Even as they aggressively expand their chain of hospitals across urban India, healthcare majors Apollo Hospitals, Fortis and Max Healthcare have now evinced interest in setting up medical colleges and managing them in a bid to find a captive source for scarce medical talent in the country. The hospital majors have urged the government to introduce necessary policy changes and relax existing norms to help the country overcome its shortage of over six lakh doctors, two lakh dental surgeons and over 10 lakh trained nurses.
Aware of the acute shortage of medical professionals, the government is seriously considering opening up medical and dental education sector to the private sector, a member of the Planning Commission told FE. ?The government?s role should be limited to opening a few high-quality institutions dedicated to research. Having regard to the magnitude of the investment requirement for healthcare education and the paucity of resources with government, there is no alternative to allowing greater involvement of the private sector in health education,? he said.
A delegation led by Apollo Hospitals group chairman Prathap C Reddy recently met Planning Commission officials and demanded lowering of entry barriers like land requirement and built-up space to realistic levels to help set up new colleges. The delegation, which also included Fortis Healthcare Ltd CEO and MD Shivender Mohan Singh and noted cardiac surgeon Naresh Trehan, proposed to double the number of medical colleges under the PPP over the next five years from current number of about 270.
But, for the idea to translate into reality, the human resource development ministry and medical education regulator Indian Medical Association (IMA) will have to amend the relevant rules to allow the private sector to set up medical colleges on their own. Under existing norms, the eligibility for setting up medical or dental colleges is limited to organisations such as the state government, university, an autonomous body promoted by the central and state governments, a society registered under the Societies Registration Act, 1860 or a public religious or charitable trust registered under the Trust Act, 1882.
The private sector medical and dental colleges that have been established in large numbers have all done so by setting up not-for-profit societies. For medical colleges, another access barrier is the condition that the applicant must own or possess a suitable single plot of land measuring not less than 25 acres by way of 99 years? lease for the construction of the college. For dental colleges, the requirement is slightly less restrictive? only an area of 5 acres is required for a minimum period of 30 years.
The healthcare majors? decision to get into construction of medical colleges is expected to give a fillip to the government?s plans to set up 60 new medical colleges and 225 new nursing colleges through the public-private partnership mode besides upgrading existing nursing schools into colleges, strengthening of existing nursing colleges and upgrade and strengthening of existing government medical colleges in the 11th Plan period. According to Apollo Hospitals Group director Shobana Kamineni, ?We plan to impart medical education considering the huge shortage of skilled medical professionals in the country. The shortage is acute in super specialities.? She, however, declined to elaborate on the number of medical colleges or the investment the group plans to make.
A recently released report of the Planning Commission on services sector puts the number of doctors registered by different state councils at 6, 68,131 in 2006, giving a doctor-to-population ratio of 60:1,00,000. Although this is better than the standard set for India by the Bhore Committee just after independence (50:1,00,000), it is well short of the ratio prevalent in developed countries like Australia (249.1), Canada (209.1), United Kingdom (166.5) and the US (548.9).
While shortages run into lakhs, the annual turnover of medical colleges is about 30,000 and about 20,000 from dental colleges. The number of postgraduate degrees/diplomas being awarded annually in the country is only 3,181. The delegation also urged the government to recognise medical degrees awarded in developed nations like the US and the UK, to help meet the ever-increasing demand of doctors in the country. Medical degrees from countries such as Japan, Italy, Germany, Ireland, the Netherlands, Myanmar and Hong Kong are already recognised in India.