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There is urgent need for a massive investment in healthcare, particularly in the northern states. The world-class hospitals in the South which cater to the needy and provide free services could serve as models for setting up medicities in Chandigarh and Punjab, writes
Ram Kumar
Public health institutions in the primary, secondary as well as tertiary levels, which were responsible for most of the healthcare to the community, are now sinking. Punjab has high infant mortality rates (IMR) of 52 per thousand live births, and life expectancy at birth of 67.4 years. In these two crucial parametres of human development, Punjab is far below Kerala, which has IMR of just 14 and life expectancy of 73.1 years, despite Punjab being more prosperous. This means Kerala has better standards of healthcare for its population than that of Punjab, where healthcare is ailing. Also, higher female IMR in Punjab, than several other states in India, indicates gender bias against the girl child, especially in rural areas. In a study it was revealed that only 7 per cent OPD patients availed of government facilities in rural areas and 6 per cent in urban areas of Punjab. For hospitalisation government facilities were utilised by 39 per cent in rural areas and 28 per cent in urban areas. This abysmally low use of public healthcare services is attributed to lack of trust in government services, poor availability and accessibility of staff, inconsistency of their service, unresponsiveness and lack of empathy. Despite high cost, even poor consumers are turning to private health service providers due to lack of trust in public health facilities. There is lack of accreditation and unethical practices are rampant in these private healthcare shops, which are often manned by quacks. There is scarcity of good corporate hospitals in Punjab. The few hospitals that are available are too expensive. In Chandigarh the healthcare services, though better managed than in Punjab, also suffer from several deficiencies—overcrowding, poor funding, lack of medical insurance and training facilities for staff and absence of corporate hospitals. On visiting corporate hospitals in the South, the services in hospitals like Narayana Hrudalaya, Wockhardt, Manipal group and Apollo are found to be world class in standards and are well managed. The two hospitals at Chennai—Voluntary Health Services Centre and Sri Ramachandra Medical College Hospital—provide almost completely free OPD services, and the diagnostic and indoor services are there at a nominal price for the poor. Punjab can explore the possibility of emulating the model of these two hospitals to improve healthcare. There is an urgent need to have massive investment in healthcare in India in general and the northern states in particular. The country is short of 30 lakh hospital beds as per CII estimates to match Second World countries. Chandigarh is in a position to serve the region’s needs for high-quality healthcare, and to be a model for institution-building in the region. Chandigarh is considering to set up its Chandigarh medicare city model on the pattern of Dubai Healthcare City, which has taken a monumental step towards becoming a regional centre of excellence for healthcare delivery. The centre has Harvard Medical International (HMI), Mayo Clinic and Boston University as its partners, besides others. The Chandigarh medicare city project authorities may also consider the working model of Bumrungrad Hospital, Thailand, the best hospital from medical tourism point of view. The proposed medicare city may have $5 billion outlay with a strength of 5,000 beds in various specialties. Due to paucity of land, it would be prudent to grow vertically. The city model administration has to commit itself to the principle of accessibility to all, to professional and academic excellence, and to international recognition for quality of care as well as patient privacy, rights and satisfaction. This entails world class infrastructure, top class faculty and accreditation with JCI. Closer home the healthcare city may be spread over 800 acres with an estimated investment of Rs 20,000 crore. The proposed health city will have 100 hospitals with a total capacity of 50,000 beds. Besides hospitals, the healthcare city will have medical colleges, nursing institutions, para-medical training institutes, technical training centres and hospital management schools. The hospitals will have super-special facilities like referrals and laboratories for investigations. Telemedicine facilities along with telecardiology and telepathology will be set up in individual hospitals. It will also have provision for hotels and guest-houses to accommodate about 25,000 people visiting along with patients. The city will have a shopping mall and a cineplex, too. There will be an international building for foreign medical tourists that will house interpreter services, travel services, representative offices of foreign consulates and other government offices. The building will also have a helipad on its roof for air-lifting emergency patients. Plans are also there to outsource common services like catering, laundry and advanced diagnostic services. There will be other common facilities like waste management, power plant, electronic laboratories, ayurvedic centre and naturo-therapy unit. On the hospital campus, pharmaceutical and other companies will set up warehouses, where surgical, disposables and implants will be stored. The health city is projected to provide employment opportunities to almost three lakh people.
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