Gaurav Malhotra, managing director and chief executive officer of Bourn Hall Clinic, which runs two hospitals specializing in infertility treatment in Gurgaon and Kerala, says, the goal of ‘health for all’ can be achieved through incentives for the private sector to train more medical professionals, single-window clearance for new hospitals, and wider health insurance coverage.

Bourn Hall Clinic is the Indian subsidiary of UK-based Bourn Hall International Group, and plans to expand to more cities in India.

Edited excerpts from an interview:

What are your expectations from the government for healthcare in the forthcoming budget?

With the new government in place, we are very optimistic about having a healthy economy. If we want to achieve “health for all", I think the government needs to play a very critical role. The first problem we have is that of resources. We don’t have adequate number of resources—nurses, doctors, paramedical staff. So the main challenge will be skill enhancement and ensuring adequate training at medical colleges that we have created. There has to be transparency in policy and incentives have to be given to the private sector so that they can invest aggressively in education (of medical professionals) and making sure there are enough resources to take care of the growing need of the sector.

The second big challenge is in setting up big tertiary care hospitals. We have been told there is enough land bank to offer. So, getting enough land at an affordable cost is crucial for viability of health projects. This way, the private sector can also pass on the accrued benefits to the patients.

The third critical area is streamlining the licensing mechanism for the sector. There is a ‘Licensing Raj’ culture going on, which needs to end and the government must ensure a single-window clearance structure. At present, more than 150 licences—including those from the health, fire and pollution department—are required to start a hospital. The single-window clearance should also operate in a time-bound manner. The healthcare sector can achieve a transformation if the government can focus on these issues.

What are the lessons from the earlier budgets? There is a perception that healthcare has never been much in focus so far.

If we need to achieve health for all, there has to be a healthy balance between the government and private players. The earlier government suffered from a complete policy paralysis—neither was it hand-holding the private sector, nor was it putting processes of excellence in the government sector. To give you an example, 50% of the beds in government hospitals are non-functional. So, if we can put proper governance in place in the healthcare sector and make these beds functional, ensure doctors at the hospitals at an appropriate time, strengthen our primary healthcare in the government machinery—then that will go a long way in providing healthcare to a majority of society.

Secondly, the government must offer incentives that are meaningful to the private sector. For example, we were given incentives to open hospitals in small towns. Now, other basic infrastructure is not made available in such areas; the clarity among the statutory bodies for implementing the incentive policy is not there. So the government needs to create the whole infrastructure rather than asking us to spread healthcare in remote geographies. Plus, there are many urban poor living in metropolitan towns who are living in a much worse condition than those living in small towns because they are exposed to a larger number of diseases and they have nowhere to go. So the same consideration for the urban poor will also make a lot of sense.

If your expectations are fulfilled in this budget, where do you see the sector going? What is its growth potential?

Healthcare is at a point of inflection. Currently, we have estimated the sector at $75 billion and this is estimated to grow to $240 billion by 2020 and $480 billion by 2025. And all these expectations are based on the assumption that our insurance penetration is between 25-30%. If our insurance penetration is increased and it becomes close to 35-40% of our population, then sky is the limit. So, one important initiative that the government can take is to provide health insurance cover to a larger section of the society. This can be done by having proper schemes, right implementation and appropriate checks and balances. If we can bring in a larger population into the health insurance ecosystem, that would itself transform the healthcare sector of the country.

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