Reforming India’s healthcare system: A critical imperative

India's healthcare system stands at a crossroads. After 78 years of independence, the persistent challenges facing public healthcare reveal a pressing need for reform. The current state of the sector underscores a glaring disconnect between policy intentions and practical realities, revealing deep-seated issues that demand immediate attention and action.

A fragile public healthcare infrastructure
Government hospitals often struggle with inadequate funding, outdated facilities, and a shortage of skilled personnel. This underfunding has led to a public perception that government hospitals are subpar, prompting even high-ranking officials to avoid them. It's time for a shift - public healthcare must be revitalised to ensure that it meets the needs of every Indian citizen. Government hospitals should be modernised, staffed adequately, and made fully capable of providing comprehensive medical care.

The need for specialised governance
The governance of healthcare remains entrenched in the Indian Administrative Service (IAS), a body not specifically trained in medical administration. To address the complex needs of healthcare, there should be an establishment of an Indian Medical Service (IMS), consisting of experts with specialised knowledge in healthcare management. This move would ensure that healthcare policies and operations are guided by professionals with a deep understanding of the sector's demands.

Insurance discrepancies and financial inequities
The insurance sector's regulatory framework is skewed, with minimal representation from healthcare providers. This lack of balance has resulted in inconsistent and opaque rate charts that complicate billing and reimbursement. It is imperative to overhaul the insurance regulatory framework to include diverse stakeholder perspectives, establish transparent and standardized billing practices, and ensure fair reimbursement processes.

Compensation and coverage concerns
Doctors, particularly those working under government schemes, face inadequate compensation, while patients often bear the brunt of high costs for advanced treatments. Government schemes must be expanded to cover a broader range of treatments, and compensation structures should reflect the expertise and experience of healthcare professionals. This adjustment is crucial to maintaining a high standard of care and ensuring that financial constraints do not impede access to necessary treatments.

Emergency care and accessibility issues
The current emergency care system is marred by inefficiencies, including inadequate ambulance services and poor coordination between private and public hospitals. A robust system needs to be established that facilitates swift and seamless emergency care. This includes improving ambulance services, ensuring timely patient transfers, and enhancing the overall infrastructure to handle emergency situations effectively.

Legal and regulatory inconsistencies
The disparity in regulatory frameworks between professions - such as the unrealistic expectations placed on doctors compared to other fields - highlights a need for reform. Legal frameworks should be revised to ensure fair regulation across all professions, and grievance redressal systems should be implemented to resolve disputes between patients and providers effectively.

Addressing violence and ensuring security
Violence against healthcare professionals remains a significant concern. The government must develop comprehensive security protocols for hospitals and invest in staff training to handle high-stress situations. Addressing the root causes of violence, such as patient frustration due to inadequate care, is essential for creating a safer environment for both healthcare workers and patients.

Simplifying hospital operations
The process of starting and operating a hospital is encumbered by bureaucratic red tape. Streamlining the licensing process through an efficient online system would reduce unnecessary hurdles and promote transparency. Additionally, regulatory frameworks should support hospital operations without imposing undue burdens.

Supporting healthcare professionals
The medical profession deserves greater respect and support. A positive public perception of doctors must be cultivated, and legal expectations should align with the realities of the profession. Ensuring that healthcare providers are valued and supported is essential for maintaining trust and effectiveness in the healthcare system.

A call to action
India's healthcare system is at a critical juncture. To build a more effective, equitable, and responsive healthcare system, we need a concerted effort from both the government and private sectors, with active engagement from the public. By addressing these key issues and implementing strategic reforms, India can ensure that its healthcare system meets the needs of all its citizens and supports its healthcare professionals in delivering the best possible care.

Dr. Deepak Baid is the former President of AMC (Association of Medical Consultants).

The views expressed here are the individual's and don't represent those of the paper.