 रवज्ट्टः पीयं क्रोना काल में हम कासदोर सेवोकुस ख़ोगा है है है हैं हमारी स्वासठच्च्चमर और बबडएच चवाल भी उठे है है है हैं हमारी निजीचापर, करोना वाईरिस के तहत खिस सरहां से औरोगया से तू जैसी अपस अर्कन्तेच उपनबही, लिघ अब भी सबगस्त को सामने लाए और सरकार ने लोगो को पुची समय दिया स्ञुप तीन सतंबर तक समय दिया था की लोग आपने प्रस्ताव आगे रख हैं अपने अबज्ठ्शिंस को आगे लेक राए यि और ये पुलिसी हमें किस तरहा से प्यबभविद करती है ख्या इस तो दितिका हम सबते पहले दर्षकों को ये बताना चाहेंगे क्या अखेर ये पूलिसी है क्या और इते इस परहांसे क्यो प्रस्टाव सरकार इती जल्डी में क्यो लाएई है ये पूलिसी का. टेटा मानेज्बिन पूलिसी सब भीस आगस्ट को सरकार नहीं ज़ाफ लीज किया है कुनसल्टेष्टेष्ट्टेष्ट्चट्ट के लिए. बागत से पहले ही पन्दा अगस को प्राँमिनिस्टर नहीं नेश्टन्ल जिटिल लग्ट मिशें अनाउन्च् किया था. तो इन दोनो को साथ में बहुत ज़रूरी ज़रूरात है हम को देखने की जो NDHM आनाूंस वह ता उस पे कोई कनसलतेशिम जास्च होई नहीं ते even though उसे पहले जो भुप्रेंट ता उस में होई ते but एक हमारी जो इस ट्रोंग मांग है कि आप HDMP को जो पन्द्रा अग्ट्गस का जो अनाूंस में ता उसे अलग कर के नहीं देख सकते हैं तोनो बहुती नहीं तरीके से लिंग तेखने ज़सके बारे मांगे बात करेंगे 2013 में स्वकार लेएब मिनिस्छी ने एकट्ट्टी को अग्ट्ट्री कोछड मैंडीद है उतानगाए जाएद देख वोँथ शांती थी फिर 2017 में हमारी नाशनल एकट पोलिसी आई थी 2018 में इक बोथ प्रुषिल डोक्मेंत आया था जो नीती आयोग ने रिलीस किया ता नाशनल हेल्ट स्ताक कर के विरिच अना सेंस एक शुरुाती डोक्में ता ये हेल धिजिटाइटाइशेशें प्रोजेक्त के लिए उसके बात अगले साल याने कि पिष्ली साल 2019 में नाशनल दिजिल तिंगय तो पन्रागस कोई अनाश्मच्में तुआ खूँद ता नाशनल दिजिटल, डिटिल, हेल्ट मिशन अन्दीएचम उस में, जिस में हेल्ट अईदी की बात की ठी। और जिसके बारे में कापि चर्चा हो रए थी उस पे कोई कुई खुँँँँँँँ� उसा भी लिए ख्तावोड् Nunopdha gacy wildlife is a direct link to the policies in the country. ये जो पलोज्ँे ये ये लिए फ़ेंद हैंद वेलकुल At our residents in this country, किसला रहासे वो प्रभबईत करेंगे किसला वो नका है? How will they influence, वो वह थादज्यस क्या हैंगे या अप रहाने सवाते नदा है? How dangerous is it. यो धियो येड़ढार आईद्या है, यी एक याईदिया आरान, जिजिटलाईशेश आप हर्च्ट्रिकोल्गs. आप जब अस्पताल, सब से फ़हले तो जब एक पेशिन्ट अस्चपताल जाता है, तो it says, दिजिटलाईशेशन आप KlinicAll, Klinically relevant encounters. अप की जियो दिजाच टिकिट्स हैं, अप की एक स्वेर लिए एक से आप परची करती है, उंसब को दिजिटलाईशेशन का ये एक प्रोँसेः है, ये पहला चीश. दुस्थरा हैरजीस्टरी जी पेशिंस की ही नहीं दोभ्धर्स की, असापतालों की, ता की ये incarcable exchange रिऑुच़े के सात ये के लेक पहद अगर की अगरple Chuka 저희가 waiver exchange ये लेक जीए हे जो आतर growth. लिए � гारगा प़जी कि मक्रहित ही दिलतए carra pap treat ci k però aur ze k co saat it mixed with elsewhere. अरी socks karayak tozone, अरी को इस ग Elekt्द, ये सीझ भो कि मी जनी, गली।ег,। अब यह था इस दोकिमन्ख दे पाद के मुड़े है.... यह तुरा यह देटा माएज़ुन पुलेषी है, यस की अठारेटी है वो नैश्नल एड़ थाठारेटी को दे रकी है। आई वो वो नाश्याल हपात्याद़ी, दो वो लोगता, इस दखा हददा थी. यह यह यह यह टेईंपे प्यणज एग भाए बना एग रोगे गे नहीं, यहदेता वो खरेटा, आप्द उनके तो एसकिज़े थ सब आप श्द्च में पिज्गने. मीटी है, मिनिस्ट्टी अप अपन्प्मश्यन टेकनोलगी, अईना सेंस माजनेलाईस देंवो से लेगुलेट्टरी अवर्सीं करी हैं, अन एन एचे एक लाज़र इंप्लिम्टेशन रोल ले रही हैं। तो ये एक पहला मुद्डा है, जो की आम सब को आम सब को आम सब को प्रशने करने की ज़ोरत है, सचे तो जाने की ज़ोरत हैं। तो हमारी दिमान यही रही हैं कि अगर आप नाश्नल अठ़ोड़ी से इसका इंप्लिमेंटेशन करवारे है, तो it should be backed by a legislative framework. आब बिल should be passed in the parliament for that one. Second is the inconsistencies in these two things are very closely related. NDHM and HDMP and HDMP refer to NDHM. The policy refers to National Digital Health Mission. But there are many inconsistencies in it. तो यह ज़े से में बता की जहापे NDHM में फिर भी अगर आब भेखे तो health ministry का फिर भी a better role. जादा रोल है. तुस्रा उस में आप की अपकी अंpowered committees हैं, steering committees हैं, जिस में अलगल अब ministries involved हैं। ती के you have NTIO, you have health authority, etc. But you have different ministry, WCD, social justice and empowerment, health ministry, etc. उन सब का मेंजिन कही भी हैं देटा मानिज्मन पूलिसी में कही भी नहीं हैं। जो की which is a matter of concern. पड़ा सवाल तिस में फिर नीजिता पर भी आजा तो data collection हो रहा हैं और हमारे अगर अगर अगर आप हमें बता हैं। जब आप when you read the policy it's all about collecting patient data आप आप ये नहीं ही बता रहें कि आप फिर मतलप क्या इसका eventually its public health role क्या है Is it collecting data for collection sake or is it what is the eventual how are you eventually planning to use this data what is the larger public health purpose of such kind of collection one second, it feels that the whole focus is on individual case management this person this person and we all know that the insurance company will favor it more or will favor the practices of such telemedicine so what is the role of this data collection in the larger public health systems that is a matter of concern second, the role of public health informatics is not talking about health policy the big question is what is the need of an additional ID we already have half of it which is a big surveillance and data collection exercise so what is the role of public health informatics and how do you reflect on it so this policy says that the first step towards the implementation of this policy and also the entire digital health mission is the creation of a digital health ID so the idea is that you have a separate ID digital health ID which will be linked either to adhaar and which will either link to adhaar or you know adhaar so adhaar is one option that has been given in this policy it can be your phone number, email, other ID cards so you are absolutely right that concern is more about creation of this digital health ID and putting all your records at one place it's like a repository of all the patient health records and even though this policy is saying that patient is the eventual data owner and you know eventual final rights lies with the data but we have had bad experiences with adhaar and aroge setu like apps where at one time by saying non-mandatory what kind of executive orders were made by adhaar and aroge setu so it's very difficult to trust this health ID despite the assurance in the policies it is very difficult for us to believe that this health ID will not be hurdle in patients access to health services so this is what our past experiences have told especially when it's very easy to pass executive orders when it is being implemented by national health authority so that is one the other is about consent again it's about the patient so despite again all the insurance consent we all know how much information is asymmetry if you and I go to the middle class private hospitals we have seen the stories of how much people are forced to go despite being well literate we are not able to negotiate with private hospitals even if it's simply asking to give us our papers imagine in this kind of situation the non-literate person will have a real consent second especially in something like health where you are forced where you are always in a vulnerability position you go to a vulnerability facility so these are all the questions apart from very weak grievance redressal in the policy no provision for penalty where you suspend the doctor in the name of penalty or if my data is leaked whose responsibility was to the hospital or to the doctor then what suspension is enough I remember once in 36 houses there was this case where women were being removed without consent from them just to make a lot of money through insurance cards even though they didn't need it so at best these practitioners got one week suspension and the hospital was opened again so your larger grievance redressal system accountability system if it's not already then how are you expecting to be able to deal with such issues through this policy so all those concerns are still there and of course as you said in the beginning surveillance and authoritarianism as I said earlier data seems to be the end of it is data collection it seems like the end of it is data collection the entire project so what is it and in recent times having such a large data repository on a central level how safe it is and how it won't be used against citizens are the other concerns that there are questions on this policy if you want to give a message on how we should get rid of these policies and what kind of campaign we should have how to get rid of these questions if you tell us about it and then we will finish it I think first of all there are already different stakeholders who are getting resistance so our privacy activists here Jan Swa Stabyan is planning a campaign about it so before getting engaged we are questioning the consultation processes after that we will get engaged in a question I think all the health movements plus all the other civil society organizations also the privacy activists and the legal community need to critically look at these two bills and in tandem with each other we are already planning to start a campaign to tell the consequences because see what is the eventual objective of such a policy is this the first priority that the health system is facing today is it in today's days patient's problem is he doesn't want to get a bed in the nearest hospital or he doesn't have money or already they don't have internet or communication technology they have so do you think that this is a digital health project a priority rather than investing more rather than putting more budgets on your these are not the substitutes for your traditional health care system so rather than putting more money on your health systems rather than recruiting more health workers in rural areas if there is a substitute for recruiting health workers then we do not agree with that it might not be a very valid solution things like that so it is very important to raise questions about the priority or the mission mode the project is being started especially when our foundations of public health systems in our country are very deep this is a very insightful thing there are so many questions and a health crisis and what is the need of this policy without any consultation process so with these questions we will leave the viewers how they think about the policies of the government what are our priorities what are the priorities of the government so to watch this interview thanks to the viewers thanks to Deepika for joining us