Invest Upto 5 % Of GDP In Health Sector: Dr Harish Pillai, Chair, FICCI MVT Committee

Looking at the current situation, the craters in the health sector might have become even bigger. “It’s a wakeup call no doubt for the country,” said Dr Harish Pillai, Chair, FICCI MVT Committee during an interview with BW Businessworld. Pillai is the member of FICCI Health service committee and Chief Executive Officer of Aster India, Aster DM Healthcare. 

Here is an excerpt:

To what extent, COVID-19 and lockdown have impacted the Health sector?  

It’s a truly Black Swan event that no one can plan for; the biggest impact for all of us has been the disruption of routine work and the consequent economic and human impact. Unlike other sectors, Private Healthcare providers are in the Front line along with the Public System in the management of COVID positive cases. There are variations in the model across states and districts however across the country select private institutions have been designated as COVID Hospitals who need to receive patients referred from the government agencies. Unfortunately, we also hear and read stories regarding many healthcare workers who were inadvertently exposed and consequently quarantined; in the earlier phase of the lockdown, several Healthcare workers faced social stigma and ostracization from the community, greatly adding to their mental stress. We also hear reports of several hospitals being totally shut down to prevent it from becoming a Hot spot and arrest the spread of the virus. The smouldering economic impact in the coming 2-3 quarters will be disastrous as the Outpatient and Inpatient occupancy volumes have crashed significantly across India impacting revenues big time. The single greatest worry for all private hospitals now is Cash flow management and how to meet both payroll and material costs. I will not be surprised if we start hearing bankruptcy-related closure of numerous hospitals across India. Unfortunately, this will be sooner than later causing a big dent to our already creaking health infrastructure. 

How important is it to resume certain units/areas of the industry? Can you name these areas of function?  

This has to be a nuanced and balanced act which also accounts for stricter lockdowns of Virus hot spots either cluster wise or district wise to prevent transmission; as we are heading to the Rabi crop harvesting season, it is very important to facilitate the resumption of farming activities; need to kick start of the logistics industry to resume transportation of goods; resume construction of Highways/buildings; accelerate manufacture of drugs / PPE’s /Diagnostic Kits /Ventilators etc; all finances services on digital mode; IT services could still commence in a graded fashion; it’s important for hospitals to resume seeing regular patients who were stuck on account of lockdowns to ensure appropriate delivery of care after adopting all mandated precautions. This is just a dipstick of the larger formal economy; we need to also figure out how to extend support to the informal sector and MSME’s that will face untold misery and bankruptcy. 

How prepared are the private hospitals for COVID-19? What percentage of patients are arriving at such hospitals in ratio to governments? 

The lockdown period has been utilised suitably for enhancing staff cross training especially for non-core specialities (the core specialities being those deployed in Emergency, Fever Clinics, Internal Medicine, Pulmonology, Critical Care and Infectious diseases ) ; phased duty rosters such that only 2/3rd front line staff are deployed ( 1/3rd to manage COVID zones and the other 1/3rd to attend to other non-COVID cases and 1/3rd at home to preserve them to be deployed to relieve other staff; in spite of the lockdowns and supply chain disruption,  the inventory of PPE’s has been ramped up ; those units which have NABL accredited molecular diagnostic units have got ICMR approvals for starting RT PCR tests; many centres are now ramping up inventory for Rapid testing . Based on the instructions of the District administration, there are designated private and public COVID hospitals; overall the case ratios in Public facilities are much more than private hospitals due to the availability of larger capacity of Public facilities at District headquarters. 

Apart from safeguarding the healthcare service providers, where else the health sector lacks? How can we overcome it? 

My sincere hope for India 2.0 post COVID is to adopt a national strategy to invest upto 5 per cent of GDP in the Health sector. We have big gaps in Sanitation in spite of the herculean efforts to make the country Open defecation free; access to potable water; gaps in Nutrition especially in children; maternal health etc. The National Health missions need to reinvigorated and funded adequately. The National immunisation programs need a huge push especially to protect the most vulnerable segments. There are several success stories within India of excellent Physical Quality of Life Index and fulfilment of the Millennium goals. In addition to all this we need to develop national capacities both for infrastructure and human resources in R&D; Diagnostic labs; Medical devices; Public Health and Curative medicine across the districts. Even in the much-lauded Pharmaceutical industry, we must resolve to ‘Make in India’ the key source ingredients like API. I hope that this Pandemic is a wake up call and reminder that NO ONE can remain isolated and hope to be protected either from the Pandemic or the follow up economic tsunami. There must be greater equity, especially in the Health sector. 

Do you think India has enough resources and funds to tackle the pandemic like COVID-19? Both now and for Future? 

We do have gaps as mentioned before; however, states like Kerala have effectively demonstrated a prudent model in deployment of scarce public funds for the greater good of Society; can the country take a leaf of this book and institutionalise these protocols. Just like we are obsessed regarding National Security threats, can we start obsessing regarding Pandemic/healthcare threats that have a devastating impact on GDP and economy. I hope the media will popularise the concept of DALY- Disease adjusted life years, an important metric that measure productivity loss on account of illness or death in a nation.