Whenever the government is put in the dock, especially for its handling of the health sector, it is usual for the ruling class, be it the LDF or the UDF, to fall back on Kerala's supreme health indicators like low infant and maternal mortality rates.

On Monday, inside the Kerala Assembly, local self government minister M B Rajesh, who was substituting for health minister Veena George, went a step further. He said that these high indicators were not achieved by chance. "It is the result of the huge capital investment made in the health sector by this government," Rajesh said while replying to an adjournment motion moved by Congress MLA P C Vishnunadh on the "falling healthcare standards in Kerala". This contention was vehemently disputed. First by Vishnunadh and later by opposition leader V D Satheeesan.

Vishnunadh began his adjournment motion by referring to a public road that the ministers take to reach the Secretariat complex. "It is called the Punnen Road. It is in memory of Mary Punnen Lukose, India's first woman surgeon general. In 1924 when she was heading the Thiruvithamcore medical system, there were 32 government hospitals, 40 government dispensaries and 20 private institutions functioning under her," he said.

Kerala's public health history predates even Dr Punnen by over a century, Vishnunadh seemed to suggest. "It was in 1818 that a dispensary was opened in Kerala for the first time, in Mattancherry. In 1812, six trained 'achukuthu pillamaar (vaccinators) were appointed in Kochi. Vaccination began in Travancore in 1877 through royal proclamation. It was the civil hospital that was established in 1896 that later became the Thiruvananthapuram General Hospital," he said.

The Congress MLA added: "I said all this only to remind the House of the historical fact that Kerala's public health system was far advanced than other states in India long before Independence." As an aside, in response to a comment by a fellow UDF MLA, Vishnunadh was heard saying that the Communist party was formed in the 1930s.

When it was his chance to counter, Rajesh right away attempted to separate the pre-Independence gains from the achievements brought about by Left governments. "His (Vishnunadh's) argument is that Kerala's health system was already in an advanced stage before Independence and the Left governments that came to power subsequently had nothing to do with any of these," he said with a knowing sarcastic smile. "In fact this has been the argument that right wing forces have always unleashed to undermine the Kerala Model. The achievements were already there and the Left had done nothing seem to be their preferred narrative," he said.

He laid down his facts. "What was Kerala's life expectancy in 1947? It was 45 years. Today, it is 75 years, the highest in the country," Rajesh said. "Can you say that this increase was in proportion to the increase in the national average? No. Kerala's life expectancy is comparable to that of developed countries," he said.

The minister had more numbers at his disposal. Maternal Mortality Rate (MMR) is 97 in India but 19 in Kerala. In Kerala 86.7% of people are treated in hospitals. The national average is 48.7%. Kerala is the only state with single-digit Infant Mortality Rate (IMR): 6. National average is 28. Neo-natal deaths in Kerala is 4 while the national average is 20. In Kerala, the deaths of children below the age of five is eight. For India, it is 32. 99.9% of mothers in Kerala had their deliveries in hospitals.

Earlier Vishnunadh had said that Kerala tops in 'out of pocket' expenditure for health in the country- people were increasingly dependent on costly private hospitals. Rajesh countered this saying that Kerala was also the state that gave free treatment to the highest number of people: 30 lakh.

The minister said even advanced and costly surgeries like liver transplant were carried out in government hospitals in Kerala after the LDF came to power. "Where in India can you find government hospitals with the facilities to perform such advanced surgeries like liver transplant," he asked.

The opposition leader was ready with an answer. "It has been two years since liver transplant had started in Tamil Nadu's Rajiv Gandhi Government General Hospital and Stanly Medical College," he said.

Satheesan was particularly amused by the minister's life expectancy argument. "The minister said our life expectancy in 1947 was 45. What was the national average then? It was 31. Given that difference, Kerala should have actually enjoyed a life expectancy of 90 years now," Satheesan said. Currently, India's life expectancy is 67.74 and Kerala's is 77.28.

Then Satheesan took up the minister's resentment about right-wing forces undermining the Kerala Model. The opposition leader said that it was after 1980 that Kerala Model captured the world's imagination. "How many years were you in power between 1947 and 1980," he wanted to know. "Just six years. So don't forget the fact that it was during the tenure of UDF governments that the Kerala Model was brought into being, the primary health system was strengthened, medical colleges were started and the political leadership necessary for all this was provided," Satheesan said.

He said that health indicators like IMR and MMR had always been high for Kerala, and was not the result of what Left governments had done. "Our argument is that we are now slipping dangerously," Satheesan said.