Bhutan’s health system has come a long way. When the nation began planned development in the early 1960s, we had just two hospitals. Today we have more than 30 hospitals, close to 200 basic health units and 700 outreach clinics. Health continues to receive the highest priority because the Constitution requires the state to provide free access to basic public health services in both modern and traditional medicines.
The establishment of the Khesar Gyalpo University of Medical Sciences of Bhutan could be one of the most important milestones in the history of Bhutan’s health system. There has been perennial shortage of doctors and other health professionals in the country. Currently, we have just about two doctors and eight nurses per 10,000 individuals, lowest in the region. There was a need to accelerate and achieve human resources self-sufficiency in the health sector.
So the university’s mission to “develop health human resources for the provision of sustained quality, patient-centred care through innovative, learner-centred, integrated and humanistic training curricula and research activities in consonance with the principles of Gross National Happiness and universal human values.”
Training doctors and specialist has been costly for Bhutan. And we have now arrived at a time when we are faced with the challenge to retain specialists. That’s how the whole idea of corporatising Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) became a heated national issue recently. We may feel the shortage now, but in the long run, we will be able to produce enough to man our health centres.
Even though we have not the capacity yet, we have established a radiotherapy service at the JDWNRH with the help of CARE Australia, an international aid organisation. Eighteen cancer patients are availing the service since January 1. The idea is to gradually build in-house capacity which might take some time, but ultimately have a solid Bhutanese team to render the service efficiently and effectively.
This is an important development in the health sector in that the nation will be able to cut down on referral cost that runs into millions every year. Between 2010 and 2011, referral cost was 5.37 percent of our total health expenditure, which amounted to Nu 122 million. And it has been growing. In 2014, the expenditure increased to Nu 184.5 million. Last year, a total of 1,500 patients were referred to India at a cost of Nu 200 million. Of the total referral cases, 550 were cancer patients.
Radiotherapy service, in this sense, is a new and significant development. Others will follow in the future. Human resource self-sufficiency is at the core of the sector’s development. And that could make providing free access to basic public health services by far less expensive.