Dr Rajendra Patankar
Nanavati Super Speciality Hospital

Indian Healthcare a Just Case for an Industry Status

Government should invest in connecting PHCs, CHCs, and the state-level emergency ambulance network with tele-medicine applications with broadband connectivity to provide tele-consultation through a network of super-specialty hospitals, and conduct remote monitoring assessment of patients.

The healthcare market in India is on the rise and has seen a drastic growth in the last 10 years. Healthcare has become one of India’s largest sectors both in terms of revenue and employment. The industry is growing at a tremendous pace owing to its strengthening coverage, services, and increasing expenditure by public as well private players. The total industry size is expected to touch around USD 280 billion by 2020. This can be substantiated by the huge amount of investments from major corporates and PE players from India and abroad. Both in India and globally, healthcare providers are looking at cost-effective and innovative solutions for the patients which are technologically driven.

India’s competitive advantage lies in its large pool of well-trained medical, nursing, and para-medical professionals. India is also cost-competitive compared to its peers in Asia and Western countries. The cost of surgery in India is about one-tenth of that in the United States of America or Western Europe. Thus, India is on the threshold of developing and emerging a healthcare hub for many countries for affordable and quality treatment. The Indian government is also changing policies, processes to ease the burden of healthcare and treatments on the patients. Healthcare IT, medical tourism, and Indian pharma have the unique capability of outshining in the global market. Rural India, which accounts for over 70 percent of the population, is set to emerge as a potential demand source for the Indian and global supply market.

On budgetary allocation in healthcare

Ayushman Bharat is the attractive title under which the Union Budget of 2018 has given a massive boost to the healthcare industry and the health insurance sector. By adding more medical colleges we will improve the doctor population ratio thereby helping us with many more hands to achieve a healthier India. With the provision of `5 lakh per family per year for medical reimbursement as a part of its ambitious National Health Protection Scheme, the government has taken a path breaking step in securing the need of the underprivileged section of the country. As a word of caution for achieving success in this mammoth task the government must consider merging all other parallel schemes into a single payer mechanism to be able to achieve its mission marching toward Universal Healthcare.

On planned budgetary allocation

Normally this is driven by the type of healthcare facility based on the different types of medical programs running. As a benchmark on an average one could consider spending between 5 and 15 percent annually on medical CapEx depending on the availability of infrastructure and skill sets available to utilize these funds.

On vision for health and family welfare

The Indian government has taken necessary steps in implementation of health and family welfare policies. The policies and programs are introduced by the ministry keeping in mind the current problems of the country. With various initiatives such as rural health, quality in healthcare, gender sensitivity  reaching out to the masses has been a success. This coupled with the Swach Bharat Abhiyan will help in reducing the infectious and communicable diseases burden of our country.

On monitoring the quality of private healthcare

Quality in healthcare is the key driver to run a successful brand. At Nanavati Super Speciality Hospital, we aim to be service and outcome differentiators by ensuring the highest standards of quality benchmarked with the best in the world. We have identified and mapped more than 170 Patient Touch Points to give a completely different patient experience. Apart from the mandatory clinical quality indicators as prescribed by NABH, we have devised our own matrix to monitor and control operational parameters which has the potential to increase efficiency of operations while maintaining patient and staff safety. All necessary steps are taken to ensure we adhere to the highest quality standards. It is particularly important in a healthcare industry since we deal with patients who are more informed and understand their rights and responsibilities better than ever.

In India, NABH is the torch bearer for quality and has been approved by the International Society for Quality in Healthcare, an international body that grants approval to accreditation bodies in the area of healthcare. While this is still a voluntary requirement as yet, an initiative for following certain minimum standards across healthcare delivery systems in India if made mandatory will go a long way to achieve clinical excellence in delivering healthcare in India.

On importance of public private partnership (PPP)

The PPP has been proven beneficial for:

Infrastructure development. Since last two decades we have seen various examples of PPP wherein government has given land (on lease for long tenure) to private players to construct hospitals or develop healthcare infrastructures. Developing and maintaining the infrastructure to ensure the quality of services is not compromised upon. We have been optimistic that in this fiscal budget of FY 2018-19, hospitals will be granted an industry status. It is quite an irony that hotels have been granted industry status but the much needed reform step of granting hospitals an industry status is still far away.

Management and operations. This essentially becomes the backbone of every hospital/organization. Governments at state and central level shall openly provide opportunities to private players to come up for O&M of PHCs, CHCs, which will create a huge impact in the base of the healthcare pyramid of services for the common needy patient in the rural region. Healthcare needs to be managed by those who are professionally trained in following the best practices of management in order to achieve greater efficiency. A clear job description coupled with authority and responsibility will help in improving the whole outcome for a PPP to succeed.

On areas where government should invest

The government has taken many initiatives to ensure that healthcare is provided to one and all irrespective of their class and economic status. Government should invest in connecting PHCs, CHCs, and the state-level emergency ambulance network with the tele-medicine applications with broadband connectivity to provide tele-consultations through a network of super-specialty hospitals, and conduct remote monitoring assessment of patients. Under the skill development initiatives government should initiate courses for support staff such as receptionists who can operate HIS, technicians who have ITI courses in IT who can operate a tele-medicine setup. This will not only improve the employment generation at the local regional level but also provide the skills at the rural level to connect the patient and doctor so that a correct clinical assessment can be done and lives of the needy can be saved by timely advice and interventions.

On policy intervention

The state government has budgeted less for the nutrition and social welfare schemes. The state government should also replicate some health initiatives such as eradication of TB, health expense reimbursement for the under privileged. Some of these schemes will help local implementation of the programs and better reach of the people. There are many areas in which the possibilities of alignment of initiatives are possible such as CSR funds allocated by corporates every year and their contribution in the health sector. Major focus of CSR funds is toward the Clean India mission, environment, and education as compared to CSR contributions in the health sector. If at the state level or the center level some desired percentage of fund contribution toward health can be defined it will definitely fulfil the gap of deficient funding to an extent.

On mobile health

The next big thing in Indian healthcare is mobile health and technology interventions. Government should extend special tax relaxations to mobile health applications and the technology hardware and devices so that the cost can be reduced and can be implemented by all healthcare institutions at a mass scale.

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