A strong healthcare system can positively influence the socio-economic status of a country by reducing the burden of diseases and related costs to the nation and its people, and by raising the productivity of its workforce. However, given the size of our country and population, providing accessible and affordable quality healthcare in India is a challenge. At 1.4% of GDP (2017-18), India has one of the lowest public healthcare spends in the world. Raising public health spends to 2.5% of GDP has been envisaged in the National Health Policy 2017, this should preferably increase up to 3%.
Although, healthcare has eventually been given its due recognition in the government’s development plan through various comprehensive initiatives in recent years and specifically with the launch of our very own UHC program – ‘Ayushman Bharat’, itseffective implementation would require extensive investments from the public as well as the private sector. It is estimated that 2,500 new modern hospitals will be built, following the launch of Ayushman Bharat, over the next 3 years. With limited public funds, government needs to provide appropriate incentives to encourage private investment in targeted areas specifically tier II and III cities.
Long term financing to the healthcare sector, as provided to other sectors with the infrastructure status, will not only promote investment in healthcare infrastructure but will also provide the much-needed boost to the entire sector. The government should announce National Priority Status for the Healthcare sector; designating Special Healthcare Zones in key geographies with associated benefits like earning exemptions for facilities located there, infrastructure support and manufacturing incentives.
In addition to the conventional modes of financing, the government further needs to promote and facilitate alternative mechanisms to channelize investment in healthcare such as taxes on specific commodities, FDIs, CSR funds etc. Specific funds like Healthcare Infrastructure Fund and Healthcare Innovation Fund should be developed to boost entrepreneurship, start-ups and newer business models, which are needed to improve access, availability and quality, especially smaller cities and rural areas.
India has been suffering from an acute shortage of healthcare workforce – which is the backbone of any healthcare system. With the launch of Ayushman Bharat, it is estimated that we would need to increase our doctors by 1 million, nurses by 2 million and specialists by 0.1 million by 2022. This calls for some immediate steps like fast-tracking the upgradation of our district hospitals to medical colleges, increasing PG seats, both, in district hospitals as well as private healthcare facilities and incentivising private sector for investing in workforce training. We need to promote hospitals to undertake on the job training by extending deductions under Income Tax Act- Section 80JJAA on stipend paid to professionals undergoing vocational training and DNB courses and Section 35CCD on expenses incurred on skill development projects. Further, we should expand healthcare skills-sets to include more of allied healthcare professionals like physician assistants, nursing aides and technician assistants to evenly distribute the burden of the healthcare workforce.
To help augment the quality of care and improve patient outcomes in the country, there is a critical need to promote standardization in clinical practice and other processes by robust implementation of standard treatment guidelines, clinical audits and accreditation across public and private providers. Rolling out National Health Stack (NHS) using a standardized, integrated and interoperable EHR system will enable availability of centralised healthcare information, which is a crucial element for an effective healthcare system.
(The author is Co-Chair, FICCI National Health Services Committee and Chairman, Medica Group of Hospitals)