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Strangled by red tape
India's healthcare system is broken, with high infant and maternal mortality rates. While increasing healthcare budget could help, the main issue is lack of skilled healthcare workers. There is a severe shortage of specialists like gynaecologists and anaesthetists. Medical education produces many doctors but few postgraduate seats, so most spend years preparing for exams instead of treating patients. The document proposes reforms like increasing postgraduate medical seats, recognizing training in non-medical hospitals, leveraging other healthcare workers, and using technology and micro-insurance to expand access to affordable care.
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Strangled by red tape
- 1. Strangled By RedTape How to fix India's broken healthcare system without spending big money Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 2. Contd.. India's infant mortalityand maternal mortality rates are worse than in sub-Saharan Africa. Every 10 minutes a young woman dies during childbirth. Three lakh children die the day they are born and 1.2 million die before celebrating their first birthday . Policy makers believe we can address the crisis by increasing budgetary allocation on healthcare. The truth is that even if we increase it from the current 1.1% to 10% of GDP, maternal and infant mortality in India will not come down because we do not have the skilled manpower to address the crisis. According to information from the health ministry the shortage of medical specialists in community health centres where the majority of children are born in rural India is close to 75%. Every year 26 million babies are born in India; at least 5.2 million require caesarean sections. To perform these we need at least two lakh gynaecologists. We only have 30,000; nearly half of them do not practice obstetrics. We need two lakh anaesthetists for the pregnancies alone and we have less than 20,000. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 3. Contd.. Predominantly the shortfallis because even though we produce 50,000 doctors a year, there are only 14,000 PG seats for them to become specialists. Because of the acute shortage of seats, young MBBS students spend two to five years in coaching classes swotting up multiple choice questions in Kerala and Kota instead of taking care of patients. We have rigid Medical Council of India (MCI) regulations as to who can perform what procedure. If we look at the top causes of death in India heart disease, liver failure, psychiatric illness, accidents, pneumonia and TB doctors without postgraduate qualifications cannot treat any of these cases. How do we expect the death rate to come down? Today, when it costs close to Rs 400-500 crore to start a medical college, state governments are reluctant to get involved. I can't also think of a single trust with the honourable intention of building a medical college that would spend Rs 500 crore and not expect anything in return. As a result, it is people with ill-gotten wealth who build medical colleges and medical education has become extremely expensive. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 4. Contd.. With the strokeof a pen India can equalise undergraduate and postgraduate seats in medical colleges. This can happen without billions of dollars in investment or a long wait. Worldwide, higher medical education happens in non-medical college hospitals which are centres for excellence. One of the issues raised by various councils is the shortage of faculty. But who is allowed to teach? According to MCI neither Naresh Trehan of Medanta Hospital nor Ramakanta Panda of the Asian Heart Institute both recognised as pioneers of cardiac surgery are allowed to teach cardiac surgery in India. Clearly, there is fundamentally something wrong with how we conduct medical education. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 5. Contd.. Across the world,medical education is an integral part of healthcare delivery. By converting jobs available in rural India to part of the training programme, we can bring talented doctors to these difficult areas. But we seem to have consciously avoided using medical education as a tool. Few would have heard of the College of Physicians and Surgeons based in Mumbai. The oldest medical university in this part of the world, it was established 105 years ago and gave diploma degrees in gynaecology, anaesthesia, paediatrics and radiology, to address the needs of rural India. Unfortunately, a few years ago their degree was de-recognised. But their training programme can happen at any government hospital, which would convert all MBBS doctors in government sectors to medical specialists in two years, addressing 75% of the shortage of specialists in the government sector. All it requires is a simple instruction from the health ministry. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 6. Contd.. Worldwide, nurse practitionersor physician assistants provide primary healthcare. Unfortunately, here we have never created a legal framework for them to dispense basic medicines. We also have close to six lakh Ayush doctors who are graduates from the same universities that gave medical doctors their MBBS degrees. They just need a six-month bridge course to prescribe 47 basic drugs in primary health centres. This could address absenteeism of MBBS doctors and ensure quality healthcare to rural India. In spite of several meetings and expert opinions, nothing has changed. We just need the political will to make it happen. Technology can also massively impact how healthcare is delivered and funded. Eleven years ago we conceptualised a micro health insurance scheme, Yeshasvini, launched by Karnataka's department of cooperation. In the first year 1.7 million farmers paid Rs 5 per month as a premium and the state government became the reinsurer. Today over 4 million farmers pay Rs 10 per month and close to 10 lakh farmers have had surgery. Close to one lakh farmers had heart surgeries in one of 476 network hospitals. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 7. Contd.. We can scaleup. Today, India has close to 900 million mobile phone subscribers, who spend at least Rs 150 per month for basic services. If we create a regulation to get even Rs 20 from each subscriber, we can cover surgical costs for all 900 million. It is not rocket science. We have the opportunity to become the first country to prove that a nation's wealth has nothing to do with the quality of healthcare its citizens can enjoy . The writer is a cardiac surgeon and Chairman and Founder , Narayana Health Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 8. This platform hasbeen started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India. We need lots of funds manpower etc. to make this vision a reality please contact us. Join us as a member for a noble cause. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
- 9. Our views haveincreased the mark of the 1,91,000 Thank you viewers Looking forward for franchise, collaboration, partners. Brought to you by The Nurses and attendants staff we provide for your healthy recovery for bookings Contact Us:-
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