The domestic healthcare sector, at $34.2 billion, is the largest service industry in India in terms of revenues. But, in terms of infrastructure – beds, doctors, nurses, — we rank a poor 112 as per WHO country rankings. Even to provide basic healthcare, as advocated by WHO, we will need an additional investment of $88 billion. Clearly, the government lacks resources for this and the private sector needs to take the responsibility for the bulk of this investment.
To induce the private sector to invest, and keeping in mind the long gestation period for break-even of hospital projects, I am hopeful the Government will grant ‘infrastructure status’ to this sector. This will help in raising investments to create a modern healthcare delivery system.
The Central and State Governments need to support robust public health programmes to improve the basic health indicators: life expectancy, infant mortality and morbidity. India lags behind considerably as compared to developed countries on these indicators. Robust public health programmes need the Central and State Governments support for providing a thrust for further improvement of these indices.
Also, while the National Rural Health Mission needs to continue to flourish, the time has come to initiate and announce a National Urban Health Mission for the economically weaker sections of urban society. I look forward to such an announcement in this budget. Having said that, the focus needs to be on outcomes, not outlays.
The Indian healthcare delivery market is highly fragmented. Private hospitals have bed strength of only 22 on average. Smaller hospitals have limited infrastructure and lack the ability to provide tertiary care or attract talent. Therefore, consolidation is the key for quality enhancement in hospitals across metros and smaller towns. I am sure that the Government will recognize this and provide a policy to facilitate the same.
It is fashionable in some circles to talk about free care for weaker sections, but this mindset ignores the responsibility of the government to provide “access” to healthcare and to make it “affordable”. The private sector is only one of the many “delivery vehicles”. The answer to broad basing access to quality healthcare lies in wide spread penetration of health Insurance. Not only should the government put in the requisite insurance premium for those who can’t afford quality medical care, it should also introduce separate licenses for health insurance and relax capital adequacy norms to encourage more private sector participation. I am optimistic of seeing some progress on this in this budget.
The author is managing director and CEO, Fortis Healthcare Ltd