The Indian health ministry has published its annual National Health Profile showing serious deficiencies in the numbers of physicians, hospitals, and hospital beds in the public sector.
IHS Life Sciences perspective | |
Significance | Dr Harsh Vardhan has released statistics on India's public healthcare system for 2013. |
Implications | The statistics show a high doctor-patient ratio, declining numbers of new doctors registering, static patient-to-bed ratio, and a worrying patient-to-hospital ratio. The data suggest that public spending on health contributed 26.7% of total healthcare expenditure in 2008–09. |
Outlook | Despite the poor health statistics, the government appears reluctant to improve the state of the public healthcare system. |
Union health minister Dr Harsh Vardhan has published India's National Health Profile 2013, according to LiveMint. The document includes key statistics used to judge the healthcare system in India and specifically the government's successes and failures in providing care.
Alarmingly, the report indicates that India has a doctor-to-patient ratio of one per 1,200. Although the 2012 report did not include a physician-to-patient ratio, the LiveMint article suggests that the figure falls far short of the Medical Council of India (MCI)'s 2011 aim of a one-to-1,000 ratio by 2013. Compounding the shortage of physicians is the low numbers of physicians registering with state or national medical councils. In 2012, 30,017 physicians registered, compared with 26,876 in 2013. In terms of other medical professionals, the report suggests that the dentist-to-patient ratio rose from one per 993 in 2012 to one per 10,121 in 2013, while the pharmacist-to-patient ratio increased from one per 1,916 in 2012 to one per 1,987 in 2013. The nurse-to-patient ratio slightly improved during the period, from one per 569 in 2012 to one per 532 in 2013.
The report also touched on healthcare funding and provision. In terms of hospital beds within the public sector, the document shows that the patient-to-hospital-bed ratio decreased very slightly from one per 1,947 in 2012 to one per 1,946 in 2013. The average population served by each government hospital saw a dramatic increase, from 50,689 in 2012 to 61,744 in 2013. The report's examination of healthcare expenditure, which used 2008–09 data, suggests that public spending on health represented 71.62% of total healthcare spend, while 26.70% of disbursement was from public (government) sources and 1.68% was from external sources (such as charities and international assistance).
In his comments on the report, the health minister has stated that the government needs to work on the development of a more detailed healthcare database so that "the country should be prepared and geared up for meeting any medical emergency".
Outlook and implications
In his statements, Vardhan appears to miss a key point raised in the report, which is that public infrastructure has not kept pace with increasing demand for healthcare from India's fast-growing population. The minister's digression to discuss national medical emergencies seems to stray from the main issue that patients, especially poor patient groups, are seeing their access to care decrease.
Although the government announced some infrastructure projects in last week's budget, including the establishment of more All India Institute of Medical Studies (AIIMS) teaching hospitals, much still remains to be done to tackle the lack of access to care, especially primary care (see India: 10 July 2014: Indian government budget shows modest increase in health expenditure, reversal on health insurance, minor support for biotech). Furthermore, the fact that healthcare spending has only slightly increased suggests that the new Indian government is unwilling to confront the challenges faced by the healthcare system, and no granularity of data will ameliorate this.
For pharmaceutical companies, the deteriorating state of the public health system and the administration's seeming reluctance to improve it mean that the Indian pharmaceutical market is not reaching its full potential as patients are increasingly forced to pay for care out-of-pocket and therefore make difficult choices regarding medicines and care.