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Introduction

India’s health sector is witnessing rising privatisation, weak regulation, and chronically low public spending, widening inequalities in access. The National Convention on Health Rights (2025) has revived debate on whether the right to health can be made truly enforceable. In this context, assessing barriers and identifying actionable reforms becomes essential.

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Challenges in realising Right to Health 

• Privatisation pressure: Expansion of PPPs and handover of public facilities to private players weakens equitable access and affordability.
  Eg: Movements in Andhra Pradesh, Karnataka, MP and Gujarat highlight the impact of privatisation.
• Weak regulation: Poor enforcement of the Clinical Establishments Act,2010  leads to overcharging, unnecessary procedures, and violation of patient rights.
  Eg: High caesarean section surgeries rates and opaque pricing were noted.
• Low public spending: Only 2% of the Union Budget goes to health, limiting infrastructure, staff, and service quality.
• High Out of Pocket (OOP) costs: Insurance schemes have not reduced household medical expenditure, making access dependent on financial capacity.
  Eg: Out-of-Pocket Expenditure as percentage of Total Health Expenditure still remains around 40% as per the NHA estimates
• Social exclusion: Dalits, Adivasis, Muslims, LGBTQ+ persons and persons with disabilities face discrimination that undermines universal access.

Reforms Needed

• Boost public funding: Higher government investment and stronger primary care to reduce inequality and make health a real entitlement.
• Strengthen regulation: Enforce the Clinical Establishments Act, standardise rates, mandate patient rights, and ensure grievance redress.
  Eg: Convention demands transparent pricing and rate regulation.
• Support health workers: Improve wages, job security, and working conditions to build a resilient public workforce.
• Make medicines affordable: Expand price controls, remove GST on essential medicines, and increase public-sector drug production.
  Eg: Over 80% of medicines remain outside price control.
• Promote inclusive governance: Use decentralised planning, community monitoring, and equity frameworks to address discrimination and improve accountability.

Conclusion

Making the right to health justiciable requires comprehensive reforms across financing, regulation, and governance. Strengthening public systems while curbing exploitative market practices is essential to ensure universal, quality care. Only a rights-based, equity-driven approach can translate constitutional intent into real health security for all Indians.

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