Dr Raj Nagarkar
MD and Chief Surg. Oncologist
HCG Manavata Cancer Centre, Nashik

Future of Indian healthcare market-Lessons learnt from COVID pandemic

Healthcare has become one of India’s largest sector, both in terms of employment and revenue. The Indian healthcare market is also growing incrementally, where hospital industry is accounting for 80 percent of the total market. India’s healthcare sector worth is projecting to reach up to USD 372 billion by 2022. It is growing at rapid pace providing services, solutions, and products across the care spectrum for prevention diagnosis, and treatment. Growing incidence of increase in technological advancements, the emergence of telemedicine, rise in healthcare costs, rapid health insurance penetration, and government initiatives are driving healthcare market to the next level in India.

Recent, global havoc caused by COVID-19 pandemic has also shown us multiple gaps in our healthcare sector, giving a chance for the industry to reform in future. Worldwide, the healthcare industry is expected to witness a drop in growth from 5.3 percent to 0.6 percent in 2020, with revenues remaining below the USD 2 trillion mark.

On budgetary allocation in healthcare
As per WHO, India ranks 184 out of 191 countries in terms of GDP percent spend on healthcare. The healthcare allocation in the Union Budget 2020-21 is just a modest increase of 5.7 percent compared to the previous year. Comprising of just 1 percent of total GDP, which will be highly inadequate for any major leap forward in the sector. Investing and allocating more in the health care sector can help us to give critical and quality healthcare facilities at more accessible costs to the masses. Despite the limitations with the present budget, announcements like Jana Aushadi stores, PPP model hospitals, MJPJAY, Ayushman Bharat, and Mission Indradhanush will benefit the common man and also giving a positive hope in the healthcare sector.

On your planned budgetary allocation for the fiscal year 2020-21
Even as India’s expenditure on healthcare has shot up substantially in the past few years, it is still very low in comparison to the peer nations.  The average allocation of budget in organization for Economic Co-operation and Development (OECD) countries were 8.8 percent of GDP. So we have expected a considerable increase in budget allocation for healthcare sector but it was observed to be limited to very minor increase from `62,659.12 crore of FY 2019-20 to `69,000 crore for the FY 2020-21.

The novel coronavirus pandemic crisis has created a large vacuum in medical devices during the initial phases of the pandemic. It is because of the larger dependency of our country on foreign countries for medical devices. In the recent budget, government proposed a 5 percent tax be levied as part of customs duty on the import of medical equipment. The proceeds were said to be used for creating healthcare infrastructure. It is estimated to earn around `1800-2000 crore through the health cess on import of medical devices because we import over 70 percent of our medical device. This increase in tax proposal can help to accelerate the domestic medical devices manufacturing, provided the regulatory structure will help in ensuring transparency and ease of doing business. It will also help in supporting the Make in India initiative proposed by our honorable Prime Minister Narendra Modi.

On your vision for health and family welfare
My vision goes hand in hand with the vision of our Indian government. As a healthcare professional and doctorpreneur, we as a team always aim to provide quality treatment to all the patients who approach us at an affordable cost.

Major challenges we faced and still facing is bringing out the world-class facilities at affordable prices to the patient. We are expecting a major change in this scenario in future because of the various initiatives government of India took to support and develop the indigenous technologies.

On monitoring the quality of private healthcare
Healthcare can be provided through public and private providers. Delivery of medical care through private healthcare providers is a boon in many parts of the India, where people can have access to all sophisticated medical facilities in their own localities, which was a dream come to moment in such a large country.

At the same time, we are also trying our best in maintaining all the standard regulation levied by various national and international regulatory bodies to maintain the hospitals and giving them high end care.

Compared to concerns related to public healthcare such as quality, availability of trained and qualified human resources, adherence to standard treatment protocols, and noncompliance to processes; private healthcare centers and corporate hospitals have overcome all these hurdles and took paramount care in providing the best possible treatment to patients by maintaining the quality in terms of treatment waiting time, timely care, improving patient experience, and compliance with best practice. These initiatives are helping us to serve both national and international patients and overall helping us to enhance the medical tourism.

I feel the quality monitoring should be strictly regulated and all the private facilities should be strictly followed and adhere to the rules and regulations laid by the government of India for better outcomes.

On public private partnership in making healthcare a success
With the rapid growth of the Indian economy, there has been an immense change in the healthcare requirements of the country. PPPs provide a vehicle for coordinating with non-governmental actors to undertake integrated, comprehensive efforts to address public health problems through the combined efforts of public, private, and development organizations. It will further help in improving and increasing the accountability, quality, quantity of manpower, services provided, and augmenting resources. By combining public interest with private-sector research and development, PPPs have injected new life into stalled projects and delivered innovative solutions to numerous diseases.

On areas where government should invest to make healthcare available to everyone
As a nation to prosper and grow, a healthy population is stepping up investment from the government. India has come forward and made enormous progress in lasts 40 years in the health care sector that too in the private healthcare industry. However, India’s healthcare system has major inadequacies especially in rural parts; still, much of the population is struggling to get basic medical facilities. The major challenges in our healthcare system are lack of awareness, lack of access, workforce shortages, lack of affordability and accountability. The current pandemic, COVID-19 has also made us realize and appreciate the importance of having a robust healthcare system, one that is fully equipped and battle-ready. To face such pandemics in future effectively, the government should be increasingly proactive in setting up hospitals, clinics, and other such healthcare facilities on PPPs. The government should also develop a national framework and roadmap that defines the roles of the states and center, besides that of both public and private sectors. It is important, therefore, to define and agree on the vision and goals for 2030.

On policies interventions that the healthcare sector in the state needs to align with the healthcare objectives at large at the national level
The state healthcare sector should align itself with central government objectives by strengthening the public sector infrastructure. Proper training centers should be developed and healthy work environments should be created. Increase in the number of postgraduate inputs both at public and large private or corporate hospitals should be considered. The Government of Maharashtra and Ayushman Bharat are working well in co-ordination. However, the amount giving by the government to treat a patient under schemes is not sufficient and with such funds giving a quality treatment is a highly challenging task. 

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