Managing Covid-19 3rd wave: NATHEALTH submits recommendations to govt

New Delhi: NATHEALTH-Healthcare Federation of India, an apex body representing the ecosystem of private healthcare sector in India has submitted a set of recommendations to PMO, Department of Pharmaceuticals, Central Drugs Standard Control Organization, Ministry of Health and Family Welfare and NITI Aayog, for bolstering the existing healthcare infrastructure to be well prepared for the third wave.

The representation highlights that while first two waves of the COVID-19 pandemic have already overburdened the health system of India, there are countless non-COVID patients who are suffering prolonged agony and are at risk of worsening physical and mental health in the absence of adequate medical attention. The submission also included findings from a recent patient study conducted by NATHEALTH with IQVIA in 2021 on the impact of COVID-19 and delay in treatment, on patient behavior due to restrictions in accessing healthcare facilities. The recommendations urge Government to initiate urgent action on granting flexibility to hospitals to give adequate attention to non-COVID care alongside COVID, catalyzing new medical infrastructure creation, unlocking working capital for the MedTech and broader healthcare sector, expanding health financing and public spend, developing resilience in the rural and peri-urban areas and scaling up healthcare service access beyond metro cities through technology.

The Patient Confidence Study Report submitted along with the recommendations highlights that 57% of the surveyed patients, cancelled/postponed/rescheduled their treatment plans between March-December 2020, almost 100% of patients cancelled or postponed or rescheduled their surgeries due to lockdown, 34% of OPD patients cancelled or rescheduled their visits to hospitals, 82% patients wished to reschedule/return to their treatment plan by June 2021, and 62% patients believed that their health condition has been negatively impacted.

Key recommendations include:

1. Catalyzing New Medical Infra Creation: Incentivize incremental quality MedTech infra creation backed by commensurate investments to expand CC/ICU Infra in hospitals and ambulatory/home care infra outside hospitals. This should be done by creating a level playing field between local and global manufacturers, creating a roadmap for quality innovative medical infrastructure by raising investment (both public and private) in the GDP from current 1.7% to between 4%-5% over the next 5 years. The time to do this will be now when this investment can have a multiplier network event in restoring the economic health of the nation past the pandemic while laying the healthcare foundation of a 5 trillion USD modern economy.

2. Boost short term health infra-availability and productivity: Use technology and automation for productivity gains and augment surge capacity: Draw cross funding from PM Care, PMJAY/Insurance flexi funds and CSR spend to fund AMC for all medical equipment, get spares and equipment up and running, develop e-ICU mandate in hospitals above minimum beds, training for frontline equipment technicians and remote monitoring.

3. Unlock Working Capital: Release MedTech payment dues, receivables and arrears to free up working capital to invest in inventory of critical spare and lifesaving equipment. The duty and CESS announced in previous budgets on MedTech equipment is adding costs to providers and a waiver of this tariff will be a reasonable step benefiting the citizens, at a time when global supply chains are tight and escalating inputs costs, freight and other logistics costs are an ever-increasing burden.

4. Health Financing: One additional area for focus could be expanding private insurance cover. Increased coverage of insurance particularly in tier 2-3 towns will drive capacity growth as high-quality providers will have confidence in the paying capacity of the patients.  48% of the population travels 100 Km to access healthcare, there are opportunities to build asset light models powered by digital technologies improving access and affordability with appropriate reimbursement and financing models.

5. Building Rural/Peri-Urban Pandemic Resilience: Invest in Emergency ambulances and medical/testing infra for rural India where the pandemic is gaining grip – community testing, referral emergency and non-emergency transport and vaccination. Accelerated capex spends under 108/104/NHM/NDMA programs for the next two years to FY 2021-22. PPP and explore asset light PPP models for peri urban/rural infrastructure building and services delivery.

6. Ease of Doing Business: Develop a transparent predictable regulatory environment, particularly around pricing. Create mechanisms where these decisions are not unilateral, linked to quality/standards and arrived at after due deliberations at central and state level with appropriate input from industry. An unstable pricing regulatory environment has deep disincentives for investments and access to financing, which are critically needed now.

Speaking on the recommendations, Dr. Shravan Subramanyam, Senior Vice President NATHEALTH and Managing Director, Wipro GE Healthcare said, “The pandemic has exposed the missing links in the Indian healthcare system – shortage of skilled staff, beds and infrastructure has taken the limelight. It is heartening to see how private players from across industries have joined hands with the government to close these gaps and to help healthcare providers navigate strongly during these times. Example of this has emerged everywhere, remote monitoring solution has brought added ICU capacity to rural and urban areas, AI chest x-ray applications help doctors diagnose faster, unique CT solutions help keep staff safe from the virus, the skilling initiative is also helping to upskill and train professionals for better healthcare delivery.”