India Private healthcare accounts for over 77% of spend and 74% of hospital beds

Nandita Vijay, Bengaluru Wednesday, August 22, 2012, 08:00 Hrs[IST] India's private sector accounts for more than 77 per cent healthcare spending and 74 per cent of the country's hospital beds. Yet the growth of private hospitals has also been inequitable, with more than a third of all hospitals present in the metros and Tier I cities.It is the private hospitals which clearly dominate Indian healthcare delivery, especially in tertiary care. A large part of the population relies entirely on the public sector for their healthcare needs which remains inadequate for the rapidly increasing needs."It is ironic that although Indian healthcare has made rapid strides, basic issues of affordability, availability, and quality continue to persist and affect a large section of the population. Driven by the pressures of increasing costs and reducing margins, healthcare providers are also grappling with challenges around improving productivity and efficiency of healthcare services," stated Charu Sehgal, senior director, Deloitte Touche Tohmatsu India Private Limited.Delivering affordable and quality health care to India's billion-plus people presents enormous challenges and opportunities. Innovations could be a way out for a large number of people get quality care at a cost that the nation can afford. "This is where Public Private Partnerships (PPPs) are emerging as a successful model that integrates the private sector expertise, quality and efficiency with the reach and scale that is possible with the public sector," she added.The various mechanisms involved in PPP include contracting in, contracting out, subsidies, leasing or rentals etc. PPPs are being experimented within various spheres of healthcare including healthcare delivery, medical education, diagnostics, medical devices etc. A few illustrations in the health sector include the Urban Slum Healthcare Project in Andhra Pradesh which is a partnership between State Commissionerate of Family Welfare and NGOs. Another is outsourcing emergency transport services in 14 states in the country where state governments are in partnership with private providers like EMRI, Ziquitsa etc. Further there has been the practice of contracting management of PHCs and CHCs to NGOs in Karnataka and Gujarat. GE Healthcare too has partnered with public hospitals to set up diagnostic centres within the hospital.Addressing healthcare challenges is a complex proposition. It requires a thorough understanding of the continuum of care as well as the various stakeholders involved, said Sehgal.It also becomes equally important to appreciate the role various stakeholders play along the care continuum. The stakeholders are across a wide spectrum, including the Government, insurance providers including public and private players, pharmaceuticals and medical equipment players, NGOs and the academia. A number of enabling functions, including hospital management, ancillary services maintenance, IT systems, supply chain systems are all advanced in the private healthcare compared to the public and government hospitals. Understanding the dynamic interplay between the various stakeholders will form the basis for addressing key challenges around availability, cost and quality of care besides improving efficiency and productivity, she stated.The enormity and diversity of the challenges faced by the healthcare sector calls for large scale interventions that yield desired results, that too, in a timely fashion, Sehgal said.