Dr Adit Desai
MD,
K D Hospital

Healthcare in India: The way forward!

The healthcare market in India is definitely the fastest-growing market around the world. Yes, we do still trail behind America and, to a certain extent, Germany in terms of technology and quality control, but we are getting there slowly. India is also making great progress in the medical tourism market as more and more Middle-Eastern and African citizens are choosing India as their go-to healthcare destination. NRIs from America, UK, and Australia are now choosing India for all their healthcare needs as we offer quality treatment with great outcomes as well as at an affordable rate as compared to the other markets. With increase in direct connections to multiple cities in India, every part of the country is being exposed to medical tourism, which will help showcase India as a leading healthcare destination in the world.

On budgetary allocation in healthcare

For corporate hospitals and private nursing clinics, budgetary allocation has to come in their top priorities as it will have a huge impact on their cashflow statement and annual P&L. A budget would set the path straight for your annual growth plan, your current situation, and your future expansion plans. This will also help the hospital management to plan accordingly in terms of individual departmental growth, marketing, and strategic planning for the year.

On planned budgetary allocation for FY20

Budgetary allocation is the key factor in deciding a hospital’s sustainability. Checks and balances in and around the financial pillar of an organization is what decides the growth pattern of a hospital, or on the other side, it is demise. Around 20 percent of the budget is allocated toward facility maintenance and 30 percent toward upgradation of the facility, majorly in the IT sector and to create a more patient friendly environment. Around 30 percent has been allocated to marketing and budget, 15 percent of which will be toward digital marketing and the rest toward community-marketing activities. And the rest, i.e., 40 percent, is allocated for procuring latest cutting-edge equipment and technology to improve outcomes and for the benefit of the patients everywhere.

On vision for health and family welfare and the challenges you face while implementing health services

My vision is in alignment with WHO’s vision of comprehensive healthcare for all. Right to health is a basic human right for all citizens. There should be centers available in each and every part of the country with basic infrastructure and technology. The government should install a proper EMR software in order to gather database of patients and diseases across the country to identify areas requiring the maximum support. This technology will also help to predict probable epidemics and will help in taking quick actions.

The basic challenges that I faced while setting up my facility were related to infrastructure in the beginning. I wanted to make one of the most patient-friendly hospitals in the country. We took a lot of inputs from doctors and regular people in the city on issues faced by them in other hospitals and tried to incorporate as many of those changes as possible. Software implantation was another challenge I faced as the market has tons of products available for you to choose from – each one with a distinct advantage over the other. We finally picked a software which was the most suitable to our hospital and also user-friendly. And of course, the biggest challenge was to find doctors who were in sync with our vision and ethics. We ended up finding a lot of good doctors and are still recruiting heavily in all departments. A great team of doctors, coupled with great service, is what makes a hospital stand out from the rest.

On monitoring the quality of private healthcare

Despite corporate culture trying to take over stand-alone nursing homes and clinics in India, the scattered healthcare segment is here to stay. In order to ensure uniformity in the quality of healthcare dispensed across the country, standard regulations need to be followed by all. NABH accreditation should become mandatory for each and every clinic, nursing home, and hospital in the country. The government has already taken the first step by making NABH accreditation compulsory for hospitals and clinics to avail cashless facilities, the current deadline to comply with this is tentatively extended till July 2019. Certain infrastructural regulations also need to come in place for small clinics and nursing homes in terms of space allocation, fire safety, biomedical waste management, and IT (to maintain and collect data for research purposes). To maintain people’s trust in the healthcare sector and in doctors, we have to take certain steps to ensure that there is no compromise in quality of healthcare services. Cost-cutting is an effective way to increase profits, but there should be a line drawn to establish the fact that patient safety is of utmost importance.

On public-private partnership in making healthcare a success

It is a great opportunity for corporate hospitals to expand to rural areas. A lot of corporate group hospitals are in a way, PPPs. Because of this, these hospitals have to take in all government schemes and hence the outreach of such partnerships is huge. The layman can avail quality healthcare with great infrastructure at an affordable cost, whereas the hospital gains the volume. Now, the government has also rolled out a PPP venture to set up medical colleges. But, at the same time, the government must ensure that the government schemes allow a hospital to be sustainable and to dispense ethical and quality healthcare services. Certain factors make it impossible for hospitals to join hands with the government and hence not a lot many hospitals opt for a PPP.

On areas where government should invest to make healthcare available to everyone on the go

A larger number of medical colleges is definitely the go-to solution. But in the long run, the government will have to ensure that private hospitals and clinics are not burdened by Ayushman Bharat and the individual state schemes. The government needs to smoothen the process right from the admission process to the realization of the money to the hospital. A lot of private players are hesitating to take in these schemes mainly because of two reasons: non-viability and delay in realization of money (which leads to less cash and more credit). The government needs to really work on the rates of Ayushman Bharat for corporate hospitals to take part in it. Apart from this, PHCs should be installed with basic necessities for patients and doctors, IT infrastructure to standardize processes, and equipment required for basic diagnostic purposes. The government should look into the possibility of connecting rural PHCs to tertiary care hospitals through telemedicine. Telemedicine will help patients in rural area get consultation from super specialists. It would reduce the time, money, and distance (virtually) and would also result in better patient outcomes. Tele-radiology is already being implemented by a lot of private players. Along with that, tele-pathology is also now being introduced in the rural setups. All of this will result in reduced pressure on tertiary government hospitals and will ensure quality healthcare at both tertiary and rural government setups.

On policy interventions that the healthcare sector in the state need to align with the healthcare objectives at large at the national level

As mentioned above, comprehensive healthcare for all has to be the priority because advanced technology is of no use if the people in the country have issues accessing basic healthcare. That should be the state’s as well the Center’s priority. Improved healthcare accessibility will indirectly benefit the society in ways more than one can count. It will lead to an improved quality of life, which will directly impact the per capita income of households across the country. For this, the government has to increase budgetary allocation in healthcare. In India, it is one of the lowest around the world. More money should be spent on increasing healthcare facilities around the country than on any other thing. It has to be the government’s priority. Right to health is a basic human right and every citizen has the right to the best healthcare services that we can offer. For this, the government has to invest heavily in new infrastructure, technology, and the use of IT to reduce the distance and improve the accessibility for everyone.

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