Charu Sehgal, Partner and Leader, Lifesciences and Healthcare, Deloitte India, urges the government and healthcare bodies to support and motivate the healthcare service sector in times of COVID-19
In these difficult times when the world is reeling from the human and economic effects of a pandemic, the sector that seems to be at the forefront of the fight is the life sciences and health sector. It is the sector that holds the key to identifying, mitigating and treating the disease. Any efforts towards long term prevention and protection by means of a vaccine as well as a cure are also under the purview of this industry.
At times like this, it is critical that we take both a short term view of solving the immediate problem, as well as learn lessons for the long term on how to view this sector and its criticality.
India’s response
This crisis has also brought to the fore the importance of a continued focus on public health. The need for continuous collection and analysis of epidemiological data and a robust public health structure. India has acted swiftly and decisively. There is action both at the macro as well as at the local level. States are working very hard to test, isolate and treat. Contact tracing has been done at a remarkable scale and with admirable doggedness and persistence. Rajasthan’s Bhilwara example of such excellent strategy, planning and implementation is already out there to see.
There are examples of some excesses and some slippages but on the whole, the government and its advisors seem to have done a commendable job.
What needs to be borne in mind is that as we invoke the health sector for its unflinching support and cooperation in this fight, we do not forget their constraints and economic realities.
Support the Industry
We need to motivate, support and nurture it through financial and other means.
We must remember- the survival of this sector is critical. We need R&D and innovation to flourish so that new vaccines, testing options and methodologies evolve. We immediately need increased manufacture of PPEs (Personal Protective Equipment). We need frugal innovations for equipment such as ventilators, which are in very short supply. Thankfully we are already seeing Indian ‘jugaad’ at work with some very cheap and effective versions of ventilators emerging.
We need the pharma companies to stay viable so that they can continue to produce the drugs that India and the world will need more of in these times. They are seeing a drop in demand for certain drug categories- as the public postpones outpatient visits and elective surgeries. They need to be allowed to supplement their incomes through exports, at least of items that are truly surplus and do not constitute an immediate need for India This income will facilitate their survival and therefore enable them to support India’s fight by stepping up to undertake the production of other necessary drugs.
Everyone is talking about how hospitals, doctors and paramedical staff are selflessly working to test the suspected and treat the infected. This is currently happening in large government hospitals and a few private ones, which seems to be the right way to do it.
However, there are thousands of other mid and small-sized hospitals who are ready and waiting. Their staff are attending every day, ignoring the risk of infection, overcoming all odds to reach the hospitals and treating whoever is arriving for help.
There is a crisis lurking right there though. These hospitals, however, have almost no outpatients and the inpatient occupancy is down to 20-30 per cent since all elective procedures are on hold. The hospitals are incurring almost all their costs, in fact, many have cited that their expenditure has risen sharply due to the need to purchase PPE, masks and sanitizers in large quantities.
With income significantly down (in many cases to around 20 per cent) and expenses almost constant, these institutions are staring at a very bleak situation. Most of these are run by individual doctors and have very little reserves. There is a real risk that some of them may need to shut down if there is no help. India can not afford it’s already stretched healthcare sector to be further diminished.
There could be many mechanisms that can be used to provide support. Some suggestions include:
- Provide them protective gear, masks and sanitizers free or at subsidised rates
- Help ease their cash flow situation by releasing all payments due to them from central and state governments for treatments done on behalf of the government eg. CGHS Delhi governments DAK scheme etc to ease up their cash flows.
- Directing the health insurance companies to release held up payments.
We also need to be cognizant of the fact that we cannot delay elective surgeries and procedures for too long. They will at some point not remain elective and become critical. There is a need to, therefore, create protocols and mechanisms that will allow for the resumption of surgeries in hospitals in a phased manner.
The pathology labs are facing a similar predicament. Their regular load is significantly down (in many cases to around 30 per cent). As they come forward to help in the increased testing, we need to ensure their sustainability by reimbursing at least their costs.
The world is looking up to the healthcare sector for helping us out of this crisis, and we need to ensure requisite and nuanced support to it.
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