THE BHORE COMMITTEE REPORT OF 1946 charted a course for public health investments and infrastructure for the emerging nation state. Its recommendations were manifold, all with the aim of making healthcare equitable and universal. Among them, some key ones included a vision of a healthcare system that had –
three levels – primary health centres (‘PHCs’) at the village level, secondary health centres (hospitals) in districts, and tertiary level hospitals in metropolises
a focus on preventive health, over curative services; free and universal healthcare and,
investment in human resources for health through medical and nursing education at scale.
Vitally, it recommended a significant proportion of the government’s budget – 15 percent – to be dedicated to health. Its vision included a thirty year timeframe within which all these components were to be fully realised.
What is visible today is, at best, a partial implementation of these recommendations, and a healthcare system which is the opposite of the egalitarian and humane approach that the Bhore Committee espoused. Over time inequity in Indian healthcare has become further entrenched. Although a three-tier system was implemented, reporting reveals the abysmal state of much primary healthcare, the shambolic condition of district hospitals, and increasing number of poorly resourced government tertiary health institutions due to lower financial outlays for public health.
