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What is the future of healthcare in India?

Major stakeholders in the health industry met up recently to discuss the problems ailing India's healthcare system!

Healthcare in IndiaThe fact is that none of talk in the run-up to the Lok Sabha elections discusses medical services or healthcare and the truth is since the very beginning and despite sporadic victories like the eradication of polio, the government of India has never been bothered about its denizens' health. Rural healthcare is non-existent; the doctor-patient ratio is abysmal, out-of-pocket healthcare spends are 78% of the total and our government spends (% of GDP) are lower than Nigeria's!

These were problems obviously dwelling on industry captains of the healthcare sector as they came together for the Future of Healthcare conference. Captains of India's healthcare industry, including Dr Devi Shetty, Dr Naresh Trehan, and Shivinder Mohan Singh came together on a common platform in the city recently to share their vision of the future. The doyens of India's health sector talked on key issues plaguing India's healthcare industry, including the lack of manpower and policy and regulatory issues as well as the need for greater integration of modern and traditional systems of medicine, better use of technology and the need to upgrade skillsets to ensure a better healthcare system for the 21st century.

Calling for major changes in the existing health system, Dr Naresh Trehan, CMD, Global Health (Medicity), said: 'Healthcare is basically disease management. We should build our system from the ground up to create a new blue-print of India's healthcare. We have over 800,000 ASHAs (Accredited Social Healthcare Activists) in India, but they are ill trained and don't have any medical skills. Their costs are a huge burden on the exchequer and nothing gets accomplished in return. All we have to do is to upscale their skills so that they can be the eyes and ears of the healthcare system on the ground. They need to monitor hygiene and find out who in the community needs medical assistance. This will be a big help in ensuring quick diagnosis of diseases and reducing the incidence of NCDs.'

Talking about the acute shortage of medical specialists in the country, Dr Devi Shetty, Founder & Chairman, Narayana Health, pointed out that whiletheUS has 19,000 undergraduate medical seats and 32,000 PG seats, in India it is the opposite the country has close to 50,000 undergraduate medical seats but only 14,000 PG seats. 'The low number of PG seats results in a shortage of specialists. This can have terrible consequences on the ground. For example, India has one of the highest maternal mortality rates in the world and this is unrelated to the amount of money we spend on healthcare. The reason is that we have created a regulatory structure where only a specialist can perform certain tasks, and the country simply doesn't produce enough of these specialists,' he said.

Dr Shetty suggested that to tide over the problem, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anesthesia, gynecology, and pediatrics to medical graduates. 'This can convert the entire 50,000 medical graduates produced in India every year into specialists who can then help reduce maternal mortality in India,' he added. 'If we want to deliver better healthcare outcomes, India doesn't require money. We only require policy changes. This will not happen till the Government looks at medical education as integral part of the country's development.'

Dr Shetty also expressed concern about the nursing profession in India, which he said would die down in a few years if urgent measures are not taken. 'There is zero career progression for nurses. Nursing is now considered a dead-end career. Admissions to nursery colleges in India have come down by 50%. Half of the nursing colleges in Karnataka have shut shop. In the years ahead, there will be an acute shortage of nurses in the country. There is a critical need to empower nurses by offering them a path to upgrade their skills and become specialists. About 67% of anesthesia in the US is given by nurse anesthetists. In India, we don't allow a nurse who has worked in critical care for 20 years to even prescribe a Paracetamol tablet!' he said.

Dr Devi Shetty highlighted the need to look for alternative ways of funding healthcare, such as by a surcharge on mobile phone bills, bring down the cost of building hospitals, develop patient management software, and establish one or two health cities with 3,000 to 5,000 beds in each metro where cutting-edge work can be done.

Outlining his views on the role of technology in ensuring greater access to quality healthcare, Shivinder Mohan Singh, Executive Vice Chairman, Fortis Healthcare, said, 'Technology has played a vital role in healthcare in the last 30 to 40 years, whether it is diagnosis or treatment. Going forward It is going to trigger more changes in healthcare than any other factor. Healthcare access will get radically transformed with technology whether it is in terms of proximity through devices planted in our bodies or by low-cost healthcare using innovative technological solutions or the speed with which information is shared.'

Singh added, 'A healthcare ecosystem would be created in future where different silos begin to talk to each other about patients and exchange information. Healthcare delivery is going to become more personalized in terms of tailor-made treatments for an individual.'

Talking about the need for better integration of different systems of medicine, Singh said: 'Allopathy has taken a predominant share of the existing market in healthcare, but I think we can't avoid for too long the benefits that other health sciences bring to the table. Some kind of integration of different health disciplines is bound to happen in future.'

He also emphasized that the onus of taking charge of one's health has to rest on the individual. 'We need to be more concerned for what we do to our health rather than what healthcare would do to us. We need to take ownership of our own bodies and mind and not outsource these to healthcare providers. People need to focus more on preventive care rather than just landing in sick care this is going to the mantra of healthcare in future,' he said. 'The Future of Healthcare: A Collective Vision' was the first-of-its kind global healthcare conference that was held in Delhi in March 3-4. With participation from over 15 countries and the presence of more than 500 delegates, the two-day event, hosted by The Healthcare Alliance, saw an impressive turnout of thought leaders, policy makers, senior Government officials, and business and health leaders from India and across the globe.

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