Journal of Family Medicine and Primary Care

LETTER TO EDITOR
Year
: 2019  |  Volume : 8  |  Issue : 4  |  Page : 1514-

Primary care is the key to health for all


Jayanta Bhattacharya 
 General Practitioner, Raiganj, North Dinajpur, West Bengal, India

Correspondence Address:
Dr. Jayanta Bhattacharya
MBBS, PhD, General Practitioner, Raiganj, North Dinajpur - 733 134, West Bengal
India




How to cite this article:
Bhattacharya J. Primary care is the key to health for all.J Family Med Prim Care 2019;8:1514-1514


How to cite this URL:
Bhattacharya J. Primary care is the key to health for all. J Family Med Prim Care [serial online] 2019 [cited 2019 Dec 7 ];8:1514-1514
Available from: http://www.jfmpc.com/text.asp?2019/8/4/1514/257094


Full Text



Sir,

The editorial by Raman Kumar is of immense importance with respect to the present academic scenario in India.[1] He has raised an important question, “The absence of the discipline of family medicine/general practice within the MBBS curriculum is not inadvertent. It has been deliberately blackened out.”[2] We can benefit by focusing briefly on the historical trajectory of primary health care (I like to use this particular term). Comprehensive primary health care (CPHC) was the pivotal issue of the historical Conference of Alma-Ata in 1978. As a result of sustained pressure from giant corporates and MNCs CPHC was later reduced to “selective primary healthcare,” then to GOBI and so on. The Conference enunciated, “An acceptable level of health for all the people of the world … can be attained through a fuller and better use of the world's resources, a considerable part of which is now spent on armaments and military conflicts. A genuine policy of independence, peace, détente, and disarmament could and should release additional resources that could well be devoted to peaceful aims and in particular to the acceleration of social and economic development of which primary health care, as an essential part, should be allotted its proper share.” Logically, medical curricula would follow suit.

According to Reddy, India is “a country that's become the global pharmacy for myriad inexpensive drugs but allows 63 million of its people (almost the population size of UK) to sink into poverty each year as a result of unaffordable health care costs.”[3] 70% of health care expenditures consist of out-of-pocket spending, which is highly impoverishing. Neologisms like “medical poverty trap” and “medical tourism” are well-known now. Today, the private sector provides nearly 80% of outpatient and 60% of inpatient care.

National Health Policy 2017 assures “availability of free, comprehensive primary health care services, for all aspects of reproductive, maternal, child, and adolescent health and for the most prevalent communicable, non-communicable, and occupational diseases in the population.”[4] The policy has also noted that right to health cannot be perceived unless the basic health infrastructure spread-out across the geographical frontiers of the country. However, the right to health is not included in the fundamental rights of the Indian Constitution.

In American experience too, there is dire need of primary care physicians – “Primary care is the foundation of effective health care systems … primary care physicians, patients, and physician's value continuity in their primary care relationships, which can last many years.”[5]

Should we care to listen to it?

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Kumar R. The tyranny of the Medical Council of India's new (2019) MBBS curriculum: Abolition of the academic discipline of family physicians and general practitioners from the medical education system of India.J Family MedPrimary Care 2019;8:323-5.
2Kumar R. The tyranny of the Medical Council of India's new. MBBS curriculum. 2019. p.325.
3Srinath ReddyK. India's aspirations for universal health coverage.NEngl J Med2015;373:1-5.
4National Health Policy, Government of India. 2017 (2.3.1).
5AyanianJZ, Harmel MB. Transforming primary care - We get what we pay for. N Engl J Med2016;374:2390-2.