Anti poor policies
From healthcare to passports, the government’s policy of giving priority to richer service seekers is quietly creating two governments in Nepal — one for the rich and another for the poor. The current government, as well as those who succeed it, should immediately end these discriminatory practices that are, in effect, creating two class of citizens, thereby making mockery of the state’s responsibility to treat all the citizens equally.
Within public hospitals, for example, discrimination between rich and poor patients is institutionalised. These hospitals are required to provide medical service at minimal cost to everyone but all major public hospitals including Bir hospital, Tribhuvan University Teaching Hospital and BP Koirala Institute of Health Science, have set up two different services: within the premise of the hospitals those who seek better services can get it by paying more. For example, the usual cost for registering for a general appointment in a public hospital is Rs 20. This money is for the initial check-ups, and it will mostly be the interns and the inexperienced doctors who will examine the patient. These patients are not consulted thoroughly about their symptoms, and kept in the dark about possible side effects of the prescribed medication. Due to the large number of parents that puts constraint on the doctor’s time, the consultations are rushed and sometimes border on being rude. On the other hand, paying Rs 150, one will get special appointment with more experienced doctors with better qualifications. They are given more time and more attention than those who pay less. The senior doctors are almost always inaccessible to those who cannot afford the extra amount, or to those who are not well connected.
The two-tier system works by creating “special,” paying clinics within the hospital premise by the hospital boards. The fact that poorer patients are prevented from accessing good doctors and medical care goes against the very principle of public service—in addition to being offensive and discriminatory. The government institutions should treat all citizens equally.
As it is, Nepal has the worst income inequality in south Asia, according to the Human Development Report, 2011, published by the UNDP. The problem, therefore, is hardly one of medical care. If you want to obtain a passport, you can get it faster if you can pay more. For those who can afford Rs 10,000 you get a passport in less than 10 days; if you cannot afford the higher price, you can pay Rs 5,000 but you have to wait for about a month. Similarly, the government’s authorised translation firm — Law Book Management Board institutionally discriminates between citizens. Paying double the regular rate gets you a translation on the same day whereas paying the regular rate you have to wait for three days. Another egregious example is the education sector. The government, although it commits frequently to making at least secondary education free, and to bridging the widening gap between private and public schools, has shown remarkable apathy in dealing with the inequalities in this sector. In general, the trend in health and education reflects the increasing acceptance of inequality in Nepali society. This trend should be reversed.
Posted on: 2012-01-03 09:13
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