Dr Ananth Rao
General Manager,
Columbia Asia Referral Hospital

Indian healthcare – Budgets, quality, and other perspectives

On the healthcare market in India vis-à-vis the global market

Healthcare market in India is expected to reach nearly USD 375 billion by 2022. Factors contributing to this projection include greater penetration in the insurance sector, increasing awareness, chronicity of lifestyle diseases, and lastly rising incomes. CAGR for the hospital industry is expected to grow around 15 percent.

The medical tourism market is poised to grow at around the 25 percent mark in India, and we thus have a good chance to be the Global Village for Healthcare.

On budgetary allocation in healthcare

Honestly, I feel the heath sector deserved more than just a remark during the budget session. The healthcare budget saw a 19 percent increase in total allocation this FY by the Union government, with nearly `6400 crore marked for Ayushman Bharat, the government’s special scheme for inclusive/affordable healthcare, which was launched in September 2018. The scheme is said to cover over 10-crore families in India. The National Research Foundation to boost research is a good move.

Looking carefully, there are no incentives for encouraging the setting up on hospitals by major players on tier 2 and 3 cities. Such a move could have been a shot in the arm towards realizing the dream of access to quality healthcare to all in the long run.

Thoughts and specific allocations for mass screening programs through primary health centres for early detection of lifestyle diseases in the younger population is one more area that the government could take up with help of bodies such as the Indian Council of Medical Research. Such efforts do exist but more span could definitely do more good.

On monitoring the quality of private healthcare

India’s private healthcare sector has emerged as a vibrant force & has made a mark both within and outside the country in aspects of quality, costs, policies, futuristic views, and adopting various proven care delivery models.

In India, the quality of medical care is governed by various bodies. In fact, healthcare is one of the highly regulated field. Let us be clear on one aspect – no one intends harm. With bodies like the National Accreditation Board for Hospitals (NABH), National Accreditation Board for Laboratories (NABL), Quality Council of India (QCI), State Medical Councils and many more, it is imperative that one delivers quality care and services. The reach and span of these organizations must increase to usher in a greater sense of long-term sustenance in care delivery systems. A quality consortium among likeminded private players would do good toward drawing and upgrading treatment guidelines, enhancing safety levels, immunization updates, mass screening programs etc. This could unify the private sector.

With greater access to information and growing expectations from a younger population who may have seen/experienced care in other parts of the world and increasing consumerism in healthcare, organizations strive to the meet expectations. Clinical care being the core of existence for healthcare, no player would want to compromise on outcomes and patient safety aspects.

Increasing accessibility beyond the metros is an urgent need for working toward uniformity of healthcare delivery. The private players would possibly be happy to set up smaller units and work on a hub-and-spoke model, but as I said earlier, some incentives would be encouraging. Such incentives would encourage players to look beyond the operational challenges of such models.

On public private partnership in making healthcare a success

PPP models are one of the most suited methods to boost accessibility and affordability of healthcare in India. The government, with its limitations on healthcare budget allocations, would benefit from the model. It is about the ease of doing business that is key to its success. While India now ranks much higher of this parameter, healthcare has not seen much on this front. The complexity of setting up a healthcare delivery system and its components needs to be addressed, one by one. Starting from procurement of land up to functionalizing the hospital, there are too many stakeholders. While they are all up there in the right spirit, it is important they are all aligned rather than scattered. Most healthcare startups are on the information technology, operations, and data science front, but not many in creating a healthcare delivery set up. This needs to be attended to. Addressing these concerns on a common forum, supported by skill development planning and data unification platforms would help build more robust and time-tested healthcare delivery models for the future through PPP platforms.

Globally, there are multiple models available for us to study (both successes & failures) and thus need not have to start any such research from scratch.

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

As I have already said, proper implementation of accessibility plans for healthcare is the primary goal. Policies to fuel growth in healthcare and pharma are the need of the hour. Skill building at all levels of hospital functions is an urgent need, be it doctors, nurses, paramedics, and the like.

The shift from incremental budgets to reformist budgets is the need of the hour. Laying out plans for the next two decades with a clear project management approach is the need. With a stable government at the Center and respective states, this ought to be the baton that is passed on every 5 years to each successive incoming government.

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

The proper implementation of ambitious programs like National Heath Mission, Ayushman Bharat, Employee Beneficiary Schemes hold a major role. A PPP model could be of immense value here. Also, procurement policies of medical equipment, tax incentives for capacity building, priority sector tag to healthcare, incentives for starting care centers in tier II and III cities, land allocations with long term outlook in such cities, investing more on in-house pharma R&D, multi-level skill development centers across the country, IT overhaul for unification of reporting platforms.

Predictive thinking on outbreaks, antibiotic resistance, supply shortages is the need of the hour and needs data that is valid, reliable & action oriented outcomes by their analysis.

A more congenial business atmosphere for attracting more foreign direct investment would add fillip to the plans too.

Anything else you would like to add

Healthcare as a sector, is here to stay for the good of mankind! It is in our best interest to nurture it…

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