An integrated approach to universal healthcare in India

The CEO of Indo UK Institute of Health (IUIH) weighs up how the India-UK partnership can help India realise its universal health coverage objectives.

One of the major challenges for healthcare ecosystem in India is to enhance the service quality and ensure equitable access to masses besides increasing its capabilities to manage the changing disease incidence profiles. According to a recent McKinsey report, India will have a total bed density of 1.84 per 1000 people against the global average of 2.9 and WHO guideline of 3.5 by 2022.

As a country, India accounts for 20 per cent of the global disease burden and only 12-15 per cent of Indian population is under health insurance cover. Private sector caters to over 90 per cent of hospitals, 80 per cent of doctors, 80 per cent of outdoor patient and close to 60 per cent of indoor patient care services in India. This overtly high dependence on private sector has debilitating effects on the poor leading to liquidation of their assets, indebtedness etc. Two-fifth of those hospitalised in India end up becoming BPL category (below poverty line) every year owing to out-of-pocket expenses being as high as 80 per cent.

Public Private Partnership (PPP) model, on which Prime Minister Narendra Modi's flagship healthcare initiative Ayushman Bharat, also popular as “ModiCare”, leverages on, can address these issues very effectively. We, at Indo UK Institute of Health (IUIH), the largest PPP project, firmly believe that it is the way forward to improve healthcare in India.

The healthcare industry is vast and in addition to conventional medicine and treatment of patients, comprises several ancillary and complementary areas such as education and training, clinical support, manufacturing and technology, research and development, mental health, alternative medicine and commercial health. The confining of these within a specific land area allows for an efficient sharing of ideas and resources and creates invaluable economies of scale and size. The 11 Indo UK Institutes of Health across India, designated for the provision of integrated healthcare facilities to over 400 million patients in India, will build a capacity of 11,000 beds, 5,000 doctors, 25,000 nurses and generate direct and indirect employment for over 300,000 Indians.

The Indo UK Institute of Health (IUIH) will provide an integrated approach to healthcare across India by partnering with the UK's best organisations in research, education, manufacturing and healthcare delivery. Each IUIH Medicity shall have a medical college, nursing college, PG academy and a training facility for allied health professionals. It shall also have a separate zone for medical equipment and device manufacturing, and pharmaceutical production. The goal is to bring healthcare to India which is Available, Affordable, Accountable and Appropriate to all.

When it comes to affordability, IUIH will ensure:

- no patient is turned away;

- reduce costs across the value chain to make care more affordable

- operate a tiered system of charges

- cross-subsidize patients

In terms of accountability, IUIH will ensure:

- transparency of charges

- transparency of treatments

- transparency of outcome

For making healthcare more available, IUIH will:

- bring in all major specialities and treatments

- provide outreach programmes to rural and semi- urban areas

- develop digital health initiatives by providing remote consultations, advice and

monitoring

- connect with local doctors and nursing homes

- deliver medical education, training and research to increase the number of skilled

medical professionals

For appropriateness, IUIH will ensure:

- no over-treatment or prescription

- appropriate healthcare professional for the task

- individual patient pathway concept from the NHS (National Health Service, UK)

At all IUIH facilities, 20 per cent of patients will be treated free of cost. Construction of the first IUIH Medicity, a fully integrated facility, is underway already in MIHAN SEZ of Nagpur, Maharashtra. Besides this, IUIH is also exploring how mobile diagnostic units, high penetration of smartphones and other disruptive technologies can be used for extending primary healthcare and treatment of patients.

The 11 states to benefit from the IUIH programme include Maharashtra, Andhra Pradesh, Telangana, Punjab, Gujarat, Rajasthan, Karnataka, Uttar Pradesh, West Bengal, Madhya Pradesh and Haryana. IUIH has also signed MoUs with two more Indian states - Assam and Uttarakhand recently.

Dr Ajay Rajan Gupta is the Group Managing Director & Chief Executive Officer of the Indo UK Institute of Health (IUIH). Dr Gupta is a Consultant Orthopedic Surgeon at the UK's National Health Service (NHS) and is spearheading the IUIH project leading a team of Indian and UK based promoters with the support of the Indian and UK governments.