Clinics and small hospitals with upto 20 beds and managed by individual doctors and their immediate family members will have to be closed down in India in the future because of various reasons, said Dr M C Gupta, medico legal consultant and former dean at the All India Institute of Medical Sciences (AIIMS), New Delhi.

Dr Gupta made this comment in answering a query put to him by some practising doctors from across the country about the future trends of hospitals in India, through an on line platform discussion to which Pharmabiz also participated.

According to him, as what is happening in USA, the number of hospitals will diminish, but the Corporate set up will flourish even more. He pointed out the reasons that the cost of medical care including the cost of land, equipment and maintenance of staff will increase so much that will force the small type health care institutions to close down. As far as individual doctors are concerned it will not be a viable option for them to run a hospital.

He said the proportion of rural population has started to decrease now and that phenomenon will continue in future. As a result there will be less captive population to depend on small hospitals in rural areas and in small towns. Further, medical insurance/mediclaim will become more common and the insurance companies will prefer to deal with big hospitals.

Dr Gupta, speaking about the Clinical Establishment Act, 2010, said that the big and small divide will get widened because of this Act, which has already been notified. This will affect the owners of small nursing homes.

Apart from these technical and legal issues, the small hospital owners will become unable to find enough doctors to work with them as they cannot afford high salaries required by the doctors. Further, majority of the doctors would prefer to go abroad, or work in India on high salaries which can be provided by corporate institutions.

He commented that in USA, there are 5754 registered hospitals now according to the American Hospital Administration. By 2020, one third of these will either be closed down or converted themselves into different type of health care service institutions.