The tipping point?

The ongoing dengue infection has become fodder for the political mill in Delhi and while we all mourn the loss of lives, there is hope that at least now, the centre and state health functionaries will be forced to cooperate and work together

201510ehm02The ongoing dengue infection has become fodder for the political mill in Delhi and while we all mourn the loss of lives, there is hope that at least now, the centre and state health functionaries will be forced to cooperate and work together.

Unfortunately, public memory is short, and that of politicians even shorter. Why else would we not learn from our experiences of past years? With the winter season around the corner, the situation is bound to get worse not better in Delhi, and yet we see no real signs of change.

Today, the Indian Medical Association’s April 21 release on vector borne diseases to mark World Malaria Day on April 25, like writing on the wall, remain stark reminders that all the awareness drives and media coverage is just not working. Have we, as citizens, become adept at tuning this out, as long as it happens to someone else, some place else?

And might I humbly add that the media too is guilty on this count. Why else would journalists ask, sometimes politely and most times not, to be taken off the daily news feed from IMA? There is no doubt that the present dengue deaths are getting covered only because of the location, with each side milking the situation for political gain.

It is indeed ironical that the capital hosted the Medical and Wellness Tourism Summit 2015 on August 27 and will be hosting Advantage Healthcare, another event highlighting India as a destination for medical value travel.

Express Healthcare‘s October issue too will carry a section on this section of the healthcare delivery sector, (See story, Journeying for good health, pages 42-47) but we hope that in the hopes of attracting foreign patients, the stakeholders lay out a roadmap for the sustainable development of medical tourism.

India has still not got its act together on the medical tourism front. A host of issues, ranging from lack of coordination between government, hospitals, hotels, airline and tour operators to taxation and medical insurance anomalies need to be first resolved before the country can truly claim to be the ‘first’ destination of choice.

Outbreaks like the dengue infection in Delhi prove that healthcare facilities are not accessible for the economically weaker sections of society. While laying out the red carpet for overseas patients and their families who flock to India for more affordable healthcare, the government should also look at revamping our public healthcare system to provide the same for the millions of patients who migrate to the cities for treatment.

A Bank of America-Merril Lynch report on the emerging market (EM) private hospital market points to the obvious fact that with low government healthcare spends (public spend on health is just 1.3 per cent of India’s GDP), the largest growth will come from countries like India (16 per cent CAGR) and China (20 per cent CAGR).

With a bed penetration of just 1.3/1000 people against the global median of 2.5, India is tipped to see the strongest growth with the report projecting that the India private hospital market would reach $120 billion by 2020.

While growth in the private sector is required, simply to increase the number of beds and choices available to the patient community, what will it take to increase beds in the public healthcare sector? Public-private partnerships (PPPs) with hospitals could have been an option but most of these have run into glitches and are today not seen as the way forward.

While the government’s intentions are good, implementation is the bug bear. For instance, the much needed mental health policy is progressive and even radical in some areas but certain loopholes can destroy the purpose of safeguarding mental health in India. Without adequate implementation guidelines, the policy can end up doing more harm than good. With World Mental Health Day coming up on October 10, our cover story in the October issue looks at the issues in more detail. (See story, Safeguarding India’s mental health, pages 28-33)

Viveka Roychowdhury

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