Questions
Q1. Sex workers have been structurally kept outside the dimensions of equal opportunities. Analyze with respect to the recent Supreme Court judgement on Sex workers in India. (15 words) 10 marks
Q2. The socio-economic benefits of Universal Health Coverage are plenty, but for it to be a reality the government must learn core lessons from pandemics and rebuild trust in public health. Comment. (250 words) 15 marks
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Model Solutions
Q1. Sex workers have been structurally kept outside the dimensions of equal opportunities. Analyze with respect to the recent Supreme Court judgement on Sex workers in India. (15 words) 10 marks
Model Structure
Introduction:
- Under Article 142 in Budhadev Karmaskar v. State of West Bengal & Ors, Supreme Court has recently recognised prostitution as a profession and stressed on the dignity and constitutional rights of the sex workers.
Main Body:
- Structurally kept outside the dimensions of equal opportunities
- State:
- Constraints on movement: Article 19 places restrictions on movement and residence.
- Discriminating laws: Immoral Traffic (Prevention) Act, criminalises money from sex work and living with a sex worker.
- Right to organise denied: Brothels and organised sex work are illegal, making them vulnerable to exploitation.
- Institutionalised discrimination: Immoral Act forces them to maintain a 200 metres distance from any public place.
- Social:
- Denied child rights: Their children are denied admission in schools, or employment opportunities.
- Societal stigma: Prevents them from seeking relief from harassment even by the police.
- Violence: Sex workers are especially vulnerable to violence because their status, which may be unlawful, tends to marginalize them.
- Conflation of trafficking and migration: leading to denial of labour rights.
- State:
- SC called for following changes
- Limits on police action: Puts them and their children at par with the rest of the people.
- Recognition as a profession (Under Article 21): It will remove presumptive criminalisation of their work.
- Medical assistance: to provide immediate medical assistance to sex workers who are victims of sexual assault;
- Reduce sensationalization: to ask the Press Council of India to issue guidelines to the media.
- To not reveal the identities of sex workers while reporting on arrest, raid and rescue operations;
- Access to justice: to ensure that the legal service authorities of the Central and State governments educate sex workers about their rights vis-à-vis the legality of sex work.
Conclusion
- With this judgment correcting the historic injustice, now the role of the civil society is important to destigmatize the profession.
Q2. The socio-economic benefits of Universal Health Coverage are plenty, but for it to be a reality the government must learn core lessons from pandemics and rebuild trust in public health. Comment. (250 words) 15 marks
Model Structure
Introduction:
- India with mass poverty, geographically distant communities, absence of healthcare infrastructure and shortage of healthcare professionals, needs a robust universal health coverage programme.
Main Body:
- Socio-Economic benefits of Universal Healthcare Coverage
- Social:
- Enhance accessibility: every individual should have access to services that address the causes of disease and death.
- Improve health: UHC ensures that quality of health services are good enough leading to improved health of people
- Formation of human capital: affordable and good quality health services to women, children, adolescents and people suffering from mental health issues, would enhance human capital.
- Economic:
- Reduction of financial distress: it protects people from spending on healthcare services out of their own pockets.
- Reduction of poverty: it will cut down the risk of people being pushed into poverty due to huge amounts of spending on unexpected diseases.
- Economic development: In the long run, good health will allow children to learn and adults to earn.
- Building a foundation of economic development in the country.
- Social:
- To provide UHC-core lessons of the pandemic
- Human Resources:
- Shortage of healthcare professionals: especially in rural and small cities.
- Only 45 doctors per lakh population are available, against WHO recommendation of 100.
- Compulsory Rural Stint: To enhance availability and accessibility.
- Maharashtra’s step to stop doctors avoiding rural stint after paying 10 lakhs fine.
- Shortage of healthcare professionals: especially in rural and small cities.
- Affordability:
- Price Regulation: Need to regulate rates and quality in the private sector.
- Insurance coverage: Increase insurance penetration and also the spectrum of treatments covered and PMJAY’s hospital coverage.
- Decrease out of pocket expenditure: Report by Pew Research Center states that the pandemic pushed 32 million out of the middle class.
- Structural changes:
- Increase vaccination infrastructure: to tackle mass vaccination on lines of Polio eradication programme.
- Network of laboratories: Robust testing infrastructure, with hub and spoke model.
- WHO’s framework of six healthcare system building blocks: Study the lessons learnt post pandemic and create actionable points.
- Innovative Approach:
- Behavioral change campaigns: On lines of Swachh Bharat Mission to instill hygiene habits like hand washing.
- Focus on NCDs: NCD burden was highlighted by comorbid complications of COVID-19. They account for 2/3rd deaths in India.
- Technology leverage: Tele-medicine, mobile-health, and digital platforms should be used for healthcare delivery at remote locations.
- Human Resources:
- Steps to rebuild trust in healthcare
- Increase public spending on health: By at least 3% by 2024.
- Expand healthcare workforce: multilayered, multi skilled teams that can deliver the needed services must be made available.
- Address regional disparities: incentivising rural areas for healthcare infrastructure.
- Reduce out-of-pocket expenditure: essential drugs and diagnostics at public health care facilities should be made free, especially in rural areas.
Conclusion
- In the pandemic era, it is the public system, with all its problems, that has risen to the occasion.
- There is a need to transform the fractured healthcare to a single healthcare system for everyone involving both public and private sectors.