The healthcare industry in India is truly at an inflexion point. Whilst most sub-sectors of the industry are witnessing an impact of changing regulations, some are bearing the heat of changing overseas political scenarios and the change in stance thereof.
The Indian healthcare industry has notched up several significant achievements over the past few years particularly in terms of life expectancy, infant mortality rate and improvement in clinical outcomes of various dreaded diseases. This has been made possible by a slew of enabling factors such as:
• Availability of superior clinical talent,
• Relatively moderate base levels accentuating the impact of improvement,
• Business risk-taking ability culminating into fruitful innovations,
• Enhanced awareness and increased assimilation of healthcare in lifestyle such as more people opting for regular monitoring of their health and easy accessibility of quality healthcare and affordability to the citizens at large continue to be key concerns. Be what may, healthcare has become one of the largest sectors in India in terms of revenue or employment and has a positive growth outlook.
In terms of the overall healthcare market in India, an industry report valued the market at around US$ 100 billion in 2015 and is expected to touch US$ 280 billion by 2020, at a compound annual growth rate of 22.9 per cent. Nearly 65 per cent of overall market includes hospitals, nursing homes, diagnostics centres and pharmaceuticals. On the other hand, healthcare Information Technology market which is valued at US$ 1 billion currently is expected to grow 1.5 times by 2020.
What is also interesting to note is the different growth engines for each of the sub-sectors. While a demand supply mismatch domestically as well as in the markets catered to internationally has been a major driving growth factor for product sub-sectors such as pharmaceuticals and biotechnology. Much of the growth outlook in the private healthcare delivery space is attributable not only to the hospital bed/facility demand-supply mismatch but also increasing awareness of curative interventions, leap-frogging diagnostic modalities and changing mindsets leaning towards a disease free lifestyle.
In five to six years from now India would require about 600,000 to 700,000 beds implying an investment opportunity of US$ 25-30 billion. Given this demand for capital, the number of transactions in the healthcare space is going to surge in the near future. The average investment size by private equity funds in healthcare chains has already risen to US$ 20-30 million from US$ 5-15 million. These numbers reflect the significant scope and penetration potential of healthcare services from all quarters and are compounded by the rising healthcare spending as a percentage of GDP. Rural India, which accounts for over 70 per cent of the population, is set to emerge as a potential demand source for secondary and tertiary healthcare delivery. Most of the private investments in healthcare delivery have till now been focussed primarily in the urban regions for super-speciality and quaternary care, with high cost of capital and concentrated competitive environment leading to shrinking margins and this has been challenging the rationale for these investments. While a lot of optimism was placed on medical tourism primarily due to the cost competitive edge of India in terms of highly trained and capable medical professionals, the market lacked in reaching potential due to operational insufficiencies and non-clinical service standards. This learning from the medical tourism market that is now being translated on the ground also holds the next promise for growth. The medical tourism industry currently pegged at US$ 3 billion per annum is expected to reach US$ 6 billion by 2018, with more or less 230,000 estimated tourist arrivals.
On the state front, steady steps are being envisaged for the healthcare industry. In the Union Budget 2017-18, the overall health budget increased from Rs. 39,879 crore which is 1.97 per cent of total Union Budget to Rs. 48,878 crore which is 2.27 per cent of total Union Budget.
In addition, the Government of India made important announcements such as harmonising policies and rules for medical devices industry to encourage local manufacturing and move towards improving affordability for patients. The move and announcement of modifying the Drugs and Cosmetics Act, to promote generic drugs and reduce the cost of medicines was really welcomed by the industry.
A recent interesting initiative from the Government of India is its plans to set up a single window approval system for innovation in medical research, in order to grant permission or approvals within 30 days from the date of application to Indian innovation projects who have applied for global patent. Another noteworthy initiative for healthcare; 'Sehat' (Social Endeavour for Health and Telemedicine) has been launched at a government run Common Service Centre (CSC) to empower rural citizens by providing access to information, knowledge, skills and other services in various sectors through the intervention of digital technologies and fulfilling the vision of a ‘Digital India’. The e-health initiative which is a part of ‘Digital India’ is commendable. It aims at providing effective and economical healthcare services to all citizens. The programme aims to make use of technology and portals to facilitate people to maintain health records and book online appointments with various departments of different hospitals using eKYC data of Aadhaar number.
India’s health reform journey has already gained momentum. While the journey is challenging, the outcomes and opportunities will continue to inspire. With best-around-the-globe clinical talent, business managers and policy evangelists, India seems well positioned to achieve its healthcare vision and provide its populace with best in class health outcomes.
(Author is chief operating officer of Gleneagles Global Hospitals)