fees, patients' rights and a grievance redressal mechanism. Towards this, standard guidelines for quality of care, treatment protocols and rational cost estimates of common health care services need to be developed. Trust hospitals, which have availed of large-scale public subsidies in terms of land at minimal cost and other benefits, must be made to effectively provide 20 per cent of beds for economically-weaker sections. • Substantially increase public health financing: India is already committed to increasing health financing to 3 per cent of GDP from the current level of 1.2 per cent. This implies making a quantum jump in the health care budget, a significant part of which should be utilized for strengthening of the public health system and enhancing health sector human power, while developing frameworks for regulating the private medical sector in parallel.
• Ensuring laws and governance for the health system: Enactment of a National Health Act, which ensures the right to health and health care for all, could be an important legal step.
Community Based Monitoring should be extended to ensure participatory planning and monitoring of all health services, with active involvement of civil society organizations.
Generating widespread awareness and people's organization for health rights is an essential condition to make any UHC system in India work successfully in people's interest. The dozen questions and answers above should give the reader an overall idea about a system for UHC, and how this goal can be achieved in India. Though it may sound like a dream, given the experience of so many other countries, it is clear that UHC is a realizable dream.
In the early twenty-first century, for both people and doctors, health care should cease to be a commodity, and should become a publicly organized service. With such a framework, health care should be considered a human right. Starting from the present crisis situation, moving towards a system which would fulfil the health rights of all residents in India, and would provide a stable, decent income with healthy working environments for all doctors, is a stupendous challenge, and would require extensive social churning. It is high time that all of us rise to meet this challenge, and convert the dream of Universal Health Care into reality
sections, and would also induce more doctors to step out of the commission-based rat race, and practise ethically. Some public-minded individuals or social groups need to engage with a few rational and ethical doctors in their area to initiate such a process. One essential ingredient for success would be the availability of at least a few rational and ethical doctors to start with, who would devote some time and energy for this activity. A second important component would be the presence of a committed social group or NGO, which may work as the secretariat of such a forum, particularly keeping in mind that most doctors are quite busy and may not be able to devote much time for coordination of such an activity. The core activity of such a forum would naturally be informing patients about some appropriate, rational doctors, based on their specific conditions and requirements. As far as possible, the options of a few providers would be given, enabling the patient to make the actual choice based on their own specific requirements and preferences. Along with this, regular public discussions could be conducted to promote interaction between doctors and citizens on key issues like: What would be a desirable form of regulating private hospitals? What are patients' rights and responsibilities? What is a rational approach to common conditions like childbirth, or measures like child vaccination? The 'Citizen—Doctor forums' would need to be given wide publicity so that
large numbers of citizens and more doctors would progressively join the group. It must be underlined here, that at the time of initiating such a process.
It must be underlined here, that at the time of initiating such a process in any area, clear criteria and procedures for including names of specific physicians in the list of rational and ethical doctors would have to be worked out. The forum could come out with a list of basic conditions that the involved doctors would need to sign, for being included in the list. This might include a poster display in the clinic on patients' rights, and a personal declaration that the doctor respects these rights; a declaration that the doctor does not take gifts and favours from pharmaceutical companies; a commitment to answering patients' queries and following rational treatment practices etc. At the same time, feedback from individual patients regarding each doctor would need to be analysed and taken into account, and if any doctor is found not following the basic criteria or declarations made by them, then they might be removed from the list. At the same time, doctors who have been
positively rated by large numbers of patients would be appreciated and continued in the forum. Some of the exchanges in the forum related to health awareness topics, rational treatment practices etc. could be mediated through a web portal or online platform. However, care would need to be taken that at no stage, or in any form, is an individual doctor or hospital allowed to advertise through this kind of a platform. Provided that the forum gets strong support from a number of rational and ethical doctors, it can start something like a second opinion service, whereby patients could choose from among a panel of rational and ethical specialists, to seek a second opinion (some appropriate fee could be charged for providing such opinions). Based on the demands of the forum's work, a person could be assigned to respond to the queries coming from patients, and for coordinating activities. Such Citizen—Doctor Forums are an emerging idea in the Indian setting. In this context, a notable voluntary service is currently run by the Hospital Guide Foundation, where referral advice is provided to patients free of charge in certain major cities. Hospital Guide Foundation—Connecting Patients with Quality
Hospital Guide Foundation—Connecting Patients with Quality Health Care Providers Hospital Guide Foundation (HGF)I is an NGO with a vision to revolutionize health care in India, by bridging gaps to make quality health care accessible across all sections of society. It is a free service that does not charge its patients, and also does not have any . commercial transaction with suggested health care providers/doctors, hence ensuring unbiased suggestions. HGF's current core service, • focused in Bangalore and Delhi, provides health care solutions by referring patients to appropriate doctors. HGF affiliates itself with practitioners after doing a reference check, so that the best of advice • can be given to patients. HGF draws upon the goodwill and help of doctors both in private and government sectors. Every patient request • is strongly evaluated and given equal importance, and then the patient : is referred to the appropriate specialty/doctor. This methodology gives the patient a fair chance in getting the correct diagnosis, • prognosis and treatment.
• Ensuring laws and governance for the health system: Enactment of a National Health Act, which ensures the right to health and health care for all, could be an important legal step.
Community Based Monitoring should be extended to ensure participatory planning and monitoring of all health services, with active involvement of civil society organizations.
Generating widespread awareness and people's organization for health rights is an essential condition to make any UHC system in India work successfully in people's interest. The dozen questions and answers above should give the reader an overall idea about a system for UHC, and how this goal can be achieved in India. Though it may sound like a dream, given the experience of so many other countries, it is clear that UHC is a realizable dream.
In the early twenty-first century, for both people and doctors, health care should cease to be a commodity, and should become a publicly organized service. With such a framework, health care should be considered a human right. Starting from the present crisis situation, moving towards a system which would fulfil the health rights of all residents in India, and would provide a stable, decent income with healthy working environments for all doctors, is a stupendous challenge, and would require extensive social churning. It is high time that all of us rise to meet this challenge, and convert the dream of Universal Health Care into reality
sections, and would also induce more doctors to step out of the commission-based rat race, and practise ethically. Some public-minded individuals or social groups need to engage with a few rational and ethical doctors in their area to initiate such a process. One essential ingredient for success would be the availability of at least a few rational and ethical doctors to start with, who would devote some time and energy for this activity. A second important component would be the presence of a committed social group or NGO, which may work as the secretariat of such a forum, particularly keeping in mind that most doctors are quite busy and may not be able to devote much time for coordination of such an activity. The core activity of such a forum would naturally be informing patients about some appropriate, rational doctors, based on their specific conditions and requirements. As far as possible, the options of a few providers would be given, enabling the patient to make the actual choice based on their own specific requirements and preferences. Along with this, regular public discussions could be conducted to promote interaction between doctors and citizens on key issues like: What would be a desirable form of regulating private hospitals? What are patients' rights and responsibilities? What is a rational approach to common conditions like childbirth, or measures like child vaccination? The 'Citizen—Doctor forums' would need to be given wide publicity so that
large numbers of citizens and more doctors would progressively join the group. It must be underlined here, that at the time of initiating such a process.
It must be underlined here, that at the time of initiating such a process in any area, clear criteria and procedures for including names of specific physicians in the list of rational and ethical doctors would have to be worked out. The forum could come out with a list of basic conditions that the involved doctors would need to sign, for being included in the list. This might include a poster display in the clinic on patients' rights, and a personal declaration that the doctor respects these rights; a declaration that the doctor does not take gifts and favours from pharmaceutical companies; a commitment to answering patients' queries and following rational treatment practices etc. At the same time, feedback from individual patients regarding each doctor would need to be analysed and taken into account, and if any doctor is found not following the basic criteria or declarations made by them, then they might be removed from the list. At the same time, doctors who have been
positively rated by large numbers of patients would be appreciated and continued in the forum. Some of the exchanges in the forum related to health awareness topics, rational treatment practices etc. could be mediated through a web portal or online platform. However, care would need to be taken that at no stage, or in any form, is an individual doctor or hospital allowed to advertise through this kind of a platform. Provided that the forum gets strong support from a number of rational and ethical doctors, it can start something like a second opinion service, whereby patients could choose from among a panel of rational and ethical specialists, to seek a second opinion (some appropriate fee could be charged for providing such opinions). Based on the demands of the forum's work, a person could be assigned to respond to the queries coming from patients, and for coordinating activities. Such Citizen—Doctor Forums are an emerging idea in the Indian setting. In this context, a notable voluntary service is currently run by the Hospital Guide Foundation, where referral advice is provided to patients free of charge in certain major cities. Hospital Guide Foundation—Connecting Patients with Quality
Hospital Guide Foundation—Connecting Patients with Quality Health Care Providers Hospital Guide Foundation (HGF)I is an NGO with a vision to revolutionize health care in India, by bridging gaps to make quality health care accessible across all sections of society. It is a free service that does not charge its patients, and also does not have any . commercial transaction with suggested health care providers/doctors, hence ensuring unbiased suggestions. HGF's current core service, • focused in Bangalore and Delhi, provides health care solutions by referring patients to appropriate doctors. HGF affiliates itself with practitioners after doing a reference check, so that the best of advice • can be given to patients. HGF draws upon the goodwill and help of doctors both in private and government sectors. Every patient request • is strongly evaluated and given equal importance, and then the patient : is referred to the appropriate specialty/doctor. This methodology gives the patient a fair chance in getting the correct diagnosis, • prognosis and treatment.
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