May , 2020
Was India’s healthcare system prepared for this?
11:09 am

Kuntala Sarkar

Globally, the coronavirus pandemic has taken an alarming proportion. The number of cases has also been steadily rising in India. In absence of any effective vaccine, the only way to control the pandemic is to prevent transmission and by providing critical supportive treatment to patients.

India needs at least ten times the number of existing doctors to achieve the standard of healthcare system prescribed by the World Health Organisation (WHO). It is estimated that India presently has a deficit of at least 5,00,000 doctors. According to another WHO data, during 2016, India had spent an abysmal figure of only $62.72 per person for healthcare, compared to China’s spending of $398.33 per person. Additionally, a National Health Accounts' data reports that of all healthcare activities, India spends around 7% on preventive healthcare - which was the most needed aspect of healthcare to combat this pandemic.

Healthcare reality

India has a population of more than 1.3 billion, with many of them living in dense clusters. Here community transmission would always have been difficult to contain. India’s healthcare system has been vulnerable and over-stretched in the wake of this crisis.

Prime Minister Narendra Modi has announced a Rs. 15,000 crore budget to strengthen the healthcare system during this crisis. However, the need was to prepare the Indian healthcare system before the crisis came knocking. According to healthcare analysts, the Indian healthcare system is woefully short of ventilators, which is an absolute necessity for treating critical Covid-19 patients.

There are 3.6 ventilators available for one lakh people in India while it is 18.80 in the US, 19.21 in South Korea, 8.30 in Italy, and 12.90 in Britain. According to a statista data, total numbers of critical care beds per one lakh inhabitants in India (till 2017) were 2.3, while it was 34.7 in the USA (till 2009) 12.50 in Italy (till 2012), and 6.60 in Britain (till 2012). India having a 1.38 billion population is running ahead of the USA which has a 331 million population. Yet, a report titled 'COVID-19 in India : State-wise estimates of current hospital beds, intensive care unit (ICU) beds and ventilators' informs, availability of total Intensive Care Unit (ICU) beds including public and private sector is 94,961 India, whereas more than 94,837 ICU beds are in the USA. This takes the availability of per capita ICU beds in India far below than the USA.

India spends only around 3.6% of its GDP on healthcare while the US spends around 17.70%, South Korea spends 8.10%, Italy spends 8.8% and the UK spends 9.60%. India has 0.50 beds in hospitals per thousand people. It is 2.80, 11.50, 3.20 and 2.50 respectively in the US, South Korea, Italy, and the UK.  

In the last few years, India has seen significant private capital inflow in the healthcare system. During this crisis, around two-third of hospital beds in India and almost 80% of available ventilator-equipped ICU beds are mostly in private hospitals. Yet, these hospitals are handling only 10% of the Covid-19 patients as the majority cannot afford these private hospitals.

Inadequacy and need of the hour

According to a government document, India immediately requires around one million coveralls and goggles, four million N-95 masks, two million nitrile gloves, 600,000 face shields and two million triple-layered surgical masks among other items. Additionally, a significant number of medical practitioners are of the opinion that the number of tests being done in India is grossly insufficient.

 In April, the Association of Healthcare Providers in a letter to the government said, “Shortage of Personal Protective Equipment (PPE) remains a major challenge. Testing centres need to be increased. Even labs within NABH accredited hospitals could be used for PCR testing. The norm regarding the minimum number of ICU beds for each million population needs to be assessed, which will become a key issue in case critical patients suddenly emerge.”

A list of recommendations on behalf of the healthcare industry, jointly represented by FICCI, AHPI, ASSOCHAM, Indian Chamber of Commerce, PHANA Karnataka, and NATHEALTH has emphasised on the need to immediately release 100% of the central and state government dues to the sector under various schemes such as Central Government Health Scheme (CGHC), Ex-Serviceman Contributory Health Scheme (ECHS), and various other state schemes. For the medical devices industry, the representation has called for a cut down in custom duty across the board for life-saving medical equipment and emphasised on the need to set up a credit window facility to enhance the sector’s infrastructure level.

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