Devolved power: key for health care in India. An interview with Michael Tharakan.

Q: What has been India’s experience since independence in 1947 in extending health-care services to the masses that were once there to serve the colonial elite? A: The situation has improved quite a bit since independence. There is a national health system and we have medical colleges, research institutes and primary health care centres in almost all regions. Nevertheless, access to the health system is not the same for everyone. Colonial rule established an unequal system, while the caste system remains strong in certain regions. The result is that health and other basic facilities are inaccessible to certain groups. In addition, the centralized planning of the past 50 to 60 years has not produced even development throughout India, and that has affected basic services, including health.