If there was one line in the budget speech of finance minister Nirmala Sitharaman that carried an extraordinary weight, it was about providing “broadband connectivity to primary health centres in rural areas under the BharatNet project.” In just about dozen words, she connected remote parts of India to the healthcare map of India.
“The future of primary care is not about getting doctors to remote areas but in getting access to these physicians from remote locations and therefore the announcement made by the finance minister is not just much-needed measure but one that was long overdue,” says Nachiket Mor, a leading economist, former banker, an expert on financial inclusion and one who has been tracking and writing on Indian health system.
BharatNet, which the Indian government likes to describe as one of the biggest rural telecom projects in the world, and implemented in a phased manner to all Gram Panchayats (approximately 2.5 lakh) in the country, is meant to prove access to broadband connectivity to all the telecom service providers and enable the launch various services like e-health, e-education and e-governance in rural and remote India.
There is apparentluy enough and more money sitting here after all a key source of funds is a levy on the revenues of telecom operators, which to a common man is essentially a small amount of money debited from each phone call made in the country and put into this consolidated fund.
“The future of primary care as one about protocol, seamless connectivity and technology in the hands of the health workers and without broadband, which can handle large medical images, this becomes difficult to manage,” says Mor.
But to really reap the fruits of the broadband connectivity, he feels, it is important that all the aspects of the health system in the country get fully automated. “After all, we have the ABDM (Ayushman Bharat Digital Mission) standards in place. What is needed now is all the government hospitals, primary care centres and community care centres to be interconnected and automated and for this invest in computer systems and automation.” Since, broadband will need transmission of data which means access to “universal electronic health records and not patients with big fat physical files.”
This, he feels, will also ensure that “we could then implement gate-keeping at the government tertiary hospitals.” Think of the long queues of patients and long hours spent at any of the AIIMS (All India Institute of Medical Sciences) hospitals. For instance, a relative of a patient at an AIIMS hospital in Bhopal tells Financial Express Online that the patient has been able to get an appointment for a CT scan only two months from now.
Unless electronically referred to the tertiary hospital, digital records could have perhaps helped address the need at the primary or secondary care level itself. Even cancer patients seeking routine checkups need not wait for long hours if their health records could be accessed electronically.
Also, if with electronic data and broadband, machines could help speed up diagnosis and access to specialists if only the various levels within the healthcare system were to invest on equipment, talent training and software. So, what kind of resources or funds would such an endeavour need? “I do not have the numbers ready in terms of the investments that will be needed but my sense is this would be less than 2 per cent of the national health budget,” says Mor and the health budget overall is estimated at about 1.84 per cent of the national budget.