Kolkata, Feb 19 (IANS): The status of health care services in India was "dismal", Nobel laureate Amartya Sen said Wednesday, cautioning against over-reliance on the private sector without the availability of basic public health service in the country.

"The state of health care is dismal... relying on private medical care, without the availability of public health services, allows extensive exploitation of vulnerable and under-informed patients and their families, because of the asymmetric nature of healthcare knowledge," he said at the 11th Kolkata Group workshop.

"We are not against private health care, but it shouldn't take the place of public health care services," Sen said.

As many as 50 participants, including doctors, public health experts, policy makers and activists gathered to discuss the state of health services and learn from experiences of other Asian countries.

The workshop was organised by Pratichi (India) Trust, Harvard Global Equity Initiative and Unicef India.

A statement issued by the group advocated an integrated approach to health care with guaranteed access for all to qualified doctors trained in modern medicine.

The participants also batted for a "comprehensive understanding of health care that must, among other things, include the provision of clean water, nutrition, sanitation and waste disposal".

Sen also said India had a lot to learn from countries like Thailand, China and Bangladesh.

"Thailand has generated several health innovations like the universal insurance system and regular health assemblies for public discussion.

"Bangladesh has shown the importance of drawing on women's agency through female community health workers as well as school teachers and the constructive role of NGOs," he said.

China, he said, has embarked on massive reforms, "not only involving near universal coverage but also showing the possibility of rapid change given public commitment".

Another key area that must be included as an essential component of health care financing is "single payer national health insurance", he said.

"The current financial allocations are massively inadequate," Sen added.

He also noted that the "arbitrary transfer of well-performing senior public servants leading the necessary reforms of health care jeopardises effective long-range planning and implementation. Sustained leadership is needed".