India as a country has made significant improvement in the healthcare sector in the 21 century from providing world-class affordable healthcare services to being the sort after medical tourism destination. India is also called a pharmacy of the world and the only country to have the capacity of producing more than 3 billion doses of vaccines annually. All these achievements seem minuscule in comparison to the demand for affordable healthcare and some serious shortcomings in medical care delivery.
It is expected that by 2022, healthcare is projected to reach $372 by 2022 at CAGR of 16-17%. In order to strengthen healthcare delivery and improve business prospects, policymakers, healthcare providers, business leaders, technology providers, and pharma companies will need to devise strategies that transform a spark into a sustainable fire. One such solution is the corporatization of healthcare.
In the opinion of Raviganesh Venkataraman, CEO, Cloudnine Group of Hospitals, the Indian Healthcare sector is faced with several challenges. These include the inadequate reach of basic healthcare services, shortage of medical personnel, quality assurance, the inadequate outlay for health research. The magnitude of these challenges is humongous, and it is excess to expect the government to take all the burden, the private sector participation should also be increased.
The use of technology is critical to mitigating these problems in a dearth of resources and skilled caregivers. Technology such as mHealth, wearable, and mobile healthcare devices could be made a part of the healthcare ecosystem to quality care without stretching on resources.
The demand for affordable, accessible, and quality healthcare as well as the burden of communicable and non-communicable diseases especially in times of pandemic like COVID-19 and chosen to sort after destination of International patients with incurable medical conditions in a hope to find a cure in India. Ayushman Bharat – PMJAY launched in 2018, the world’s largest government healthcare scheme providing access to medical care for 50 crores marginalized beneficiaries. Also, Indian Healthcare is also receiving a huge inflow of FDI and investment from PE funds.
The Achilles heels of the healthcare sector is a shortage of skilled manpower. According to WHO norms there should be 1 doctor for every 1000 people, whereas government hospitals have 1 doctor for every 10,189 people in India. There is huge disparity in the distribution of doctors, states like UP and Bihar are having a shortfall of doctors. On the other hand, Kerala, Karnataka, Tamil Nadu, Punjab, and Goa have more doctors than the WHO norm. There needs to be a system for the upgrading of skills in deficient states. Here, the private sector could play a vital role in the skill development of medical professionals.
For a healthy India in the future, a great emphasis must be laid on preventive healthcare with a strong network of the effective primary healthcare system. This system must be complemented with accessible and simple medical insurance facilities for all from government and private firms.
The fundamental problem in India lies in supply and demand. The price is an outcome of the relation between supply and demand. In recent years policymaking is heavily focused on building the capacity in the supply side to keep up pace with India’s growing demand. While price regulation of essentials is important but long term solution lies in capacity creation in medical device manufacturing and completing the supply chain of pharmaceuticals, especially of active ingredients under ‘Make in India campaign’. The best outcomes can be achieved if any policy is framed through a consultative approach with inputs from all stakeholders.
The government is implementing various measures for providing better care for its citizens. Ayushman Bharat – PMJAY, the non-communicable diseases programme, the communicable diseases programmes on tuberculosis (TB), malaria, HIV and the National Tobacco Control Programme, the Pulse Polio campaign or the national immunisation programme, have shown tremendous results. The Government of India is committed to work towards a distress free health care and functional and comprehensive wellness system for all by 2030. This is just the tip of the iceberg and more needs to be done.
Healthcare and social security is the responsibility of state and civil society. Without participation from civil society it is extremely difficult to get desired results in these domains. Clean water and air, without which good health is not possible, depends on cropping practices, industrial regulation, pollution control, environmental protection and law enforcement. It’s not a single policy, but interconnected, multi-pronged thinking that is needed. Policies pertaining to social security – that includes care of expectant mothers and children, unemployment allowance, disability payments, old age security, skills training and re-skilling, housing and healthcare, are all linked. These issues can only be addressed at policy making level.
The success of treatment significantly depends on safety and efficacy of a medicine. The safety and efficacy are intertwined issues. One is to ensure the quality of medicine produced is of the highest standard. Second to keep the prices of these quality medicines under check so that it is accessible to every person.
The first issue can be addressed by maintaining strict quality standards and effective implementation by enforcement agencies like FSSAI. The other through making generic medicines and improving expenditure on research and development. There are many startups making it accessible- these generic medicines to the public at large through an effective distribution system.
In India, healthcare is mostly sponsored from out of pocket expenses, and a huge chunk of these expenses is on medicine. The problem could be solved by developing a model by arriving at consensus from government and pharma companies. Indian government has already taken steps towards Universal Health Coverage in the form of Ayushman Bharat and Pradhanmantri Bhartiya Janaushadhi Pariyojana (PMBJP), generic medicine distribution scheme for all.
When it comes to digital revolution India is among the leading countries. This capability of India could be harnessed for transforming how healthcare services are delivered. Electronic Medical Record (EMR) is optimising efficiency by ensuring continuity and aiding information sharing across caregivers, by reducing human error.
Another technology that has paced up in India during COVID-19 is telemedicine offering convenient healthcare to patients in remote locations. Wearable technologies are improving which helps in monitoring important life processes accurately without medical professionals’ help and this information can be safely shared with physicians for review.
In the upcoming decade the healthcare sector will by great numbers with a matured digital healthcare ecosystem. The dynamic policy and further scaling of government projects like Ayushman Bharat and Pradhan Mantri Janaushadhi Pariyojna along with change in strategy of insurance company’s by covering every possible disease by providing insurance plans as per needs of various demographics.
The startup culture has taken the medical sector with storm, with various startups trying to come with solutions for different needs. These solutions are coming from the field of virtual reality, big data, Internet of things (IoT), telehealth, robotics and genomics.
The centre came with notifications in the official gazette criminalising assault on healthcare professionals till the Healthcare Service Personnel and Clinical Establishments (Prohibition of Violence and Damage to Property) Bill, 2019 is passed by the parliament in the wake of incidents on corona warriors.The offence is punishable with imprisonment upto 5 years and fine extending upto Rs 5 Lakh.
Change is a fact of life, which is inevitable. The government, industry leaders, health experts, doctors and other stakeholders have set their objectives for the future with the hope that the next decade will bring about the much-needed and positive shift in Indian health.
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