Last year I was waiting in the emergency room of a hospital, lying on a stretcher waiting to get a CT scan done (met with a bike accident which is a totally different story). Moving in and out of consciousness, I was wheeled out of the emergency room and taken straight to the imaging and scanning wing of the hospital, one of Chennai’s biggest and a highly recommended name. Even with no other patient in sight, I was made to wait for over 30 minutes to get my scan done!! (as my family told me later). Imagine being made to wait for an important scan of the head, one which would let my family know whether the clock inside is still functioning alright or not. A scary scenario for any family as I am sure you would agree.
My CT scan finally arrived and it revealed, much to my surprise, that the space between my ears is not empty and is in fact functioning just fine. Just a minor pre-frontal surface scarring, that’s all. Medication alone took care of it.
As I stayed for a few more days in the hospital recovering from my injuries, I was told by many, both patients as well as staff, that they are severely falling short on manpower (upon my revealing that I am a head hunter). No, not the ones who clean the place, cook and bring the food, or manage the cash register, no. The shortage was on the side of the skilled staff; Path lab technicians, imaging technicians (that answers the question as to why I was made to wait), emergency doctors and many more across the many ultra specialized wings of the hospital.
This, unfortunately, is true for most of the public and private healthcare centres in the world’s largest democracy, which until 2 decades back was at its core a “for the people, by the people” socialistic economy. Moving forward from the socialist era, you come face to face with the harsh reality of today, “India Shining” (for a few at least).
Our country has been an out-sourcing destination since liberalization. This is due to the availability of cheap and skilled labour in the country. Since liberalization and the pouring in of money, the economy got a taste of the growing needs of a small section of the population who could afford better healthcare and could send their near and dear ones to other countries to access it. In the new economy where more money means better access to healthcare and the prevalence of a “low cost healthcare delivery system”, why serve here? Healthcare professionals, doctors and technicians have been leaving the country in droves to these parts of the world to enjoy a better life for themselves, leaving the already fragile healthcare system in the hands of a few and spreading their efforts thin.
To give you a perspective, as per a recent report, the UK has over 40,000 Indian doctors who are treating about half the population of Britain while in the US the figures stand at 50,000. About 20% of the doctors working in Australia have received their basic education in India, while in Canada, one out of every 10 physicians has roots in India. Pretty huge numbers we are talking about.
Of the people that remain in India, it is estimated that about three quarters of the available talent is located in the urban and metropolitan areas where they cater to roughly a fourth of the population. This puts enormous stress on the talent servicing the rural population of this country, leaving quality in the hands of GOD.
In India it is common practice for an average rural Indian to go and consult a quack or a hakim for all healthcare needs. This has resulted in variability in technical competence and the absence of a standard to follow.
The numbers in the backend i.e. the medical/technical education system, and other training and development areas where Doctors, nurses, Lab technicians, other specialists are churned out aren’t very good either. Even as the country crossed a billion people mark, the intake of these institutes remained mostly unchanged, thereby putting more pressure on the few who where churned out of the system to serve the growing population.
Outlook has to change
I feel there has been a slow surfacing of a realization for the need of a better and larger volume of healthcare talent to emerge. The public healthcare system of late has taken steps to increase the enrolment and training for more prospective candidates. The private sector too has been seen contributing and trying to bridge the gap. They have been cashing in on the demand for medical and other technical degrees and qualifications by providing enrolment and training to their programmes.
I feel that the likelihood of these steps succeeding in effecting any change in the system in the short-term is going to be negligible. We are likely to see the effects being much more pronounced in a decade’s time. This is due to the fact that the gestation period for training a medical professional is almost that long.
I feel the measures that need to be taken are: -
1) A continuous effort in the direction of upgrading seats in professional institutes for training Doctors and other technical staff. We need to bridge the 50 % shortage gap.
2) A standardization of training is required.
3) An incentive to the industry in terms of universal healthcare insurance would be highly beneficial.
I feel we should start worrying ourselves now and voice our concerns more to ensure that the right people take more than adequate steps to bridge the talent short fall over the next two decades.
And if we fail, then I pray that like my brethren, I too can afford to send my near and dear ones abroad for better healthcare access.
By Anirudh Vaidyanathan