Even with an investment of $86 billion (Rs 3.7 lakh crore) over the next 15 years, India would not be able to reach the present hospital bed density levels of Brazil, China and the current world average. However, if India, which accounts for 20% of the global disease burden and 6% of world?s hospital beds, incurs this much of investment in the next 15 years, it can increase its hospital bed density to two per 1,000 population by 2025, from the current 0.86 per 1,000 population, estimates an Ernst & Young-Ficci projection.
The country would still lag miserably behind the current world average of 2.6, Brazil?s 2.6 and China?s 2.2, even as India?s disease burden is around 37% higher than Brazil and 86% higher than China. While the cost of reform may seem high, the cost of non-reform, if one goes by the World Health Organisation?s calculation, would be higher. The WHO estimates that India?s GDP could be pulled back by 5% by 2015 and the country would suffer this economic loss only on account of all the deaths caused by all diseases.
The Bulletin of Rural Health Statistics in India shows that while there has been a 66% rise in reported ailments between 1995-96 and 2004-05, the bed density has actually gone down to 0.86 from 0.93 during the same period. This doesn?t augur well for the country, considering that the growth of in-patient numbers (6%) will be higher than the growth of out-patient numbers (2.7%) between 2007 and 2017, according to a projection by Crisil research.
While the growth in rural population getting hospitalised has been 80% between 1995-2005 vis-?-vis its urban counterpart, which has grown by 40% (NSSO), rural areas still account for only one-ninth of total number of hospital beds. Also, the rate at which the number of beds is getting added in rural areas (19% between 2004-07) is much slower than urban areas (30% between 2004-07). To address the issue, the E&Y white paper has mooted a national healthcare commission with participation from the health ministry, state health secretaries, industry and the planning commission. The commission is proposed to have the mandate of preparing a national public-private partnership policy on health care.
?Till now, the PPP models prevalent in healthcare have been largely limited to facility management and not infrastructure creation. Most PPPs initiatives revolve around managing pathology, radiology centres, generic drug shops, blood storage units or hospital maintenance services. Very few initiatives, barring a few like Apollo Hospital in Karnataka or Escorts in Chhatisgarh, have explored PPP for infrastructure creation,? said M Muralidharan Nair, partner at E&Y. Learnings need to be adopted from other sectors, particularly infrastructure, from which principles like institutional arrangement, competitive bidding and viability gap funding can be borrowed and applied to the healthcare sector. PPP approach is also being proposed for the independent regulator for the healthcare sector, demanded recently.
?We are asking for a single independent regulator for the healthcare sector, which could adopt a holistic approach and basically address issues related to reliability, quality, accessibility and affordability in the space,? said Shivinder Mohan Singh, managing director, Fortis Healthcare Ltd.
