UP's model health ATM can revolutionise medicare

Bihar, MP, Rajasthan, and UP have once been branded as "Bimaru" States. But today, Uttar Pradesh has a lesson or two to teach the rest of Indian terms of healthy law and order as well as public health. The bulldozer CM Yogi Adityanath, often the butt of criticism for his style of functioning, has a positive side, too. First, he appears to have effectively created the impression that the law-and-order situation has been under check and that women in UP feel much safer now than ever before. This has won him the hearts and votes. Now, he has come out with Health ATM – a kiosk one can get 50-odd tests done in a matter of just five minutes and the reports will be sent online to doctors for prescription and follow-up advice.

Yogi has just launched the scheme at Gorakhpur and promised to extend it to 4,600 primary and community health centres. The State promises to have this facility to be made available free of cost. In addition to routine tests like weight, pulse, heart rate, the ATMs will also check blood sugar, urine, dengue, malaria, hepatitis, arthritis profile, pregnancy test, and typhoid. What is more, the ATM network will be connected to the public health network to enable tele-consultation.

All CHC-PHCs are equipped with Wi-Fi and connected via tele-consultation for this purpose. The government cleverly has roped in CSR funds of corporates for the project, much as Narendra Modi has done for Swachh Bharat. Brilliant, since it is not a pre-poll freebee. Much, of course, will depend on the execution and functioning of the system and timely availability of doctors for tele-medicine. The provider of the Health ATMs will be responsible for training the staff to handle patients, but the follow-up is equally important, and we have to see how effectively the tele-consultation will function in the short and long runs.

The Yogi government already offers free dialysis services at the district hospital levels. Smaller districts are thus helpful in making such services, apart from resolving revenue and other issues. Thus, the monitoring of functioning of these health facilities becomes much easier than in large districts. Ultimately, accountability matters, and it must flow from the top. Using the police machinery and the proverbial Danda is much easier as compared to running the sensitive public health service.

In crimes, a small number of people are involved but in health care each and every citizen is involved and affected. So, even a small mistake, pitfall or failure can bring bad name to the system. We often keep seeing attacks on hospitals and doctors in the wake of patients' deaths. These are never justifiable. Police protection or deterrent punishments can check such attacks. But in this social media era, it doesn't take too long for the bad word to spread like wildfire. I am not forecasting dooms day but want to caution the system to be alert and accountable.

Covid has taught us the need to invest in public health and today people are generally cautious even if they catch a cold or cough. They run to their doctors or make telemedicine calls. From the World Health Organisation to Prime Minister Narendra Modi have all been talking of dramatically improving the health infrastructure. Recently, the WHO and World Bank have come together to set up a brand new financial intermediary fund (FIF) for pandemic prevention, preparedness, and response (PPR). "Covid-19 has highlighted the pressing need for action to build stronger health systems," said World Bank Group President David Malpass.

"Investing now will save lives and resources for the years to come. We welcome the broad support from the international community for this new, multilateral financial intermediary fund at the World Bank to help low- and middle-income countries and regions become better prepared for global health crises and are pleased to have been able to proceed quickly in establishing the fund."

The fund will provide a dedicated stream of additional, long-term financing to strengthen PPR capabilities in low- and middle-income countries and address critical gaps through investments and technical support at the national, regional, and global levels. "The Covid-19 pandemic has been a seismic shock to the world, but we also know that the next pandemic is a matter of when, not if," said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. "The suffering and loss we have all endured will be in vain unless we learn the painful lessons from Covid-19 and put in place the measures to fill critical gaps in the world's defences against epidemics and pandemics."

Health is wealth in more than one way. Healthy citizens will be able to perform well, think well and do well in whichever field they are. This will lead to a much higher GDP and the nation will emerge as Numero Uno on the global canvass. This may sound highly political as we have been hearing this rhetoric time and again. But Yogi seems to have thought through the Health ATM system and kept the future in his mind. If the scheme succeeds, it will prove that investment in health is investment in future. It is important to win the maximum number of seats from the largest State – Uttar Pradesh – to be in commanding position in any general election and it is all the more important in 2024. As we have been discussing, perform well and votes will automatically rain in your favour.

Another important thing that I notice about Yogi is that he is being politically right by praising the Prime Minister for the progress and the schemes that his government is launching. He used the first term as the CM for consolidation and vowed to use the second one for performance. Statistically speaking, even if his welfare and employment schemes are half successful, he would meet his target of winning 75 seats. This could happen even if half the voters turn up at the polling booths and most of them press the Lotus button. This is where knowing the pulse of the people is important and betting on health infrastructure is the best political bet. We shall keep a watch on the Health ATMs as they begin to start functioning in all the districts of Uttar Pradesh. Other States will hopefully learn this rather than promising freebies which are anyway on the radars of the Election Commission and the Supreme Court. Other States, irrespective of political anatomy, will hopefully remember what the WHO director general said and how Yogi took the cue.

(The columnist is a Mumbai-based media veteran now running many news-based websites and a youtube channel known for his thought-provoking messaging. The views expressed are personal)