India’s elderly need policy resolve for a better senior care ecosystem; here’s what needs to be done

July 31, 2020 4:41 PM

In recent years, India’s demographic dividend has grabbed much international attention for its ability to drive economic growth and supply low-cost labour to the rest of the world.

Estimates suggest that by the end of this century, seniors will constitute 34 percent of India’s population.
  • Rajit Mehta

In recent years, India’s demographic dividend has grabbed much international attention for its ability to drive economic growth and supply low-cost labour to the rest of the world. While this sounds promising and could attract global investors to the country, a major point that seems to be missing from the current discourse is the rapidly growing senior population. The United Nations Population Fund (UNFPA), in its recent India Ageing Report, projected that the elderly population in the country would grow to 158
million by 2025. A major reason for the steady growth of the elderly population has been the dramatic rise in life expectancy aided by sustained periods of economic growth and enhanced access to healthcare facilities – a trend that is expected to continue for the next few decades. Further, estimates suggest that by the end of this century, seniors will constitute 34 percent of India’s population.

Proactive and early recognition of population ageing concerns at the policy level both in terms of demographic challenges and the quality of life for seniors will significantly pave the way for better senior-friendly infrastructures, healthcare facilities, and senior care services in India.

Demographic shifts and the crucial role of policy interventions

India has been watchful of its rising number of senior citizens and their specific requirements. As a result, in 1999, India, two years ahead of the Madrid International Plan of Action (MIPAA), introduced the National Policy on Older Persons (NPOP) offering state support for the well-being of senior citizens. Subsequently, in 2007, the Maintenance and Welfare of Parents and Senior Citizens’ Act was passed to provide more effective provisions for seniors. And most recently, the Government of India released the
Draft National Policy for seniors to support the ageing population with specific, tailor-made interventions to create a vibrant senior care industry ecosystem.

India’s proactive policy initiatives not only demonstrate its strong resolve to ensure the well-being of the elderly population but also set the stage for more definitive and comprehensive policy measures to usher in a phase of policy-enabled growth for the senior care space in the country.

Draft National Policy for Senior Citizens 2020: A step in the right direction

As a fledgeling yet high potential sector, senior care requires sustained government support and a close collaboration among individuals, families, communities, institutions of civil society, and the private sector in converting the policy ‘intent’ into ‘action’ for high quality outcomes for seniors. The draft policy clearly reflects its understanding of the evolving needs of seniors and promises to revamp and standardize the existing policy framework to ensure better efficiency and functional relevance. As a result, the draft policy identifies the following as key intervention areas and proposes relevant recommendations to provide the necessary support to senior citizens.

Increased focus on financial security for seniors — The draft policy adequately emphasizes the significance of financial security for seniors and recommends it as a key area of intervention as more than two-thirds of the elderly population continue to live below the poverty line in India. Old age pension schemes constitute a major source of income for seniors. However, the draft policy recognizes
that the existing pension payouts are not enough to ensure income security for seniors and therefore, seeks to revise it from time to time, keeping in mind the changing lifestyles, increasing healthcare costs, and inflation.

Additionally, the focus on senior-friendly tax structures, promotion of reverse mortgage schemes, creation of second career options for seniors, and the introduction of integrated insurance products will provide multiple income options to seniors to help them embrace a lifestyle of their choice.

Improved Access to Healthcare facilities India ranked 71 on the Age Watch Index published in 2015. The index covered 91 percent of the world’s senior population from 96 countries. One of the four elements that the index considered was health status. Majority of the healthcare services in India are not designed keeping in mind the evolving needs of senior citizens. As a result, access to affordable and senior-specific healthcare continues to remain a major challenge for them even today.

The draft policy seeks to address these concerns and promises to promote affordable and accessible healthcare for seniors with a focus on public health services, health insurance, tax incentives, and subsidies. Further, services such as preventive care, rehabilitative services, and geriatric care facilities will be prioritized to support healthy ageing for all seniors and to address age-related ailments.

Besides, the streamlining and promotion of existing healthcare schemes such as the National Programme for Health Care of the Elderly (NPHCE), Rashtriya Swasthya Bima Yojana (RSBY), and Ayushman Bharat will help in providing affordable and accessible healthcare services to seniors.

Promoting senior care products and services — The draft policy also places due importance on promoting and supporting senior care products and services to meet the increasing demand for specialized senior care services. Private sector participation, in this regard, will be key, especially in designing world-class products and services for seniors in India. Therefore, a high focus needs to be placed on incentivizing individuals and organizations engaged in services such as assisted living, residences for seniors, memory care homes, elderly therapy, medicines, nutritional supplements, assistive devices, and special care products. Further, the proposed plan to provide organizations in the senior care space with easy access to liquidity and low-cost funding will ensure timely completion of senior living projects and facilities.

Incentives and policy support at the right level will not only make these products and services accessible but also attract foreign funds to India, including patient capital from pension funds. Increased investment will create a competitive environment and would provide prospective customers with multiple options to access services at affordable rates.

Encouraging adoption and workforce training — Senior Care services, especially senior living facilities and assisted care services, are yet to find popular adoption in India. It is still at a nascent stage and would require awareness building both by the Government and private sector players to encourage
adoption and acceptance. The draft policy recognizes this as a critical need to deal with the social stigma associated with senior care services in India and build a positive perception among people.

At the same time, the focus will also be required to identify and build the necessary skill sets to meet the specialized service requirements of the senior population. The draft policy has recognized the need for organizing training and orientation programs for individuals or organizations engaged in providing services to seniors. Besides, senior living facilities/care homes for the elderly will require certified caregivers to provide specialized care to the residents. This will further ensure availability of high quality
services in the senior care space.

In short, it is a noteworthy step to have brought out the Draft Policy for Senior Citizens now after a hiatus of almost a decade, with clearly defined priority areas for Government intervention and private sector participation. However, despite the strong intent and the support promised, the draft policy document may still need to shed more light on the specific details and the long-term vision required for nurturing and building a robust senior care space in the country through committed action and timely implementation.

  • Rajit Mehta is CEO and MD, Antara. Views expressed are the author’s own.

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