Siddhartha Bhattacharya, Secretary General, NATHEALTH, speaks about the job trends for healthcare in the coming times
Healthcare is a high priority industry and a source of major employment globally. India has a large shortage for doctors, nurses and allied workers against WHO standards. The shortage is more acute as one moves from urban to peri-urban and rural areas. With the right policy framework, skilling, partnerships and an enabling digital standards and connectivity, it is possible to grow the sector while creating employment.
The Government of India has made a commitment towards universal health coverage with the announcement of Ayushman Bharat. This will entail creation of jobs across different spectrums of healthcare like preventive, promotive and curative spectrum. In the coming times, there will be a greater focus on delivering care in frontline communities where people live and integrate the continuum of care through digital health and data analytics. It is possible that with the right interventions and financing, healthcare sector can be one of the top three employment generators in India, providing stable and quality employment across all economic cycles.
Human resources for health, including health professionals and supporting human resources at all levels, are a key input in the delivery of health services. Expenditures on human resources across the public and private sectors account for an average 69 per cent of total health system expenditures across countries from all regions of the world. In India, the sector is substantial and employs around 5 million citizens. According to the most recent data for India, there are 0.7 physicians and 1.7 nurses per 1,000 inhabitants (WHO, 2014), which is an estimated 0.9 million doctors and 2.4 million nurses away from the WHO recommended levels of 1:1,000 and 2.5:1,000, respectively. Additionally, each physician on average requires support from 5.6 full-time employees such as nurses and administrators. As such, if India commits to increasing public expenditure on health, meeting international human resource targets alone would create millions of jobs. Importantly this growth would benefit all levels of health care professionals from physicians to allied healthcare professionals and administrative staff.
Job trends in future
With shortage of medical staff and the contemporary socio-economic structure, it is challenging to convince medical professionals to relocate in rural regions and we can’t expect this situation to change drastically in the next decade(s). Therefore, in the interim, we need to explore options on how to harness technology to convert complex workflows into simpler ones by translating jobs into standardised care pathways that can be automated and delivered under supervision of a competent doctor or a technician. If we breakdown medical interventions into processes, it can be carried out with adequate skill and training by any frontline and allied healthcare workers and nurses. Thus, leveraging frontline and allied workers for healthcare delivery under the supervision of doctors, using technology, is going to be a major trend. Another major trend will be the way healthcare data is generated, preserved, shared and analysed for intelligent decision making based on big data, AI and machine learning.
In future, there will be a shift in the nature of the jobs. Beyond growth in existing roles, we will see new roles that leverages technology and enables better interpretation of data and decision making to improve quality and services delivery. Moreover, the interaction between machines and humans will be seamless. The skillset is going to be more about interpreting data and harnessing the power of machine learning and analytics to develop decision support systems to accurately interpret results. Artificial intelligence will create higher-end opportunities. Many of the core repetitive skillsets may get redundant as machines will automate those processes. Therefore, the industry will have to re-tool and re-skill itself in the modern age.
How prepared are our workforces for this change?
As India prepares to deal with the twin challenges of communicable and non-communicable diseases in the decades ahead, a remodelled healthcare delivery system will have to take shape. The system needs to be agile and responsive to the needs of chronic care being delivered as close to people’s home as possible. There is also a better need to forward and backward integrate the referral pathways. The major growth in the industry will come out of the emergence of care delivery models in ambulatory care centers, clinics, and to the home. Modern healthcare focuses on slowing or arresting chronic disease progression, minimising hospital care and reducing the impact of chronic disease.
The industry growth will lead to horizontal and vertical integration of the value chains, which will lead to future workforce to be more patient centred, value driven, and knowledge focused. There is a need to address future health needs associated with 21st century challenges, including demographic, epidemiological and technological changes, including considerations on transformation of health workers’ education, new types of jobs, career progression.
The need to attract the right talent
Healthcare industry can be an engine of economic growth. The industry can offer immensely satisfying career where one can positively touch many lives apart from achieving good career growth. As the industry consolidates, grows and attains a critical sector status, there is a need for active engagement between industry and education to develop the technical, clinical and leadership talent that can propel the industry into next level. Apart from attracting the right talent, industry will need to retain the talent and provide meaningful career opportunities to many of its doctors and nurses who find better opportunities outside India. This will entail significant medical education reforms and locating future centers of medical education closer to high employment catchment areas. Healthcare can look at skilling models in other industries like Information technology where there is a significant expertise in working with education system in India to develop employable talent through rapid skilling and aptitude development.
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