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A ward in the Department of Obstetrics ward at Gardanibag Hospital in Patna, Bihar state.
In the deprived, densely populated state of Bihar, eastern India, the public health system is failing the poorest people living in city slums. There aren’t enough health centres to serve everyone, and the facilities that exist are ill-equipped and under-staffed. The poorest people have no other option – they cannot afford the private health services available in the area.
In these government-funded, public health centres, patients pay 2 rupees [a little under 10 cents] as registration fees. They are entitled to all healthcare facilities provided in the centre (such as maternity care, medicines, X-rays, ultrasound and immunisation). However, the quality of care is often very poor. Patients often end up paying for services that should be free such as diagnostic tests and medicines.
Without enough midwives and nurses, or the equipment needed for safe deliveries, women are left highly vulnerable during pregnancy and childbirth.
Background Context
Global
The extreme gap between rich and poor is undermining the fight against poverty, damaging our economies and fuelling public anger. Yet inequality continues to grow and all too often it is women and girls who are hit hardest.
Many governments are fuelling inequality by under taxing wealth and failing to clamp down on tax-dodging - while at the same time, underfunding vital public services like healthcare and education.
The human costs – clinics without medicines, classrooms without teachers – are huge. While corporations and the richest people enjoy low tax bills, millions of girls are denied a decent education and women are dying for lack of maternity care.
To prevent the world’s poorest and most vulnerable people missing out on the chance of a decent education or seeing a doctor when they fall sick, Oxfam is calling on governments to increase investment in public services and to help fund this by ensuring corporations and wealthy individuals pay their fair share of tax.
India
India is a striking example. The government’s spending on public healthcare ranks among the worst in the world at just over one per cent of GDP, while companies and the richest people enjoy low tax bills. Property and wealth taxes accounted for less than one per cent of tax revenues in 2015/16.
In the place of a well-funded public health service the Indian government has promoted an increasingly powerful commercial health sector. As a result, decent healthcare is a luxury only available to those who can pay. Many ordinary Indians are not able to access the health care they need while 63 million Indians are pushed into poverty because of healthcare costs every year.
Oxfam is calling on governments – including the Indian government - to invest more in making quality health services available to everyone – and to help fund this by taxing wealth more fairly. With healthcare high on India’s political agenda in the lead up to the 2019 elections now is the time to act. If India increased tax by 0.5 per cent on the wealth of India's richest one per cent, it would raise enough money to increase government spending on health by 50 per cent.