It has taken the collaboration between public and private sectors to improve the status of the Indian healthcare ecosystem. It is now at a crossroads to become a global hub and once again requires the spirit of partnership to shine
Health and education are fundamental pillars of society. These are basic civil rights as well. A year before our Independence, The Bhore Committee presented a report that became the template on which independent India built her healthcare infrastructure, from Primary Health Centres (PHCs), Secondary Health Centres (SHCs) to District hospitals. Planning and provision of preventive care, along with curative care, were significant recommendations for public health. PHC was suggested for a population of 40,000. They were to be staffed by two doctors, one nurse, four public health nurses, four midwives, four trained dais, two sanitary inspectors, two health assistants, one pharmacist, and fifteen other class IV employees.
Secondary centres provided support to PHCs and coordinated and supervised their functioning. Based on these seminal recommendations, many states, over a period, excelled in providing healthcare at the ground level based on key health parameters—an increase in life expectancy and a decrease in infant and maternal mortality rates. However, this is not uniform across our vast country, and various gaps need to be addressed as a priority. Let us use ‘Amritkaal’ to ensure that by 2047, we establish a truly functional healthcare delivery system at PHC and SHC levels for ‘Bharat’.
From the 1950s to the 80s, healthcare delivery was primarily managed by the public sector. A few trust hospitals existed but were limited to a few metropolitan cities. It was in 1983 that India witnessed the emergence of the private sector in healthcare substantially. Dr Prathap Reddy turned his dreams to life with the first Apollo Hospital in Madras (now Chennai).
Being a clinician in the US, he used his training and experience to develop a modern healthcare infrastructure with state-of-the-art medical equipment at par with any developed country. This attracted medical talent from across India and abroad to function and provide best-in-class healthcare comparable to the best hospitals in the world. Apollo expanded its outreach by establishing similar facilities in Hyderabad in the late 1980s and in New Delhi in the mid-1990s.
During those days, the latter was the fourth largest corporate hospital across the globe—a truly visionary step forward with the best medical infrastructure. It was also in the late 1980s when Dr Naresh Trehan, a young heart surgeon working in New York, returned to India and assisted in establishing Escorts Heart and Research Institute with support from the Escorts group. Before the establishment of Apollo and Escorts, the only option for superior quality high-end cardiac care was the UK or the US. As patients started experiencing cardiac care here, equivalent to or better than what was available outside India, high-end cardiac care started getting established in India.
These two harbingers of change in the Indian healthcare ecosystem extended the idea of private enterprise in healthcare; encouraged other entrepreneurs to build tertiary and later quaternary multispecialty facilities, such as Narayana, Fortis, Max, Manipal, and Medanta emerged as prominent healthcare providers. Growth in the private healthcare ecosystem, which had the best healthcare infrastructure, attracted the best medical talent within and from outside India to come on board and practice medicine. A reverse brain did happen, and it continues.
Medical Value Travel (MVT) is accelerating growth and helping us generate significant foreign exchange. Hospitals can avail of customs duty reduction tied in with foreign exchange they generate from MVT for the purchase of costly medical equipment—an excellent initiative from our government that has boosted medical infrastructure.
Our honourable Prime Minister has expressed his desire several times that India increases its MVT capability substantially—this will not only enable huge revenue generation but also position India well amongst other nations. Present healthcare infrastructure needs to expand to cater to the enhanced demands of our populace and cater towards MVT. The way Production Linked Initiative (PLI) rolled out for the Indian industry, something similar will help attract investments to enhance bed capacity and bring in the latest medical technology to attract more MVT.
Healthcare has huge employment generation capabilities—National Health Service (NHS) is the largest employer in the UK. In India too, healthcare and its larger ecosystem are an important source of employment.
Courtesy Forbes India