Healthcare must be quality-centric, not cost-conscious
Union Minister Nitin Gadkari’s recent call to the Indian automobile industry to focus on quality, instead of being cost-centric, gives the healthcare sector an important point to reflect on. The very essence of healthcare is to save lives and hence any move to veer towards low-quality equipment or pare the cost of care could potentially have fatal or life-changing consequences.
This situation will worsen if the focus shifts to controlling costs rather than providing high quality healthcare. The pandemic has shown us that it is imperative for the government and healthcare providers to focus on quality healthcare for all, and this focus should continue in the post-Covid era.
Increasing public spending on healthcare is the key to ensuring quality. India’s National Health Profile 2019 shows that the country only spends 1.28 per cent of its GDP on healthcare as against the WHO recommendation of 4-5 per cent. The government’s intention to increase healthcare spending to 3 per cent of GDP by 2022 augurs well.
There is an urgent need to improve facilities in primary healthcare centres as well as increasing the number of qualified doctors, nurses and midwives. The health systems also need to evolve, to be able to handle and treat cancers and many other non-communicable diseases.
Investments have to be made in medical education, staffing, equipment, and in ensuring continuous and ready availability of basic resources across all levels of healthcare including preventive and diagnostic medicine. Cutting costs will also detract from the key dimension of high-quality healthcare as recognised in the National Health Policy (NHP) 2017 which includes consistency, positive health outcomes, patient-centricity, trustworthy service and equity — all critical elements of quality healthcare.
Healthcare providers need to keep abreast of the advances in digital health transformation as the shift to AI-enabled care, advent of medical drones and use of IoT devices among others, which will not only help keep costs in control but also dramatically help improve the quality of care and service rendered to patients. Additionally, the gradual shift to preventive care will also eventually change the method of diagnosis and treatment; thereby also helping in delivery of quality service to patients without comprising on the costs involved.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) ensures free access to quality healthcare services to over 10.74 crore poor and vulnerable families. It also has a Quality Certiﬁcation programme that certifies hospitals with the aim of improving quality and patient safety.
However, while the private healthcare sector is working with the Ministry, NITI Aayog and the PMO to ensure effective implementation, there is a need to have tiered rates of reimbursement that take into account factors such as the quality of healthcare providers, location, type of care provided, quality accreditations, and benchmarked outcomes in the package rates.
There is a need to realise that in healthcare, outcomes are not just a linear addition of the inputs. There is tremendous value add in terms of skill, experience, judgment and teamwork, which cannot always be quantified and measured in terms of costs. At the end of the day, there can be no compromise by any stakeholder in the quality of care and service provided to patients.
While the citizens should take responsibility for their health to the extent possible, it is finally the responsibility of the stakeholders of the nation to ensure that no corners are cut while providing quality healthcare to all.
The writer is President NATHEALTH & Executive Vice-Chairperson, Apollo Hospitals