Recognizing the urgent need for immediate action to strengthening India’s healthcare infrastructure for managing the third pandemic wave and the massive backlog of non-COVID patients, the Healthcare Federation of India-NATHEALTH, an apex body representing the ecosystem of the private healthcare sector in India gave six recommendations to key government organisations.
Submitting the recommendations to PMO, Department of Pharmaceuticals, Central Drugs Standard Control Organization (CDSCO), Ministry of Health and Family Welfare (MoHFW) and NITI Aayog, the apex body highlighted that while the first two waves of the COVID-19 pandemic have already overburdened the health system of India, there are countless non-COVID patients who are suffering prolonged agony and are at risk of worsening physical and mental health in the absence of adequate medical attention.
The healthcare body submitted its six recommendations — catalyzing new medical infra creation, boost short-term health infra-availability and productivity, unlock working capital, health financing, building rural/peri-urban pandemic resilience, and ease of doing business.
Under catalyzing new medical infra creation, NATHEALTH asked to incentivize incremental quality MedTech infra creation backed by commensurate investments to expand CC/ICU infra in hospitals and ambulatory/home care infra outside hospitals. This was recommended to create a level playing field between local and global manufacturers, a roadmap for quality innovative medical infrastructure by raising investment (both public and private) in the GDP from current 1.7 percent to between four to five percent over the next five years, the statement added that the time to do this will be now when this investment can have a multiplier network event in restoring the economic health of the nation past the pandemic while laying the healthcare foundation of a five trillion USD modern economy.
The apex healthcare body also indicated that between 2014 and 2018, CSR spending in India grew 47 percent, but gaps in the system continue to be a cause for concern. CSR funds can be channelized (by making it mandatory for a portion of company CSR to be spent on healthcare infra funding for the next three years), to increase the much-needed capacity in the healthcare segment. In addition, the health sector will greatly benefit from a composite tax (direct and indirect) rationalisation with long-term infrastructure lending at the competitive interest rate, incentivising capacity, and employment generation. NATHEALTH can partner with the government to set up the contours of a broad plan to this effect.
To boost short-term health infra-availability and productivity, the suggestion was to use technology and automation for productivity gains and augment surge capacity. To draw cross funding from PM Care, PMJAY/Insurance flexi funds and CSR spend to fund AMC for all medical equipment, get spares and equipment up and running, develop e-ICU mandate in hospitals above minimum beds, training for frontline equipment technicians, and remote monitoring. Create a program to audit and get every medical equipment and allied COVID infrastructure to be up and running within 30-60 days.
“In addition, global innovation around COVID is moving at a rapid pace. We need an accelerated approval process for market ready innovations like vaccines,” the statement said.
In the third recommendation to unlock working capital the healthcare apex body urged to release MedTech payment dues, receivables, and arrears to free up working capital to invest in the inventory of critical spare and lifesaving equipment. The duty and CESS announced in previous budgets on MedTech equipment is adding costs to providers and a waiver of this tariff will be a reasonable step benefiting the citizens, at a time when global supply chains are tight and escalating inputs costs, freight, and other logistics costs are an ever-increasing burden.
In health financing, NATHEALTH recommended add one additional area for focus, which is expanding private insurance cover, added that increased coverage of insurance particularly in tier II, III towns will drive capacity growth as high-quality providers will have confidence in the paying capacity of the patients.
“Nearly 48 percent of the population travels 100 km to access healthcare, there are opportunities to build asset light models powered by digital technologies improving access and affordability with appropriate reimbursement and financing models,” the statement said.
In the fifth recommendation, NATHEALTH touched upon building rural/peri-urban pandemic resilience, asked to invest in Emergency ambulances and medical/testing infra for rural India where the pandemic is gaining grip – community testing, referral emergency, and non-emergency transport and vaccination.
In the ease of doing business, the healthcare industry body asked to develop a transparent predictable regulatory environment, particularly around pricing.
“Create mechanisms where these decisions are not unilateral, linked to quality/standards and arrived at after due deliberations at central and state level with appropriate input from industry. An unstable pricing regulatory environment has deep disincentives for investments and access to financing, which are critically needed now. A consultative process with checks and balances needs to be created as we need to develop a framework that ensures that quality and patient safety are never compromised, and this will require adopting value-based procurement norms which reward best quality/patient safety per unit of cost (not cost alone),” NATHEALTH noted.
Speaking on the recommendations, Dr. Shravan Subramanyam, Senior Vice President NATHEALTH and Managing Director, Wipro GE Healthcare, said “The pandemic has exposed the missing links in the Indian healthcare system – shortage of skilled staff, beds and infrastructure has taken the limelight. It is heartening to see how private players from across industries have joined hands with the government to close these gaps and to help healthcare providers navigate strongly during these times. Example of this has emerged everywhere, remote monitoring solution has brought added ICU capacity to rural and urban areas, AI chest x-ray applications help doctors diagnose faster, unique CT solutions help keep staff safe from the virus, the skilling initiative is also helping to upskill and train professionals for better healthcare delivery. Along with customers and partners such as NATHEALTH, we are also looking beyond the pandemic to ensure cardiology, oncology, and trauma patients are empowered with timely and adequate attention to ensure their health does not deteriorate further. The pandemic has shown that when industries come together, we can positively impact more lives.”