Co-op hospitalsApprox Read Time: 4 min
India’s weak overall healthcare :
- India’s public health expenditure is low:
- The government—both the Centre and the states—accounts for only a third of the annual overall healthcare expenditure in the country.
- India’s public spending on health as a percentage of GDP, at just 1.29%, compares poorly with the OECD average of close to 9%.
- Shortage of healthcare personnel:
- India is also facing a shortage of healthcare personnel in the country, with 0.6 doctors per 1,000 population and 2.2 nurses for each doctor, against the WHO recommendation of 1 doctor per 1,000 population and three nurses per doctor.
- Large inequalities across states in health metrics:
- There exist sharp divides between the states on healthcare metrics.
- Bihar, for instance, has a doctor-population ratio of just 0.26, and a functioning, government-run healthcare facility (up to the secondary level) for every 10,222 people (against the India average of one for every 6,752 people).
- At the end of March last year, the country’s rural areas were facing a shortfall of 18,000 specialists at community health centres.
Covid again highlighted the need for healthcare delivery to the grass-roots:
- The ongoing pandemic has brought into focus the need to strengthen health infrastructure in rural areas.
- It would have been a major disaster had India’s hospitalization demand due to Covid-19 been high.
- It has also been observed that many cooperative hospitals are facing a lack of credit support.
Ayushman Sahakar scheme for cooperative health infrastructure:
- Taking inspiration from the successful work cooperatives have done in the healthcare sector in Kerala, the central government recently launched the Ayushman Sahakar scheme.
- It seeks to involve co-operatives in creating healthcare infrastructure in the country.
- Ayushman Sahakar loans can be used to set up primary healthcare facilities, medical and dental education infrastructure, diagnostic centres, pharmacies, wellness centres, Ayush centres, etc.
- Under the scheme, NCDC will extend term-loans totalling Rs 10,000 crore to cooperatives to set up healthcare infrastructure in rural areas.
- National Cooperative Development Corporation (NCDC) is a statutory body under the Ministry of Agriculture & Farmers Welfare.
- Assist cooperative societies to provide comprehensive healthcare including education, services, insurance and related activities.
- Assist promotion of AYUSH facilities by cooperative societies.
- Assist cooperative societies to meet the objectives of National Health Policy.
- Assist cooperative societies to participate in the National Digital Health Mission.
Ayushman Sahakar scheme is a good step but much more needs to be done:
- While Ayushman Sahakar scheme is a good step, a lot more needs to be done if the government is to deliver basic healthcare access to all.
- Access to basic healthcare is treated as a primary governance deliverable, even a right, by many nations.
Link medical colleges to district hospitals:
- In a 2011 report for the Planning Commission, Dr Srinath Reddy had recommended linking medical colleges to district hospitals to dramatically lower costs of medical education, and ensure a greater supply of doctors in rural areas.
Set up nursing schools:
- Dr Srinath Reddy had also recommended setting up of nursing schools in under-served states.
Leverage technology and teleconsultation:
- Technology and teleconsultation also represent a huge opportunity in extending healthcare reach.
- However, for this to be successful, the government will have to invest in equipping PHCs and CHCs.
- Covid-19 infections in rural areas are rising —they now account for a fifth of India’s infections.
- This makes strengthening public healthcare in rural areas an important, not just for now, but also future pandemics.
- Cooperative hospitals will address this need to some extent, but the governments at centre and states must take responsibility for providing most of the meaningful healthcare access.