This history of pandemics shows that the lessons learned can help digital transform, or the status quo can continue to exist. The pandemic has tested the healthcare sector in India like never before — the lack of hospital beds, medical and paramedical talent, broken supply chains of medical consumables and drugs, paucity of ventilators and oxygen cylinders.
The truth is that we need to do much more digital transform in healthcare. The virus knows no boundaries it has struck both rich and poorer countries equally, providing a reminder that it can disrupt the channels of global trade and capital and redefine globalisation to national interest first. The fragmented healthcare sector and more importantly, the lack of a well-financed health system has tested our resilience during the pandemic.
India stands challenged in re-imagining its healthcare system and creating a new path ahead for its multi-stakeholder health structure while balancing the forces of public and private healthcare with social impact. With its 1.4 billion people, India is the fifth-largest economy in the world and thus makes a significant impact on the global economy. A healthy India is critical not only for its progress but also for the impact it can potentially make on the globe. The time is now ripe for digital transform.
The onslaught of the virus showed the importance of adequate infrastructure across the healthcare value chain. Shortage of hospital beds, medical technology, low manufacturing capacity of medical devices such as masks, personal protective equipment, ventilators, oxygen concentrators all pointed to a lack of infrastructure, both physical and in the form of manufacturing capacity. There is an absolute necessity to launch a National Infrastructure push in healthcare.
The government is not unaware of the gaps in the country’s healthcare infrastructure and the immediate need for funding.
In a memorandum submitted to the Fifteenth Finance Commission, the Ministry of Health and Family Welfare estimated that total funds of ₹5.74 lakh crore were needed to fortify the existing healthcare infrastructure of which a majority (₹5.13 lakh crore) would have to be spent on primary healthcare.
The government has introduced a credit incentive programme worth ₹500 billion ($6.8 billion) to uplift India’s healthcare infrastructure, which allows organisations to use the fund for expanding hospital capacity or medical supplies with the government helping to build Covid-19-related health infrastructure in smaller towns and rural areas.
Keeping a major focus on the healthcare sector, the government has also announced a cover of ₹50,000 crore for elevating the health infrastructure in tier-II and III cities, along with an allocation of ₹23,220 crore for revamping paediatric care. These loan guarantee schemes aim to provide 75 per cent coverage for new projects and 50 per cent for projects, which are in expansion mode.
As per the protocols, a maximum loan of up to ₹100 crore is set to be given for up to three years at an interest rate capped at 7.95 per cent. Between these announcements and the actual uptick of these schemes will lie the future state of India’s healthcare and the health of its population.
Plugging the talent gap
It is no secret that the lack of skilled talent has had a crippling effect on the timely testing and treatment of Covid-19 patients during the first and second waves. Hence, building educational institutions to train considerably more medical students should be a top priority for the public and private sectors.
As per the National Medical Commission, there are 554 MBBS colleges with total seats of 83,075 and 436 Post Graduate Colleges with 38,317 seats. The situation is resulting in one doctor for 1,456 people as against World Health Organisation recommended norm of one doctor per 1,000 people, according to the Economic Survey 2019-20. The focus should also be on developing more paramedics and allied workers, given their crucial role in the healthcare sector as proven during the pandemic.
As per various estimates, today, there are more than 1,200 paramedical colleges in the country. The number must increase substantially to improve the overall healthcare system in India. We must also be wary of any regulation that may inadvertently slow the momentum to create more paramedics, as seen in the past when regulatory mechanisms led to the closure of many nursing colleges across the country.
Recently, Parliament passed the National Commission for Allied and Healthcare Professionals Bill, 2021, which aims to increase employment opportunities for paramedics, regulate laboratory technicians, radiographers among others and shift the treatment of patients from a doctor-centric to a team-centric model. With proper implementation, the legislation can help generate more paramedical professionals vital to the healthcare sector’s growth. There must be concerted efforts to upgrade talent and skills using technology in a way the Information Technology sector has realised. A pivot towards digital transform in healthcare is a critical push to accelerate training of the healthcare workforce and bridge the talent need.
To conclude, the healthcare ecosystem has evolved over the last few decades on the back of the entrepreneurial efforts by the private sector industry players funded by private capital, however, massive infrastructure growth of this sector now needs a policy push by the government.
A highly significant policy change would be granting infrastructure status for the healthcare sector to incentivise and enable better finance options for the construction of new hospitals and facilities. With adequate reforms and incentives, the healthcare sector can emerge from the quagmire and embrace true transformation.
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