‘Telemedicine needs to be leveraged to its potential to make healthcare more accessible’

The health sector budget was 1.04 per cent in the 11th Five Year Plan. The expenditure on health should be increased to three per cent of GDP by the end of 12th Five Year Plan (2017) and eventually reach five per cent by 2022, in line with most developed nations.

Quality: The quality of Indian healthcare is varied. While one finds availability of adequate quality in major urban areas, occasionally meeting international standards, access to quality medical care is limited or unavailable beyond the cities and in most peri-urban and rural areas. Substantial budget needs to be allocated to re-engineer government hospitals in terms of infrastructure planning to bring in operational efficiencies and implement appropriate systems and processes to meet minimum accreditation norms for delivering uniform quality healthcare services

Infection control and drug policy: Hospital acquired infections are on the rise across all hospitals in the country more so in the government hospitals where in the absence of adequate quality protocols and infrastructure the same is rampant. Moreover, uncontrolled use of antibiotics in the absence of antibiotic policies at the state and hospital levels is creating a high risk of drug resistance in the larger population. A comprehensive effort at the national level should be carried-out for research studies across the country and come up with adequate measures before it grows out of control. The pharma sector will have to be co-opted in this endeavour.

Health financing: The lack of adequately funded public health services forces large numbers of our population to incur heavy out of pocket expenditures even in public sector hospitals, since lack of medicines means that patients have to buy them. This results in a very high financial burden on families in case of severe illness. The Rashtriya Swasthya Bima Yojana (RSBY) which provides cash less in-patient treatment through an insurance based system up to Rs 30,000 presently is restricted up to secondary care. It should be reformed to enable access to comprehensive primary, secondary and tertiary care. Also effective monitoring mechanism has to be provisioned for the scheme, which has the potential to become a large scam. The scheme, which is presently free of cost, should also explore ways to collect user fees to reduce the scope of fraud and induced demand.

Technology: The use of modern technology in healthcare is largely restricted to the private facilities with an exception of certain centres of excellences in the government system. A dedicated effort needs to be planned and executed to capture maintain and effectively use the resources available in the hospitals through integrated hospital management information systems that are also linked with the public healthcare delivery mechanism at the state and national levels. Tamil Nadu is a good model to learn from. Further telemedicine/ tele-radiology needs to be leveraged to its potential to make healthcare accessible across geographies, especially in the absence of adequate human resources.

PPP: A facilitating environment needs to be created to increase the cooperation between healthcare providers from private and public sector. PPPs will have to be envisioned and structured pragmatically with appropriate regulatory framework in place.

– Dr Alok Roy, Chairman, Medica Group