Turn to small towns for making healthcare accessible to all Indians

It has now become a cliché to refer to India as a country of paradoxes. Yet the paradoxes are nowhere more egregious than in healthcare, with abundance and paucity co-existing cheek by jowl. Even as India becomes a thriving centre for medical tourism attracting thousands of foreign patients to its shores, millions of its own citizens do not have access to good quality and affordable healthcare.
 
Life saving healthcare is a human right which every individual deserves. Whether super rich or middle class, be it in a bustling metropolis like Delhi or in a sleepy interior town like Sasaram, every individual should be at an approachable distance of good healthcare facilities. Despite the advances India has made in the field of healthcare, the reach of best facilities and quality healthcare remains a major concern.
 
In fact, World Health Organization (WHO) ranks India at a dismal 112 out of 190 (2013) on availability of good healthcare to all. WHO stipulates a requirement of a minimum 1 doctor for every 1000 people. In 2011, the Medical Council of India (MCI) estimated that India had roughly one doctor for every 2000 persons. This despite the fact that India remains a major supplier of doctors and nurses to developed countries. In fact WHO says that 45.8% of its Member States report to have less than 1 physician per 1000 population.
 
Apart from the abysmally low doctor-patient ratio, quality surgeons, cardiologists, oncologists, diagnostic techniques remain clustered in select hospitals in metropolitan cities. Invariably, if a person in a remote town of Uttar Pradesh suffers a cardiac condition and needs angiography or stenting, he or she has to travel all the way to Delhi to get treated. Given the condition of road infrastructure in the country, it is not always easy to transport a patient who is in critical condition 300 km away.
 
Yet, for millions of people, this situation remains a reality, even when he can afford the costs of world class healthcare. Every day hundreds of such people line up in hospitals in Delhi NCR hoping to find a solution to their health concern. This also leads to overburdening of these select hospitals. At the same time, many patients fail to receive the required medical intervention at the right time, losing precious time and lives.
 
Contrary to common perception, this lack of quality healthcare is not just limited to the economically deprived sections of the society. Even relatively well-to-do people often find it difficult to avail reliable, trustworthy and best healthcare advice and treatment. Even as hospitals and clinics mushroom all over the landscape, reliable medical facilities are scattered and too far and too few. Not just rural areas, even smaller towns suffer from inadequate health facilities and woeful infrastructure.
 
  The solution to India’s healthcare woes lies in simultaneously strengthening our primary healthcare system as well as our secondary and tertiary system, and the role of private sector in this domain cannot be understated. Unfortunately, most private groups of hospitals have till now focused on larger cities, and metropolitans, understandably as these centres promise more footfalls and profits. However, reaching out to the untapped smaller markets outside the six metros is a win-win proposition for all.

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A recent report by Smart Cities Council identified a list of 20 smaller towns that have the promise to become the engine of the next round of Indian growth – the six metros having already achieved saturation. As much as this is true for growth and development, this is also true for healthcare. Heavily populated cities like Kanpur, Agra, Ranchi, Panchkula, Indore, Gaya etc can become centres of healthcare excellence and cater to not just their focal populations but also a large number of people living in adjoining towns and villages. These are the centres that will also form the new growth centres for healthcare facilities.
 
Not just the government, private sector too needs to turn to smaller towns and cities in a big way, and this will not be without profits. The mushrooming of large scale multi-specialty hospitals all over the metros has also meant a saturation of space and market in these regions. In such a scenario tier II cities and smaller towns that have substantial populations is where private investors must now be headed.
 
Hopefully, more healthcare providers will take note of this gap in delivery of quality healthcare in smaller towns and cities across India and come forward to bridge it. We not just need to increase the doctor patient ratio, but also increase drastically the number of facilities that provide healthcare at par with the country’s best hospitals, at affordable prices. And private sector has a key role to play in it.
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Dr Dharminder Nagar is the CEO & managing director of Paras Hospital