Report of the Health Survey and Development Committee Vol.IV (Summary)

Abstract

In this foreword an attempt is made to present, in a nutshell, the main principles underlying the 'Committee’ s proposals for future 'health development in the country. -These are:— 1. No individual should fail to secure adequate medical care •because of Inability ti> pay for it. 2. In view of the complexity' of modem medical ,practipe, the ^eajth ^ervjces should p^vide, when fully developed, all $he consultant, laboratory and institutional facilities necessary for ,prpper •diagnosis and treatment. 3. The health programme must, from the beginning, lay special emphasis 6n ,preventive work. *The creation and maintenance of as healthy an environment as possible ‘in the homes t>f the .people as well ,a^ in all places whqre .tjiey congregate for work, fkn^usement or ^ecrea- Jiion, aje essential.H So -long as environmental hygiene is ^egjleeted, tSO long as the faulty modes of life o f ,the individual and of the, com- _’m,unity remain uncorrpctejl, so dong' as these find qth^r f actors wejik- ^ni^ig naan’s power of resistance and increasing his susceptibility to ^Ijsea^e are allowed to .operate unchecked, so long ,will qurtons., and villages, 'continue ,to-be factories r£or the supply of /?^ses *to our >hospita ls p id, dispensaries. The need is urgent for jprovi4jng as much ..me^ical^rglipf and jprj3y,§ijtive ii^alth care #s ppssibje ,to the yapt,rural population of'the %cpuntry. The debt which India .owes to .the filler of the-soil .is im- .m,eMe .find, although he pays the heaviest toll when 4apiine ,and {pestilence-,sw^ep .through the land, the medical attention <he re.cgives is‘ 6f the most meagre description. The time has therefore come to redress the neglect which has hitherto been the lot of the rural areas* 5. The health services should be placed as close to the people as spossible in order to ensure the maximum benefit to the communities ;to be served. The unit of health administration should therefore be inaade as small as is compatible with practical considerations. 6. It is essential to' secure the active co-operation of the people in ithe development of the health programme. The idea must be inculcated that, ultimately, the health of the individual is his own responsibility and, in attempting to do so, the most effective means would seem to be to stimulate his health consciousness by providing health education on the widest possible basis as well as opportunities for his active participation in -the local health programme. 7. We consider it essential for the success of the scheme that its .development should be entrusted to Ministers of Health who enjoy the confidence of the people and are able to secure their co-operation. ■Both in respect of legislation and of administration ii is likely Tihati' some of the' measures to be_ undertaken may offend existing social :and religious practices, while others may involve control over the day to day life of the citizen. We therefore feel that it is only a Minister, enjoying the confidence of the people who can carry such enactments through the legislature and ensure their practical application in the country. In putting forward its proposals for a national health organisation, which incorporates these principles, the Committee has drawn up a long-term programme which., if implemented on the lines suggested should help to* provide the people with a reasonably well developed service based on the newer and expanding^ conceptions of modem health practice- The attainment of this objective, which may take about 40 years, is to be achieved through successive -stages of intensive effort directed towards the production of the necessary trained personnel and the creation and development of the organisations and institutions which will forrfr gssential parts of the community’s health service. The Committee has attempted to outline, in some detail, the first and second five-yearly stages of such development and has. also suggested certain objectives to be kept in view for the next five years, leaving subsequent developments to be shaped in the light of the circumstances existing at the time. The doctor of the future should be' a “ social physician protecting the people and guiding them to a healthier and happier life” . He should place prevention of disease in the forefront of his programme and. should so combine remedial and preventive measures as to confer the maximum benefit on the community. The Committee’s proposals for the training of the ‘basic’ doctor, the term applied to the medical1 graduate of the future, are designed to equip him for all such duties. The active support of the people is sought to be secured through the establishment of Health Committees in every village and through the stimulation of local effort for the improvement of environmental sanitation,-control of infectious diseases and other purposes. A wide programme of health education, covering all sections of the population, is also proposed for promoting the growth of such public support.