Post Mortem

Healthcare in India needs reorganisation

By Nagaland Post | Publish Date: 1/8/2019 11:09:04 AM IST

 Healthcare in India has seen sea change since independence. Comparing the statistics since 1947, we feel proud that in the past 70 years, healthcare has changed vastly. Tremendous improvement has happened in the average lifespan (From 32 years to 68 years). The Infant Mortality Rate and Maternal Mortality Rate have come down significantly. With only 18 medical colleges and 527 Primary Healthcare centres in 1947, the progress now is that we have 497 medical colleges and 25650 primary healthcare centres. Even though such progress is applaudable the health care delivery is uneven and of unpredictable quality. Tier 1 and Tier 2 cities have seen much more development in Healthcare than the tier 3 and 4 cities.

The current Indian healthcare scenario: With the emergence of numerous corporate hospitals, the geographical canvas of healthcare has totally changed in Tier 1 and 2 cities. Earlier Indian patients had to travel abroad for medical treatment. Now more and more foreign patients are preferring treatment in India through medical tourism. This is due to the fact that Indian healthcare is affordable and qualitative. The only refrain is that it is restricted to tier 1 cities. The situation in tier 2 and tier 3 cities is that many doctors have established their nursing homes and small hospitals. However, there is a lack of standardised services. The situation of tier 4 towns which include villages and rural areas is of great concern which definitely lacks quality healthcare structure.

i. The Government Health care delivery system is organised in 3 tier. Primary, secondary and tertiary. The infrastructure and human resources are optimal in frontline states like TN and  Kerala. However, the geographical spread of this Health care is not uniform. Some states like UP, Rajasthan and Jharkhand have to reach up to the national level.

ii. Change in pattern of disease - There is a drastic change in the pattern of diseases where earlier vector-borne diseases, air and water-borne diseases were attributed to high mortality rate caused by dengue, plague, jaundice and typhoid. The Government and NGOs at that time were stressing upon controlling the epidemics, and then the pattern gradually changed to cure and later prevention of such diseases. The situation now has seen extreme transformation in the pattern of diseases with more lifestyle diseases like diabetes, hypertension, and obesity are now upcoming in the trend.

iii. Supply deficit services - According to the recent data from the National Health Profile 2018, of the total 10 lakh registered modern medicine doctors, around 80% reside in tier 1 and tier 2 cities. With highly overburdened and understaffed public hospitals, the policies must be amended to increase the number of highly-qualified medical professionals along with technology in rural areas and villages, for the betterment of quality healthcare services which otherwise is relying upon the private sector to fill the gap.

The need of the hour – leadership from the private sector: Even though Governments have come out with different healthcare programmes they have limitation in implementation.  On the other hand, wherever the society or the community has been involved with such programs they have been successful. For instance Pulse polio program and smallpox eradication program, we were able to eradicate them completely.

Government or NITI Ayog should come out to form a pattern where every health facility can be coordinated in an organized way. Today we need to concentrate on tier 3 & 4 cities which demand more attention.

Budget re-allocation - Unfortunately, allocation of funds from GDP is very low in comparison to the other countries. We hardly spend 1.3% of GDP for health and out that also 75% budget goes to the management of Medical colleges and tertiary super speciality hospitals. Even the budget allocation by the Government in tier 3 & 4 cities in the primary Healthcare sector is low.

Develop secondary care in tier 4 cities: So what needs to be done is that both the Government and the corporate hospitals need to concentrate on these areas. And time has come that there should be a policy change in healthcare, meaning that now both Government, as well as Corporate hospitals, should also think of developing secondary care hospitals in these areas. These secondary care hospitals will take care of primary and secondary health.

The secondary care hospitals should have the facilities of emergencies, accidents, minimum diagnostic facilities and able to take care of maternity work. If we are able to take care of an emergency, medical emergency and maternity work and with a robust referral system along with diagnostic facilities, much better healthcare will be developed in the upcoming 5-7 years, which is the requirement of the country.

i. Technical Advancements - With advancements in the technology, virtual medicines and command centres are a boon not only for the doctors but also for patients. Now diagnostic centres do not necessarily require the presence of specialized doctors but in fact, through its command centres reporting of X-Rays and ECG can be done with ease. All these things can be incorporated in a secondary care hospital, which is to be developed in these cities.

ii. Proactive approach from the Corporate sector – The corporate sector should come forward openly and allocate budget for the same. Instead of opening 1 super speciality, using the same budget 10 secondary hospitals can be developed in different areas. This will not only increase the geographical coverage but will be highly beneficial for the patients as well. 

iii. The government should subsidize - Government should subsidize this and promote them, through giving subsidies and concessions, so that a corporate hospital financially viable secondary hospitals which will also be supporting the national service and we will improve the healthcare in the country.

Policies need to be open and transparent with the leadership from private sectors can help in the development of a robust system for a well structured and organized healthcare system in the country.

Launched on December 3,1990. Nagaland Post is the first and highest circulated newspaper of Nagaland state. Nagaland Post is also the first newspaper in Nagaland to be published in multi-colour.

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