The Government of the Union has expressed its interest in the establishment of a medical service of India according to the Indian Administrative Service and the Police Service of India. The Ministry of Health recently issued a circular to States requesting their views on such a movement. There is a strong case for an Indian medical service – but on the basis of new principles appropriate for the moment.
An Indian medical service existed prior to Indian independence. In 1763, “64 medical services were first introduced to the Bengal, Madras and Bombay administrations, mainly to hire and deploy a relatively small number of doctors and health care assistants and military officers stationed on civil lines and in some In 1857, after the First War of Independence, the British government took direct control of the three medical services and put them together in an Indian Medical Service.
During its long history, there has been ongoing debate about whether military surgeons and civilian surgeons should be separated or in the same framework. Most of the Indian Medical Service was a military service doctors are sometimes sent to play modest roles as the civil surgeons run by some districts. However, the focus was on clinical care in barracks and civil lines. They had a very limited role in public health and a limited view of the organization of health services for the general population.
It is not surprising that this is a time when the country was destroyed epidemics. Health services were rudimentary and only affected a small part of the urban elite. The former Indian medical service operated on the simplistic approach of top-down health care and not as deputy head of health care across the country.
India needs a new Indian medical service as part of national public health managers. This service must be developed in parallel and in synergy with the creation of public management frameworks for public health.
The management of public health involves not only the management of health promotion and prevention, but also the organization of primary, secondary and tertiary care services. This, in turn, requires expertise in all major components of health systems – human resources for health, community participation, computer health, technology and technology options for health, governance and management, Health care and, in particular, the organization of health services. It is also a solid foundation in understanding epidemiology and clinical care.
Indian Administrative Service agents, even those with medical qualifications, are not prepared to understand and organize comprehensive national health care. This requires a formal qualification or training in public health management and the experience of health systems management in the state and the district. High posts in the Indian medical service should also require expertise in policy-making bodies at the national and international levels.