I do not know how many of you here have made a study of the Bhore Committee Report. I know that hardly a handful of allopaths and even smaller number of officials of the Medical Departments have waded through it. And the reason is that it is very voluminous and comprehensive, going into 4 large volumes, and it is not everybodys business to afford so much time to see its strength and weaknesses.
SALIENT POINTS FROM THE BHORE COMMITTEE REPORT.
In a very short analysis let me tell you the facts that the Report has determined. It wants 1000 Crores for it to be put into action. It cannot get it. It wants 40 years to complete its work. No social economist or political economist is prepared to tell you what the shape of things will be in the next forty years. A forty years plan can be proffered only by men totally ignorant of historical phenomena.
They have shown by their investigations that India has today 47,500 allopathic or so-called “Scientifically trained” doctors and India needs or will require 2,36,650 such scientifically trained men; that India has at present 7000 nurses and will need 7,40,000, that is, more than 100 times the number of today; that we have 5000 midwives today and need, 112,500, that is, more than 600 times the present figure; that we have 750 dentists and need 92,500 dentists; and that we have only 65 qualified pharmacists while we need 84,000. I quite agree with all these figures.
But tell me how are a people whose per capita income is Rs. 62-3-3 per annum as compared with Rs. 1049-6-5 of Great Britain and Rs. 1371-7-3 of the United States, to meet the expenditure the Bhore Committee wants? On the average the Provincial Govts spend on medical aid and health one and a half anna in Bihar to 5 annas nine pies per head per annum in Bombay, and if we were to keep on the same level as Great Britain and U.S.A. we should have to spend at least Rs. 3-3-0 per head per annum and that is absolutely impossible. There is a lot of wishful thinking even among our capitalistic economists. For instance, the Tata-Birla Plan, known as THE BOMBAY PLAN, has built up its arguments on fundamentally wrong assumptions.
According to the agrarian economists, Ramaswamy and Wadia, our agricultural production cannot be raised more than 50 p.c. and the Tata-Birla Plan puts it at 130 p.c. What the Bhore Committee forgets is that equally important, if not more important, nation building programmes, many in number, will demand equally large sums, if not larger sums, and where is the money to come from if not from the people themselves? In short, the Bhore Committee has proposed what actually amounts, in structure, to the Socialised Medical System of Soviet Russia with one great difference, that socialised medicine was possible in Russia because every thing else was socialised from top to bottom in very aspect of life.
NEWSHOLME and KINGSBURY in their classical report have recommended the Medical System of Soviet Russia as the model to copy, and in a recent lecture the famous Bombay surgeon, R.N. COOPER has warmly praised it. But one cannot have only one department of life and state activity socialised, as medicine, in a country where laws are made by landlord and the capitalist and the blackmarketeer, the war profiteer, the zamindar; and the upper classes control the political and economic power.
FUNDAMENTAL WEAKNESSES IN THE BHORE COMMITTEE RECOMMENDATIONS.
I beg leave of you to further analyse the Bhore Plan because it is the plan that the Govt has accepted in good faith, though none too wisely. But as long as we ourselves cannot produce and offer a better plan we have no right to blame the Government. And we cannot offer a better plan unless we can assess the strength and weaknesses of other plans and also have the courage to see the weaknesses in any plans we offer, not only their strength.
One way or another we have to face the problem when the Bhore plan has left us in the lurch. And the fundamental weaknesses in the plan are these: namely, that it has totally ignored, what even our National Planning Committee recognised long ago and which it very rightly summarised in the following words; “Our resources are extremely meagre.
This fact imposes the necessity of building up an organisation in the cheapest manner possible. Yet the organisation must be all-embracing and one must make at least a beginning in taking care of the health of the country.” It further observes, “The appalling ignorance of the masses and their religious and social prejudices make the introduction of scientific medicine peculiarly difficult. This circumstance makes it imperative that any organisation built up to be effective must call for the maximum cooperation of the people themselves, and must be made to appear as a result of their own effort, rather than have an appearance of an imposition from above.
The Bhore Committee has further ignored or is not aware of the findings of the League of Nations Medical Committee as has been emphasised by DOROLLE (C.H. 1253, No: 1,1937), namely, the guiding principle should be in the first place to treat only those cases with the western system of medicine that need it.
The larger percentage of those others do not need the complicated and specialised modern system; and since their condition is not serious, they should be allowed to have recourse to the traditional pharmacopoeias and systems of treatments where they are available. Further, the Bhopal statistics of COL. ABDUR REHMAN show that only 23 p.c. of those needing treatment really require allopathic medical aid, and only 10 p.c. of these 23 p.c. require hospitalization, i.e. 3 p.c. of the total.
Thus 97 p.c. of those needing treatment can be treated ambulantly or at least in simplified institutions. DR. JIVRAJ MEHTA, in his presidential address at the First Conference of the Physicians of India Association, December 1944, has made a very significant observation, namely, that 87 p.c. of all medical activity is general medicine and the remaining 13 p.c. belong to the specialised subjects such as surgery, etc., and only 13 p.c. need specialised care.
If this is conceded, then I beg leave to state that, as things stand today in India, and taking the present standard of medical practice in allopathy, the 87 p.c. of general medical activity that Dr. Jivraj Mehta spoke of can be managed any day just as efficiently, if not more efficiently, by properly trained homoeopaths and ayurvedis. I am an allopath and in therapy as good and upto date as any allopath is in India, and yet I am here to declare that homoeopathic therapeutics, certain ayurvedic methods and approach to the problems of chronic diseases, are far superior to anything in allopathy as at present practised in India.
And I am prepared to make this statement openly anywhere and before any body of allopaths. It only proves one thing, which Bhore Committee deliberately ignored, not out of forgetfulness but out of purposed policy. And that is, that a great deal of general medical activity in the field of therapeutics can be safely taken away from allopathy which is badly organised and ill-equipped and a total failure in the villages, and new forces can be harnessed which have been deliberately ignored and suppressed.
Even the President of the All-India Medical Conference, CAPT. P. B. MUKHERJEE, in his splendid Presidential Address, Dec. 1946, had to express surprise at the lame excuse that the Bhore Committee offered. We should remember that out of the 47500 allopathic doctors available in India, as many as 35000 practice in the large and smaller towns so that not more than 12500 of these scientific gentlemen are available to the 6.75,000 villages of India. If we study the Bhore Committee report we will notice the number of contradictions this august committee lands itself in when dealing with the question of the indigenous system of medicine in India.
On the one hand they confess that they did not have the time to go into the matter and to assess it properly. In the same breath they claim that the allopathic system is the only one through which the health of the country can be maintained.
In one breath they say that the indigenous systems are “unscientific” and at the same time confess that these systems have a very large hold on the overwhelming masses of the people, not only over the illiterate but also over the intelligentia. They also admit that the treatment is cheap and that the empirical knowledge that has been accumulated over the centuries, has resulted in a fund of experience of the properties and medicinal use of minerals, herbs and plants which is of value.” In other words the Bhore Committee, which claims to be”scientific” has taken a very unscientific attitude when the class and economic interests of the allopaths come into danger under competition from other bodies.
Especially if we will remember, and the Bhore Committee surely could not have been ignorant of it, that whether we like it or not, whether our Health Ministers like it or not, and whether the members of the Bhore Committee like it or not, not more that 23 p.c. of Indias sick population will go to allopaths for treatment; and the remaining 77 p.c. will fall back on the indigenous and other treatments such as Homoeopathy. The Bhore Committee has absolutely no excuse for having neglected this aspect.
