When most people think of infrastructure, they think of roads, bridges, railway lines, and airports. Healthcare is seen as different, but healthcare may be the most critical part of the infrastructure for any country.
Linda Luxon of the UK’s Royal College of Physicians categorizes various aspects of healthcare infrastructure into five “pillars.”
These include hospitals and healthcare centers. Luxon says these must be integrated into the broader community so that access, affordability, and “societal buy-in and well-being” are achieved. Very often, healthcare buildings are designed rigidly. When for example, we had to get our covid vaccines, many alternative venues had to be used, and the surge of covid cases overwhelmed hospitals that were not designed for flexibility. We seem stuck in an old idea of a permanent configuration for hospitals, but an adaptable building may be more fit for our purposes.
Here, we think of expensive CT scanners or MRI machines. Simpler and more readily available x-ray machines for example, or portable sonography equipment, might service many more thousands. The need for and the way we interact and use the medical equipment needs much greater focus.
Good IT systems can help immensely. The Cowin IT program used in India is an example of a superb design. However, this is used for our present emergencies. A comprehensive system that integrates patient information with confidentiality by relevant access to health professionals in a speedy and cost-effective manner is still to be implemented. This would go a long way in helping us in our hours of need.
Medical Staff and Human Resource Structures:
How often we face variable service from different medical practitioners. How difficult it is to get kindly and efficient nursing help. Getting the right education and passing medical exams is just one part of providing a holistic and kindly medical service. Then there is the organization of the various health care professionals. Unfortunately, people do not realize that an excellent doctor may not be an excellent health care administrator. A re-look at how medical staff are organized and more attuned to the long-term needs of patients is required.
This is perhaps the most important of the five pillars. It determines the longer-term vision of a country or organization’s health care aspirations and the values and principles under which health care is provided.
India has total healthcare spend of 3.6% of GDP. This is extremely low compared to 16.9% in the US and 10.9% in Japan. Even amongst large developing nations, India spends the least with Brazil at 9.2% and South Africa at 8.1%. But it is not just money spent but thought, and governance that matter and that make a difference in providing health care to India’s millions. The Covid crisis is a wake-up call, and we should all look to make a difference. Too often, once a problem passes, we forget the need for vital reforms. One hopes that this time we do differently.
© Kaikhushru Taraporevala