Mr. Vishal Bali, CEO, Fortis Hospitals

Health systems around the globe are designed to provide a means to distribute society’s resources to balance affordability. For any country economic growth must bring with it a faster growth of its healthcare sector. At no other time in our history has there been more debate on the healthcare agenda of this country and the need for faster reforms to bridge the growing healthcare aspirations of our people. Longevity of life in high income developed countries has often been attributed to higher accessibility, by contrast in low income economies like India poor health has been demonstrated as one of the several constraints for economic growth. The challenge to advance human health for any country besides investing in basic health and hygiene is a multiplier of its ability to train, retain and sustain its healthcare human capital through revitalizing education, improving training and preventing migration. Our population growth is touching 2% and it is estimated that by 2030 India will surpass China as the most populous country on the planet besides the fact that by 2025 an estimated 189 million people in this country will be more than 60yrs of age needing higher healthcare spends. India has 16% of the world’s population,18% of the world’s mortality and 20% of the world’s morbidity and our public expenditure on health is still 1% of GDP. Budget 2010 needs to put Healthcare on the reform agenda for the country to make a fundamental difference. In India healthcare sector is largely contributed by private rather than public funds with the private sector contributing 4.5% of GDP spend. Can a rapidly developing economy like ours be so dominantly dependent on private spending? It therefore expected that health expenditure rate will mirror the GDP growth of 7-8% and Govt will contribute through a higher spend on the sector. While we continue to build our healthcare delivery systems contributed largely by the private sector it is imperative for the government to take appropriate measures to strengthen the foundation of healthcare delivery model in our country by increasing the GDP spend to 2% and make healthcare accessible to a larger population of our country. Outlining few recommendations from the healthcare sector that Budget 2010 should provide: · Priority or Infrastructure status. If we have the intention of not being a“ sick“ country then healthcare has to be given as much importance as roads, ports, highways, airports and IT. Massive investment is required to bring up the quality of health care in India. The current ratio of bed: population of 860 beds:1mn population stands nowhere as compared to the WHO norm of 3960 beds : 1mn population. nation where the ratio is 7:1000. The budget needs to focus on ways to incentivize private sector to accelerate investments.
· A direction towards a public and private combined healthcare spend to reach 7% of GDP over the next 3 yrs.
· Focus on inadequate water,sanitation and sewage management to halt the rise of communicable diseases.The national disease surveillance program needs to be more effective.
· The National Rural Health Mission plan needs higher layout and its expanse should go beyond the current 18 states which will take its focus to a National Health Mission.
· Decrease in capex by the Ministry of Health from has resulted in lack of adequate modernization of Public Health infrastructure.The capex expenditure must move upwards of 10% of the total outlay.
· “ Healthcare Parks “ on the lines of Software Technology parks which are subsidized by the Govt should be started to provide susidized tertiary care to the less affording and those sponsored under the Govt healthcare schemes.
· National Policy Direction on Public-Private partnership in healthcare facilities. Reports say widespread malnutrition impacts economic growth dramatically with the World Bank saying that in the poorest countries it slashes 3% from annual economic growth. More than 27% of the undernourished population globally lives in India posing a huge constraint to economic development of the country. Immediate measures should be initiated to scale up of basic interventions like mass immunization and better primary health. As a country which has exhibited its prowess and intellectual capability in numerous knowledge based sectors to emerge as a frontrunner in the globe we have the unique opportunity to design viable and sustainable healthcare delivery models. We therefore need “Healthcare in India” to be a priority in budget 2010.