‘My basic agenda is to provide quality healthcare to Karnataka’

Dynamic and soft-spoken, 52-year old Dr H Sudarshan is the chairman, Task Force on Health and Family Welfare, Government of Karnataka, and member of Core Group on Health at National Human Rights Commission (NHRC). An MBBS degree holder from Bangalore Medical College, he has undertaken several projects including Ramakrishna Mission Health Projects — Himalayas (UP) and Ponnampet (Karnataka). He started integrated tribal development project at B R Hills (Mysore) in 1980 and the Karuna Trust, in Yelandur taluka, with emphasis on leprosy, tuberculosis and other rural development programmes in 1987. The Vigilance Director of Lok Ayukta (Health, Education and Social Welfare) is the recipient of awards like Rajyothsava State Award in 1984, Right Livelihood Award in 1994, Karnataka Jyothi award in 1997 and Padmashree Award in 2000. Dr Sudarshan talks to Express Healthcare Management in an exclusive interview with Vijaya K.

How can NGOs bring changes in healthcare delivery?

NGOs have an important role in bringing about reforms. NGOs come up with many innovations in remote areas showing alternate paths which the public sector can try and learn.

They have well motivated staff, are cost-effective and show efficient results. NGOs have a lot of freedom, flexibility to adapt and respond to the needs of the community.

Their primary objective is empowering people and solving their problems. However, this is inadequate as NGOs in India provide only 5 per cent of the healthcare.

Have the voluntary organisations been able to meet their objectives?

NGOs are undoubtedly trying to reform the government machinery. Their involvement, by adopting PHCs has yielded excellent results. But very few NGOs come forward because of limited capability. I believe in having small NGOs otherwise problems of bureaucracy may creep in. But instead of working in isolation, we can bring this culture and innovative ideas into the government. Partnerships should evolve from the beginning.

How can we tackle rampant corruption among NGOs?

Efforts are being made by bringing in a code of conduct, but ultimately the NGOs have to have their own credibility. It is tedious to monitor them and identify credibility.

NGOs try to get tax exemption and even bribe to get government grants. It is difficult to differentiate between a genuine and a fake NGO. Regulations may also harm genuine NGOs working at the grassroot level. But surely, committed NGOs will emerge in future.

An NGO cell has been created based on the recommendation of the Task Force on Health and Family Welfare. So convergence is taking place.

Why do many NGOs work in the field of Aids and not other diseases?

With a lot of international funding and increasing emphasis on HIV/Aids issue, a lot of vertical programmes have also been introduced by several NGOs. This has harmed healthcare services because there is lack of co-ordination and resources are wasted. Conducting a vertical programme is very expensive. Hence the need for integrated approach. In fact in Karnataka, vertical programmes like polio immunisation overshadowed other six immunisations which is not a good development.

Do we need to curb mushrooming of NGOs?

Mushrooming of voluntary organisations is seen in states like Karnataka, Tamil Nadu and Andhra Pradesh. We need NGOs with professional approach who can systematically work in partnership with government. Recently CAPART, a rural organisation of the GoI had blacklisted several NGOs, who had misused grants sanctioned for constructing houses, as fake.

What role should the government play for efficient healthcare system?

The government should encourage public-private partnerships, remove bottlenecks, red-tapism, streamline grant-making mechanisms and select credible NGOs. NGOs should work at taluka and district level with the government as providers of technical support and trainers.

Have national health programmes been successful in achieving their objectives?

Good governance, leadership, commitment and discipline are important to make them a success. Corruption and callousness are some of the problems of health management. The will to put the programmes into practice and to deliver them to the public is required.

What is your perspective on healthcare system in India?

There is a good network of primary healthcare system. We have eradicated some diseases without enough progress. Even now people die of anaemia due to vertical programmmes.

At the national level, the health and family welfare programmes should be integrated. Secondly, there should be greater decentralisation.

We need a health worker for every village. Rational drug use, streamlining of procurement of drugs, strengthening of drugs control department to eliminate spurious drugs, establishment of a good referral secondary care system and good medical education are essential.

As an NGO committed to health, what are the challenges you foresee?

Today, the voluntary movement is eroding. We need committed people to put plans into practice. It is not enough to create excellence, creating impact is necessary.

We can improve the health systems by motivating people and making it transparent. My basic agenda is to provide quality healthcare to the people of Karnataka and we are moving towards that.