As director of one the largest private sector hospital chain, the Apollo Hospitals Group, Sangeeta Reddy feels it would take the Indian healthcare industry at least a decade to see that the distribution of spends in healthcare are suboptimal. This would include providing for an additional 7,50,000 beds and a select investment of Rs 1,50,000 crore. In a tete-a-tete with P N V Nair of Pharmabiz.com, she unveils a clear-cut strategy for making healthcare largely available to the masses, including the rural populace and the efforts taken by her organization in bringing the country at par with other developing nations. Excerpts:
As a Director of the largest private sector hospital chain, what is your assessment of the healthcare scene in India?
Indian healthcare today is best described as "Islands of Excellence in an Ocean of Inadequacy". However we have everything that is required to make it "The Global Healthcare Destination". We spend 5.2% of our GDP on healthcare and this matches the healthcare spending of most developed nations, which is between 5% and 7% of GDP.
It is evident that healthcare services have improved significantly. But distribution of spends in healthcare are suboptimal. In the current scenario, we will need another 750,000 beds and an investment of Rs 150,000 crore on new healthcare infrastructure in the next 10 years.
How do you evaluate the Govt. of India's role in providing basic healthcare facilities to the people of this country?
The government today is providing about 74% of primary care infrastructure, 53% of secondary care infrastructure and 8% of tertiary care infrastructure. Various studies and analyses of the system have been done over the years, with conclusions varying from the system being "modestly adequate" to "grossly inadequate". The Govt. of India needs to recognize the importance of the private sector contribution to healthcare. The private sector needs to be encouraged to invest in healthcare. The Govt. can restrict itself to niche areas like prevention of communicable diseases and rural primary healthcare.
The Central Govt. has announced a National Health Policy some time back. What is your observation on this?
The Draft National Health Policy of 2001 has recognized the use of newer tools like IT, telemedicine and networking in the delivery of tertiary level healthcare services. It has recognized the necessity of private public partnership. These are the main positive issues in the policy. Another point is that the National Health Policy has been drafted exclusively by the Govt without the participation of the private healthcare providers. The impact of the policy will be felt by all healthcare providers - private or public. Therefore the involvement of major private players in the healthcare sector during the drafting of the policy would have helped address the issues of the private providers also. After all, private players provide greater than 80% of the inpatient care in the country.
There has been sudden surge in investments into the healthcare sector particularly for establishing modern hospitals in the country in recent years. Does it mean that this sector is a good investment option?
Investment in healthcare is definitely a good option today, because, as already mentioned, the requirement in the healthcare sector is high - at Rs 150,000 crore in the next 10 years. The Govt. cannot be expected to make the entire investment. It is for the private parties to understand that the healthcare sector has a great potential with demand being many fold higher than the current supply of services. This huge gap needs to be bridged if the Indian healthcare status has to improve.
Investment can be encouraged in this sector by declaring infrastructure status to the industry. This is because hospitals need large investments and long gestation periods. The according of infrastructure status would permit large investment in this sector and sustain projects through long gestation periods.
Do you think that the poor and the middle class would be left out of this healthcare revolution just because they cannot afford? What is your suggestion to make available quality healthcare to the less privilegedclass of people?
The middle class is already definitely a part of the healthcare revolution. The poor can also have access to quality healthcare through optimum public-private partnership in the healthcare sector. An example of this is the Apollo Telemedicine centre at the Govt. Hospital, Karimnagar. In this set-up, we have placed a CT Scan and it costs a patient Rs 300 to get a CT Scan. The Specialist's opinion is available free of charge through Telemedicine. This is just an example. Many more such services are available for the poor and the middle class. Our integrated self-sustaining healthcare model at Aragonda is another example. Therefore, quality medical care is definitely available to the less privileged, but what is required is a more equitable distribution of healthcare services and this can be achieved through private-public partnership.
The rules and regulations governing the healthcare sector and its institutions in India have been rather weak or non-existent. What are your suggestions in this regard? How should the Govt. go about it?
The Govt. could be instrumental in encouraging the healthcare sector to develop its own standards of care and implement the same throughout the system. There are a number of international accreditation agencies that we could learn from and develop standards that would be customized to our healthcare scenario. This kind of accreditation would also help in standardizing healthcare delivery across the country. In any industry, when the standards are developed at the User level, and the onus of regulation is also on the user, the models have worked best. Medical professionals form the nucleus around which all of healthcare revolves. The Govt. could play a very important role in this regard by bringing about reforms in the issue of "license to practice" for medical professionals. It should be made mandatory that all medical professionals undergo certain minimum number of hours of CME per year if their licences are to be renewed. This would encourage the medical professionals to remain updated and reflect on healthcare delivery.