Current state of healthcare in India requires action across multiple dimensions: NATHEALTH
- India’s unique healthcare challenges need collaborative approach
Recent unfortunate incidents in the health system have unsettled the continuum of care leaving the healthcare sector in a ‘state of emergency.’ While the Indian healthcare sector is passing through some sort of ‘emergency’, all stakeholders-government, public & private service providers, medical professionals and patients collectively need to make constructive efforts to end the trust deficit. Rising trust deficit between patients and the health ecosystem can hamper the desired progress of the Indian healthcare sector and hence, the health of the Nation, according to NATHEALTH.
In a statement issued here today, NATHEALTH said, “The Indian healthcare sector needs to reshape the paradigm of care and create an environment of regular introspection to achieve the goal of Healthy India. To undertake this journey, we need to redefine the health system and clearly lay out the preferred path for several key aspects, including insurance coverage, adherence to treatment & care protocols, regulations, price control, payment models, technology adoption and ethics.”
Over the last three decades, private sector has been making growing contribution and supporting already heavily burdened public health institutions at every level. The private sector today provides 58 percent of the hospitals and 81 percent of the doctors in India. This comes as a big support to public health institutions right from primary care to tertiary care like AIIMS. India’s non-communicable disease (NCD) burden continues to expand and is responsible for around 60% of deaths in India. Moreover, out of pocket expenditure (OOPE) constitutes more than 60% of all health expenses, a major drawback in a country like India where a large segment of the population is below poverty line. India has only 1.1 beds per 1,000 persons compared to the world average of 2.7. Rising dual disease burden (CDs & NCDs) in India calls for increased capacity building which is only possible with collaborative approach.
Healthcare, being state subject, is guided and governed by union and state laws. Clinical Establishment Act which has taken effect in four States namely, Arunachal Pradesh, Himachal Pradesh, Mizoram, Sikkim and all Union Territories except the NCT of Delhi since 1st March, 2012 vide Gazette notification dated 28th February, 2012. The States of Uttar Pradesh, Uttarakhand, Rajasthan, Bihar, Jharkhand and Assam have adopted the Act. NATHEALTH recommends that instead of going for stringent actions, the government and private sector need to work together in collaborative spirit for safeguarding the health of the nation. Private sector, on their part, needs to introspect and self-regulate themselves and follow ethical practices. NATHEALTH emphasized that holding doctors responsible for any mishap even before a proper enquiry, does not augur well for the health of the nation.
NATHEALTH also urged private sector providers to adopt and promote ethical behaviours and norms as India needs to redefine and ensure standards of quality care. Healthcare sector also needs to focus on capturing hospital data and also ensure proper documentation for tracking of relevant performance metrics in terms of process, outcome and safety.
According to NATHEALTH, healthcare challenges in India are unique and need innovative ways to address them. Public sector spending in healthcare is only 1.4 percent of GDP: rest (3.3%) comes from the private sector. Marginal health insurance coverage (75% of population is with no health insurance), gap in bed capacity of over 2 million and nearly one doctor per 1000 people are big challenges which can be addressed only in collaboration with the private sector. Expanding infrastructure with collective efforts and collaborations can only lead to 1.8 million additional beds, improving the density of beds from 0.9 per thousand today to 2.0 per thousand in 2025.
The National Health Policy 2017 aims to bridge the gaps by increasing public spending to 2.5% of GDP by 2025 and this Policy looks at the problems and the solutions holistically with private sector as strategic partners. To achieve the goals of the universal coverage, the government would need the support of private sector at primary to tertiary care levels. The support comes in the form of large investment, new technology, innovations and quality services. NATHELTH said, “Innovative partnership models are emerging in India, cutting across traditional business models, but the challenges still remain, how to significantly reduce treatment prices while retaining optimum quality care.”
In the spirit of collaborative teamwork, NATHEALTH strongly urged providers/hospitals to be highly sensitive towards quality of care including patient safety and treatment protocols. NATHEALTH emphasised that healthcare providers need to be always sensitive in their interactions with patients/ end users and other stakeholders and ensure that their daily activities, efforts and interactions are undertaken in an ethical and honest manner within the parameters of law for the advancement of healthcare and improved patient safety and care in India. Let us come together to build ‘Swasth Bharat’ (Healthy India).