Budget 2021 Expectations: Pandemic has reflected the state of healthcare in India

Updated: January 30, 2021 6:17 PM

Union Budget 2021 Expectations for Healthcare: There is an urgency to come up with long-term strategies and roadmaps to put in place a system to deal with the future pandemics.

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By Rustom Kerawalla

Union Budget 2021-22 Expectations for Healthcare: As India looks forward to rise to the new normal after the unprecedented disruption caused by the Covid-19 pandemic, there is growing demand to push for timely healthcare facilities. In a way, the pandemic has kind of held a mirror up to the state of the healthcare sector so far. In India, access to quality healthcare poses its own level of challenges. From time to time, the public sector units and the government have undertaken initiatives to manage a continuum that could accommodate the vision of quality and affordability. However, there are still a number of roadblocks that need to be addressed. A key reason behind this is the budget constraints and also the vast amount of population to cater to in terms of a healthcare facility that is provided.

As per the 2011 Census, at least 69% of India’s total population resides in rural areas. The public healthcare system in these areas comprises first of sub-centres that cater to about five villages with a population between 3,000 and 5,000 individuals. Then there are primary health centres (PHCs) for every six sub-centres, this is followed by community health centres (CHCs), sub-district and district hospitals. Finally, there are medical colleges.

The pandemic has put the spotlight on the state of PHCs in rural areas and highlighted their significance in early detection of cases and providing quick help before health conditions become more severe.

Therefore, in order to overcome the twin challenge of rise in non-communicable and infectious diseases, it is imperative that the public spending on healthcare is increased to 4.5% of the Gross Domestic Product (GDP) over the next 7-10 years.

The affordability in healthcare

In the past few years, the Centre has been rolling out a series of reforms to achieve universal healthcare through the implementation of the National Health Policy of 2017, the Ayushman Bharat- Pradhan Mantri Jan ArogyaYojana (AB-PMJAY), the Atmanirbhar Bharat Abhiyan and National Digital Health Blueprint. Comparatively, the healthcare costs in India are at least 10 times lower than other countries, yet due to low per capita income, challenge of access, affordability and quality care persists.

Challenge of last-mile delivery

Many people in rural set-ups still lack access to basic healthcare. Closing these gaps has gained a new urgency, especially after the wave of pandemic, which has made clear how interconnected all of the health outcomes are. There is a need for filling the gap in last mile delivery of patient care within India. As India looks up to digital transformation in healthcare system, companies or even start-ups in this space can create and deploy innovative technology to facilitate last-mile delivery of services. For instance, Unmanned Aerial Vehicles or drones can be deployed to provide medical supplies irrespective of the location. A country like India, which has an equally difficult geography and wide-raging healthcare disparities, has also recognised the need to incorporate drone delivery solutions.

Boosting digital infrastructure

Healthcare remains a capital intensive industry. It takes couple of years for a healthcare facility to reach the break-even level. There is still hope in the fact that building digital infrastructure for the healthcare sector through the National Digital Health Mission (NDHM) initiated by the PM’s Digital India movement, will introduce reforms for improving healthcare delivery to the last mile in the next few years. It is anticipated that the NDHM can leverage and maximise the potential of the healthcare industry to be the growth driver of the Indian economy in the future provided timely implementation of appropriate interventions and reforms are undertaken.

Stepping up the game with PPP models

The government can look at the PPP model wherein the private players can contribute in the healthcare domain, training infrastructure needs to be developed where healthcare professionals can get hands-on training, acquire knowledge and skills which in turn can help in better patient outcomes. The other initiative can be to reach out to the medical and pharmaceutical companies to direct their Corporate Social Responsibility (CSR) funds for the healthcare infrastructure development and capacity building.

All these years, India’s health policy focused on rural PHCs in design, though the delivery has left much to be desired due to poor resourcing and workforce. As the economy goes into a recovery mode, the healthcare sector’s resilience in the frontlines of the fight against Covid-19 will be pivotal for restarting the engine of growth. The Covid-19 has brought the emphasis on increasing public spending, creating appropriate infrastructure in the form of adequate public hospitals, and hence, the government schemes providing subsidised loans and land for building healthcare facilities is the need of the hour.

Overall, there is an urgency to allot an adequate budget for the healthcare sector, which will have a considerable influence on the entire economy in the long run. There is an urgency to come up with long-term strategies and roadmaps to put in place a system to deal with the future pandemics, considering that this is not a one-off situation.

(The author of this article is Chairman of Ampersand Group. Views expressed are personal.)

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