Although health was not an election issue, after assuming office in West Bengal, the new chief minister Subhendu Adhikary has already conducted a meeting at SSKM hospital with all hospital superintendents with a mission to make health delivery smooth and to end “Dalal raj” (agents or middlemen usually of ruling parties).
The previous government’s legacy of a threat culture must be abolished and the CM needs to start from scratch. Free treatment for all is impractical; only BPL should get partial free treatment. For others, paid wards must be reintroduced with a professional approach. The West Bengal health system needs to be revamped. State hospitals are plagued with politics, corruption and very weak administration. Firstly, trade union activities must not be allowed in hospitals. Strikes or cease work in hospitals should be banned as it comes under emergency services.
The public health system has improved significantly over the last few decades in areas such as rural healthcare access, maternal health, ambulance services, and health insurance coverage for some surgical procedures under schemes such as ‘Swasthya Sathi’. Yet major challenges remain – like overcrowded Kolkata hospitals, shortage of specialists in districts, uneven infrastructure, long waiting times, and administrative centralisation. A decentralised revamp can make the system more efficient, equitable, and people-centric.
Inter-district competitive excellence in healthcare should be upgraded into a mini-medical hub with ICU beds, advanced diagnostics, trauma care, dialysis, cancer screening, and not just naming them as “super speciality hospitals.” Cities such as Siliguri, Malda, Burdwan, and Midnapore can serve as regional referral centres to reduce pressure on Kolkata hospitals. Second, administrative decentralisation is essential. District health units should receive greater financial and operational autonomy for hiring staff, maintaining infrastructure, and responding to local health needs. A malaria-prone district like Alipurduar may need different priorities from industrial Asansol, or densely populated North 24 Parganas. Local decision-making improves speed and accountability. Primary healthcare must become the backbone of the system.
The World Health Organization repeatedly stresses that strong primary care reduces hospital burden. At present with an increased number of medical seats – both UG and PG – there is no dearth of doctors. Health and Wellness Centres (NUHM&NRHMs) should provide regular screening for diabetes, hypertension, mental health issues, maternal care, and elderly support. National health mission should have a separate office of their own to work in tandem with ULBs and panchayats. Well-equipped mobile clinics and properly functioning telemedicine can help remote areas and hill populations. Human-resource reform is another major necessity.
Continued training programmes for skill development of doctors should be the pre-requisite for promotion to higher posts. Many doctors prefer Kolkata due to better facilities and career opportunities. The government can introduce district service incentives, housing, higher rural allowances, and faster promotions for doctors serving in underserved areas. Doctors must be available at least six days and forty-two hours per week. Restricted private practice may be allowed outside duty hours. Reintroduction of afternoon pay polyclinics is the need of the hour. Nursing and paramedical training institutes should also be expanded across districts.
Poorly paid ASHA workers should be incentivised for quality work. Digital integration can further improve decentralisation. A unified electronic health record system linking sub-centres, district hospitals, and medical colleges would reduce duplication and improve continuity of treatment. Teleconsultation between district hospitals and institutions like SSKM Hospital or other medical Colleges at Kolkata can bring specialist expertise to rural patients without requiring travel. Finally, public-private partnerships should be carefully used in diagnostics, emergency transport, and specialised services with supervision and maintaining strong government regulation.
Preventive healthcare campaigns on nutrition, sanitation, vaccination, and pollution-related diseases must also receive greater attention. A decentralised health system does not mean weakening Kolkata’s premier hospitals; rather, it means creating multiple strong healthcare centres across West Bengal. If implemented effectively, decentralisation can reduce inequality, improve emergency response, lower patient costs, and bring quality healthcare closer to every citizen. Last but not the least vandalism in medical institutes, destruction of government properties, manhandling medical personnel on self-made allegations of ‘medical negligence’ should be dealt with firmly. Special teams of ‘hospital guards’ need to be posted and also ‘grievance redressal cells’ should be made active to respond within 48 hours to public grievances.
(The writer is a Specialist Physician (retired), SSKMH & IPGMER.)