Dr Shrihari Dhorepatil
Founder President, Obesity & Metabolic Surgery Society of India, Managing Director,
Shree Hospital & Diagnostic Centre Pvt. Ltd. , Pune

Healthcare – Future Challenges

The age-old concept of family doctor is losing its mark in India. It needs revival on a larger scale. Ours being a semi-tertiary care facility, we are facing a challenge of giving primary, secondary, and tertiary care at the same time.

Healthcare is one of the largest sectors in India, which was seen more as a social service till recently. Now it has been seen by governments as well as private entrepreneurs as a growing market in terms of revenue, employment, and return on investment. This is mainly due to improved quality care of the international standards in many institutions along with the growing health insurance sector and medical tourism.

On the healthcare market

Many experts predict more than 20 percent growth in India for the next 10 years. Healthy competition in India has forced the healthcare institutions to provide the best of medical services and positive approach toward patient care. There are many segments in healthcare apart from hospitals like diagnostics, outpatients clinics, clinical trials, medical tourism, etc., which need to be focused upon and need to be looked into.

On budgetary allocation in healthcare

In India, spending on health is the last bastion to be thought of by the government as well as the people. The government spending on healthcare has always been low. Most of the spending on health comes from public out of pocket. The public has to spend unwillingly because many a time they are dependent on successive governments’ claim of providing universal health for all. Government should either increase budgetary allocation in a gradual manner to fill the gap over a period of time or change the strategy to encourage private sector to make affordable healthcare possible through private players with incentives.

On budgetary allocation for the fiscal year 2016-17

The health sector is very dynamic, ever changing, and is becoming innovative day by day. Though new understanding of diseases and drugs is changing, it is the new technology to deal with which is making wider inroads. To remain at the forefront and give the best of the services, one needs to keep updated in terms of equipment, devices along with skills, services, and drugs. We make 10 percent of budgetary allocation every year for procurement and upgradation of equipment.

On challenges faced while implementing health services

Health and family welfare is a concept to provide positive health to every individual. It is the basis to create universal health. Unfortunately in India, this segment is either neglected or is dependent on the government.

The age-old concept of family doctor is losing its mark in India. It needs revival on a larger scale. Ours being a semi-tertiary care facility, we are facing a challenge of giving primary, secondary, and tertiary care at the same time. It makes primary care unnecessarily expensive and burdens the system.

We are planning to create the clusters of primary care centers in areas from where we get most of our patients. This will create a healthcare wheel, where patients need not travel for their primary care needs, saving their time and money.

On monitoring the quality of private healthcare

The monitoring of quality healthcare is the most important part in delivering quality care. It comes at two levels – from the healthcare providers and the government. At present, both fronts are trying their level best with very promising results. The government is making many laws which at best are making a good reading. The private sector is doing it voluntarily as their brand building tools, which are really looking forward to meet challenges and keep themselves in the long race.

In spite of the growth potential and need, quality healthcare is still a distant dream. There is a need for government to focus on quality healthcare and quality healthcare delivery system. It is only the government who can define, monitor, and implement quality healthcare. In recent times, NABH/NABL accreditation is sought after but in a very scattered manner. It has to be done at all levels of healthcare delivery – primary, secondary, and tertiary. Only quality healthcare at all levels will achieve universal health. It is not possible nor is expected to be done by private sector alone voluntarily. At the most, it will make some ivory towers of international standards keeping the major healthcare delivery with concern. Sure enough, there are hurdles for the government but it is the need of the hour if we wish to participate in global care.

On public private partnership

With the present system of government-sponsored healthcare segment, which is rich of resources but lack the global perspective, public private partnership has a major role to play. Government can come forward in terms of land, building, infrastructure, and private sector can play a very important role in terms of skill, manpower, and services. Public-private partnership (PPP) will help grow and deliver the healthcare in a timely manner. Today, private sector is skeptical to invest big bucks in India. Government should play a role of infrastructure provider and monitor quality healthcare. Private sector will come forward for delivering quality healthcare. PPP will surely make healthcare affordable in India where both will be winners.

On areas where government should invest to make healthcare more accessible

Government has a presence in all segments of healthcare, be it primary, secondary, or tertiary. Its performance record, barring a few institutions, is not all that rosy. Private sector is always looking for profits and will not invest in primary care where margins are low. Even today, the government is paying a lot for their beneficiaries through private sector in tertiary care. Government should invest in primary care only which is the back bone of universal care and leave the secondary and tertiary care to private sector, but monitored by them. In this way, affordable healthcare will be available to everyone.

On healthcare policy

In my opinion, the states and the center have a unique role in healthcare sector which is inseparable. This means there is no separate policy for the states or the center. The only question is how much contribution each one has to make in terms of financial provisions. There should be only one policy, i.e., National Health Policy.

I feel this is the time for India to truly bring health sector at par with global health sector. We have the manpower, we have skills, we have information, and we have knowledge. We just need to create infrastructure; we need to monitor quality care and we will do it. We will not only be able to give care to our citizens but we will be able to provide care to the world.

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