While almost all the sectors in the country have been grappling with various problems, one sector that has so far escaped the brunt of the economic downturn and global competition is the healthcare sector.
The Indian healthcare industry, which comprises hospitals, medical infrastructure, medical devices, clinical trials, outsourcing, telemedicine, health insurance and medical equipment, valued at US$ 79 billion in 2012, is expected to reach US $160 billion by 2017.
In fact, today it ranks amongst the fastest growing sector in the country, in terms of generating revenue as well as offering employment to over four per cent population and expanding its reach rapidly across the nation. The growth of the Indian healthcare sector is further driven by the 300 million strong middle class population with significant disposable income, which seeks superior healthcare services.
According to Amol Naikawadi, joint managing director, Indus Health Plus, the private sector accounts for over 80 per cent of total healthcare expenditure in India. “The industry today is growing at a rapid pace of 18 per cent plus which is fastest in the world. The growing business of health care in India, which is speeding at about 20 per cent CAGR, is about to touch $ 120 billion by 2015,” he adds.
Zahabiya Khorakiwala, managing director, Wockhardt Hospitals informs that the Indian healthcare sector is expected to grow at about 15 per cent year-on-year (y-o-y), on account of factors such as rapid growth in infrastructure development, creation of demand for higher levels of healthcare, rising awareness of end users and launch of innovative insurance, reimbursement, and financing policies.
Contribution of Gujarat
While the country is basking in the glory of a healthcare boom, the contribution of Gujarat in achieving the same is undeniable. With the government-led healthcare initiatives and leading corporate healthcare groups entering this market, today Gujarat is fast transforming into a healthcare hub. The relative ease of clearances and the investment attractiveness with economically sound population is adding to the pace of tranformation. Khorakiwala pointed out that the state Government has undertaken several initiatives to make Gujarat a global healthcare destination. Gujarat is fast evolving in terms of number of hospitals, healthcare centres and beds and is expected to continue a positive trend in future.
Moreover, Gujarat’s socio-economic indicators are better than all-India averages IMR 50 (53); MMR: 160 (254); BPL per cent: 14.1 (26.1). Gujarat is being considered as a trend setter for the healthcare industry. The state offers holistic medicinal services and cost-effective treatment through various district hospitals, sub-district hospitals and private specialty hospitals.
The most sought after super–specialties in Gujarat include cardiology, neuro–surgery, orthopedics, infertility treatment, joint replacement and eye surgeries. Share of primary care in total healthcare market of Gujarat is around 75 to 80 per cent. Market for tertiary care expected to grow at a faster rate, due to rise in income levels, increasing adoption of health insurance and rise in complex in-patient ailments like heart diseases, kidney ailments, cancer etc.
According to Naikawadi, the healthcare sector in Gujarat has moved up the value chain by imbibing the global best practices to deliver seamless patient care of highest quality. Major corporate hospital groups such as Sterling, Apollo, Fortis, Wockhardt have made significant investments in setting up state-of-the-art hospitals in major cities of Gujarat. And since Indus has had a successful tie up with them, they as Indus’s delivery partners provide quality preventive healthcare services. “The development made by Gujarat in the healthcare sector is applauded by all. From dominance of small nursing homes 25 years ago to state-of-the-art tertiary care corporate hospitals, today Gujarat has made a rapid progression. It is transforming into a hot spot for investment in terms of the healthcare sector. One can attribute this success to three important components that the state has focused on such as technology advancement, quality- oriented healthcare service and government initiatives taken to increase accessibility,” he adds.
Government initiatives
Currently, the state's healthcare sector is witnessing an exponential growth, as evidenced by the growing number of hospitals and healthcare institutes, improving emergency medical services with the help of 108 ambulance services, and increasing medical tourism, successful public private partnership (PPP) models and better medical education. This progress is a result of a concerted effort by government and the private sector such as corporate hospital groups, research organisations, educational institutes, pharmacies, medical device manufacturing companies and other healthcare delivery systems which promote alternative medicines.
Industry insiders claim that a great extent of the spectacular growth demonstrated by the healthcare sector in Gujarat is due to the backing received from the government. The state government has strived to make healthcare accessible and affordable for the common people. The available medical infrastructure and easily accessible healthcare facilities have remarkably improved the health index of the population over the last few years in Gujarat. Today Gujarat has made a rapid progression to the state-of-the-art tertiary care corporate hospitals getting established in major as well as two and three tier cities. Apart from that the state government is taking several initiatives to make Gujarat a global healthcare destination. Some of the remarkable steps taken amongst others are the medical emergency call centres where citizens of Gujarat would be able to call up 104 and get treatment or medicine for general health problems and the SamayDaan scheme, an interesting concept to encourage social responsibility amongst the youth towards the society.
Speaking about their role in Gujarat , Naikawadi informs that in Gujarat, they have tie up with Sterling Hospital as their delivery partner across centers in Ahmedabad, Rajkot, Bhavnagar and Baroda. “Gujarat, with its all-inclusive and sustainable growth, is rapidly emerging as a globally preferred place to live in and to do business. Especially since the state has directed all its efforts towards productive development in every possible form. Be it infrastructure or economic capacities, this state is a good example of progress for all other states to emulate,” he stressed.
Cities such as Ahmedabad, Baroda, Rajkot are leading the path for the healthcare sector in the state. Ahmedabad alone has more than 1000 small and big diversified hospitals providing health treatments with the latest technologies and machines available in the market. Speaking about Wockhardt Hospitals, Khorakiwala emphasised that they will strive to set new benchmarks for clinical outcomes by providing the highest quality of care, deploying the best clinical talent (doctors) and highly trained nursing and paramedical staff, and offering the latest treatments across our specialties (cardiac care, orthopaedics, neuro, aesthetics, GI) in the state.
“As of today, we have three hospitals in Gujarat in Rajkot, Bhavnagar and Surat and if you see our existing network, you will realise that we have made an enormous impact in society in the areas where tertiary care was found to be lacking. We brought qualitative tertiary care to tier-II cities Bhavnagar and Rajkot”, she adds.
She further stressed that they can make an impact in emerging cities as well and that the credit for this rapid development should be given to the changing mindset of the patients who have become quality conscious and more aware of their healthcare needs. Besides, growing per capita income and want of specialised and sophisticated healthcare has given further impetus to this healthcare boom.
While Gujarat is climbing the rungs of success with PPPs , it is also fast becoming a hub for medical tourism. Under its 'Vibrant Gujarat' banner, Gujarat has achieved overall development in health infrastructure within the state, which in turn has facilitated the growth of medical tourism. Gujarat is an ideal location for promoting health tourism in a big way because of the large Gujarati population settled outside Gujarat and India. Gujarat has service providers with state-of-the-art treatment facilities, robust planning for integrated healthcare and companion care facilities as well as world-class support services and connectivity.
Challenges
Though Gujarat has managed to match-up with the quality of healthcare services that is being provided in the developed countries with the availability of qualified medical staff, adoption of advance technology and improving healthcare infrastructure has made India an attractive destination for the patients all over the world, there are still some major issues that needs to be tackled to a ensure availability and accessibility of healthcare to all.
Experts are of the opinion that the state needs to increase the number of trained manpower; especially when planning to expand in tier II and tier III cities. The other area that needs urgent attention is the increasing real estate costs and electricity costs, as real estate prices will impact the per bed cost, therefore the kind of infrastructure built and technology brought in will impact the break even and profitability.
Naikawadi feels that this factor seems to be detrimental to the growth of medical infrastructure within the state; also, the state government needs to put all the initiatives for healthcare on fast track so that these facilities reach the people at the right time. “At Indus we did observe that the populace did not mind making an extra expenditure but they were more concerned about the outcome and package deals that we have in offer for them. Not a challenge, but this was an opportunity for us to service and provide them with package that is value for money. One needs to invest prudently and manage cost well and be prepared to invest for long term in this market. With these general trends and concerns in the Gujarat market, it however was challenging but today we look forward for a promising presence in Gujarat covering maximum pence,” he informs.
Today, one of the key challenges faced by all the healthcare players wishing to penetrate this market is the shortage of trained manpower especially when they are planning to expand in tier two and tier three cities. Experts agree that physician is a key link in the success of corporate healthcare in this market and Gujarat healthcare is also believed to be a doctor driven market.
Khorakiwala insists that one of the greatest asset for any healthcare service provider is its human resources – doctors, nurses, technicians, radiographers. But finding good doctors is a constant problem; event junior doctors are not easy to get because most of them are focused on postgraduate studies. Qualified and skilled manpower is not available in good numbers and there is approximately a 20 to 25 per cent shortage at any given time she pointed out.
Aiming high
With changes in the market dynamics in the healthcare sector which is already seeing a shift in its focus from being doctor-centric to patient-centric, the healthcare industry in Gujarat is seting an example for other states to follow. It has the potential of becoming a serious global healthcare hub in India.Which many industry insiders feel would call for serious continuing transformation efforts on the part of the Government and private players to change mindset of foreign investors and patients in order to attract global capital, talent and business flow. Focus needs to be given on stimulating private investment through PPP and fiscal incentives and enabling greater use of technology to improve healthcare service delivery along with the need of an increased penetration of social, community and private health insurance.
Industry experts suggest that since taking care of the health of the citizen is the primary responsibility of the state, if for any reason state is not able to fulfill this commitment it needs to boost the private sector facilities and investments in the sector to meet the need. In such scenario a desire list can be drawn which can include the subsidisation of the patients cost either by sharing or by tax subsidies, rationalising the taxes on healthcare infrastructure and consumables, promoting or sponsoring insurance schemes etc.
In fact, Khorakiwala suggests that after the food security scheme and right to education, the government should have health security scheme for the country. While the state and central governments are doing the best they can, there are still significant challenges facing the healthcare sector which needs to be addressed. Infrastructure and connectivity is one of the biggest challenges that hinders the accessibility to healthcare in our country, she pointed out.
Naikawadi stressed that an internationally acceptable and credible accreditation system is a necessary prerequisite to ensure quality healthcare delivery to all. Gujarat needs to address weak physical infrastructure , non-availability of medicines and supplies and inadequate budgets for repairs and maintenance.