Ayushman Bharat, a flagship scheme of the government, was launched in 2017 to achieve the vision of Universal Health Coverage (UHC). Since, various initiatives have been launched to address the critical needs and deliver comprehensive care.
On the sidelines of FICCI-Heal 2024, an annual healthcare conference organized by the Federation of Indian Chambers of Commerce & Industry (FICCI), Dr. Anna van Poucke, Global Head of Healthcare, KPMG International, and Healthcare Senior Partner, KPMG in the Netherlands, revealed that the Ayushmann Bharat program, for instance, has significantly advanced healthcare accessibility and affordability, introducing universal health coverage, setting up primary care and wellness centers, building digital infrastructure, and establishing a general mission for healthcare.
“This progress shows that India is indeed moving in the right direction. However, there is still much to be done. First, with increased healthcare access comes the need for infrastructure to keep pace. Developing infrastructure doesn’t only mean building hospitals but also ensuring a skilled workforce to meet the demands, so our work in healthcare education is crucial,” Dr. Poucke told Financial Express.com.
She also revealed that geographical disparities another major challenge. “There’s a notable divide between urban and rural areas, as well as differences across states, so creating equitable access to healthcare is essential,” she said.
According to her, the third significant challenge, which applies to healthcare systems worldwide, involves managing consumption. “With universal health coverage, there’s a tendency for overconsumption, similar to how we might use water without considering the cost when it’s easily accessible. This leads many healthcare systems to shift toward preventative, proactive models. Here, data infrastructure and technology become essential for enabling more preventative care,” she told Financial Express.com.
The biggest challenge globally is transforming healthcare from a manual to a digitally data- driven industry. Data allows for population health management, and initiatives like health observatories offer promising advancements, she said.
“Finally, there’s the importance of training healthcare workers in digital skills to facilitate remote care delivery. For example, providing a community nurse in a remote area with digital tools helps them deliver better care. One of India’s advantages is its young population, which offers a large potential workforce. The challenge lies in not only training specialists but also community healthcare providers and nurses, which is critical to building a robust healthcare system,” she told Financial Express.com.
‘Balanced approach to training’
During the interaction with Financial Express.com, Poucke revealed that balanced approach to training needs to be prioritised. “If we only train super-specialists, we end up providing very expensive care. It’s crucial to also train family doctors, community nurses, and specialized nurses who can take on tasks traditionally handled by super-specialists. Making education more affordable is also important, as we’ve seen with the example of training radiologists, which can be very costly,” she told Financial Express.com.
According to her, there are a couple of other key areas: increasing research and innovation, especially in digital and data-driven solutions. “Healthcare professionals need to understand that it’s not only about patient diagnosis and treatment but also about using data effectively. This can enable remote treatment and proactive health management. Lifelong learning is another essential component, as the healthcare sector is evolving quickly, and current practitioners will need retraining to stay updated,” she told Financial Express.com.
Meanwhile, Lalit Mistry, Partner and Co-head, Healthcare, KPMG in India told Financial Express.com that India is at a unique stage of evolution in healthcare, especially post-COVID, with greater consumer awareness.
“Data shows that more people are opting for insurance, and there’s an increasing demand for specialized care and innovative ways to access healthcare. We’re also seeing a rise in self-care and healthcare solutions closer to home, which is facilitated by the availability of technology. This changing landscape requires responses from regulators, providers, and payers alike. It’s a fascinating time for India, as we’re also positioned to become a global talent hub for doctors, nurses, and paramedics, potentially exporting skilled professionals in the coming years. Many countries are even seeking specialized training for paramedics and healthcare workers from India to help meet their demands,” Mistry said.
Climate-A serious public health issue
When it comes to climate change and its effects on health, more alternative funding is needed, especially for low- and middle-income countries, Dr. Poucke highlighted.
“Higher-income countries can manage their own interventions, but places like Bangladesh, the Caribbean, and others that face hurricanes, floods, or typhoons need more resilient healthcare infrastructures. To address this, green bonds and alternative funding models are necessary. Larger financial institutions are already looking for more responsible funding solutions, so this funding world needs to change,” she told Financial Express.com.
During the COVID-19 crisis, the pharmaceutical industry played a major role in combating the pandemic, she informed. “Without the vaccines, we’d still be in a very difficult situation. So, the life sciences industry will need to step up again. Finally, the technology industry is also getting more involved in healthcare. Big players like Microsoft, Surface, Salesforce, and Google are heavily investing in healthcare technology and data infrastructure,” she told Financial Express.com.
She also maintained that corporations will begin to recognize that the climate crisis and the health issues stemming from it are negatively affecting their productivity.
“That will shift the way they think about their responsibilities. CEOs are becoming more and more aware of the impact of climate change on health, and there’s a growing sense of corporate social responsibility. ESG (Environmental, Social, and Governance) is becoming very important,” she said.
During the FICCI-HEAL 2024 conference, a knowledge paper on ‘The Future of PG Medical Education in India: The 2047 Roadmap’ was also released which highlighted the urgent need for reform in India’s healthcare system, where universal health coverage (UHC) is a national priority. The report emphasizes the critical role of medical education in addressing the shortage of qualified professionals and analyzes the evolution of the Indian healthcare ecosystem over the past thirty years.
“There is no healthcare without a strong workforce. You can build all the infrastructure you want, but without a workforce, it’s meaningless. I remember visiting a place where they built a beautiful hospital, but they didn’t have the workforce to staff it, so it remained empty. Securing a workforce for the future is crucial. This is the third report in a row, and this one focuses on postgraduate medical education,” Poucke told Financial Express.com.
With universal health coverage, there will be an increase in demand for healthcare in India. Without enough doctors, we won’t be able to meet that demand. It’s essential to focus on training the next generation of healthcare professionals to meet the growing need, especially in specialist and super-specialist fields like obstetrics, she emphasised.
Mistry added that considering the volume of patients in India, especially the demand for specialized super specialists, there will be a lot of pressure on the health system in the future.
“What we need is not just specialized or super-specialized doctors, but a specialized, integrated team. You need highly trained nurses, paramedics, and an entire team so that the dependency on specialist doctors can be spread across the healthcare system. One doctor can only cater to a certain number of patients, so we need a larger, integrated healthcare workforce focused on specialized care,” he told Financial Express.com.
“We need a specialized care delivery team, which includes nurses, a technical support team, and paramedics. That’s very important,” he added.
Dr Poucke also added that the challenges are constant, “but we need to keep pushing forward, much like a race that never ends.”
“The lack of workforce, the rising cost of healthcare, the increase in non-communicable diseases (NCDs), and the impact of climate change on health are all major challenges. But at the same time, there is a “good horse” running, and that good horse is about training people, leveraging the capabilities of technology, and empowering communities. It’s about rethinking the workforce. Our challenge will be to make both the “bad horse” and the “good horse” run together,” she told Financial Express.com.
She believes that there are definitely solutions, but the sector needs to become more innovative. “It has to recognize that the old way of providing healthcare is no longer viable, and we are in an era of transformation,” she added.