Need to develop primary healthcare system in India say experts
Complexities in the healthcare sector can be solved mainly by concentrating on primary care and evolving the system of family doctor with the help of technology
The Indian healthcare system has become highly glamorised with growing demand for skilled and specialised treatment while crucial primary care system is been ignored, says experts from the healthcare services.
“When primary healthcare can solve 90% of the medical problems, at times, there is no system in place to provide it. Earlier the concept of family doctor played an important role, but it is slowly diminishing. Complexities in the healthcare sector can be solved mainly by concentrating on primary care and evolving the system of family doctor with the help of technology,” says Gautam Sen, chairman, Healthspring Community Medical Service, while speaking at an event to discuss healthcare services in India.
Panellist discussed at length the need and importance of primary care and the role of the private healthcare system and rising out-of-pocket expenditure on medical facilities. While host of speakers including Ashok Ganguly, a member of Rajya Sabha and former chairman of Unilever, BK Goyal, professor of Cardiology (Mumbai University) and Dr Sanjay Oak, director- medical education (BMC) were present at the event, only two – K Sujatha Rao, former health secretary and Dr Satyanand Shastri participated in the discussions. Other panellists, apart from Dr Ganguly, who just spoke informally for a while, were not present.
Ms Rao, former principal health secretary and member of Public Health Foundation of India, said, “Primary care system in urban areas is collapsing. Rural areas at least have some basic infrastructure like primary healthcare and community centres. Over the years, our policy has failed to consider lifestyle diseases like asthama, hypertension and diabetes. Government asked private sector, by incentivising them, to place a system for treatment. While the private sector is growing, at present, there is no mechanism to regulate them.” She is also a member of planning commission committee on health insurance.
Explaining the role of primary care, Dr Shastri, medical director, Johnson and Johnson Medicals, said, “If general physicians are able to give good primary care, then most of the medical problems can be solved.”
“I know a patient who was given wrong treatment for six years after consulting his doctor for vomiting blood. While just drinking alcohol once a week, he was branded as alcoholic by his doctor. The subsequent doctors did the same without resolving the issue. The real problem was not detected for many years and he had to undergo many wrong treatments,” added Dr Shastri.
According to Ms Rao healthcare system in India is full of marker failure. “About 70%-80% (around 84 crore) of the population spend out-of-pocket on healthcare. If there are corporate hospitals in urban cities who contribute to this failure, some agents present in rural areas, who are hand in glove with pharma companies, have damaged the system. Many a time wrong drugs are administered.”
Lambasting the government for spending just 1.2% of the GDP on healthcare, Ms Rao said it should be increased in the 12th five year plan. “When National Urban Health Mission kicks in, the challenge for government would be to see if they can recognize the importance of primary care community centres, and then provide them financial assurance. Incentivising and providing financial assurance would be fine, but insurance model is just not the solution,” she added.
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