commissioners to monitor offenses.
Trafficking • Comprehensive anti-trafficking laws beyond prostitution.
• Protective homes for women and juveniles overseen by High Courts.
Child Sexual Abuse • Define ‘harm’ and ‘health’ in the Juvenile Justice Act to include both physical and mental aspects.
Death Penalty • Opposed chemical castration and death penalty for rape.
• Recommend life imprisonment.
Medical Examination of Rape Victims • Ban the two-finger test; victim’s past sexual history should not influence the case.
Reforms in Case Management • Set up Rape Crisis Cells, increase police accountability, allow online FIR filing.
• Encourage community policing and increase police personnel.

Need for a Comprehensive Approach:

  • National Task Force: Improving hospital security and infrastructure alone may not be sufficient to address the problem. The national task force constituted by the Supreme Court should devise a comprehensive road map to prevent and arrest medical corruption, particularly in the public sector.
  • Need Expertise: The task force should include experts from public health, medico-legal, and other allied fields, along with the participation of the larger governing and administrative community.

Note: Recently some states have taken steps to empower women. For example, the Himachal Pradesh Assembly passed a Bill on Tuesday to increase the minimum marriage age for women from 18 to 21 years.

Mains PYQ: 

Q Appropriate local community level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain. (UPSC CSE 2018)

Q We are witnessing increasing instances of sexual violence against women in the country. Despite existing legal provisions against it, the number of such incidences is on the rise. Suggest some innovative measures to tackle this menace. (UPSC CSE 2014)

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