“For perfect health system, each nation has to learn from the other�

26 October 2015 | Interviews | By Rahul Koul Koul

“For perfect health system, each nation has to learn from the other�

Did you manage to find the perfect health system in your latest book, 'In Search of the Perfect Health System'? What are the takeaways for developing world?

Dr Britnell: There is no health system in world which could be called perfect. Each one of them has to learn from the others. Elements of healthcare systems as diverse as those found in India, South Africa and Singapore can contribute to meeting the global healthcare challenge, demonstrating how collaboration on a global scale can tackle these challenges.

I would like to point out twelve facets of universal healthcare discussed in book. Values and universal healthcare of UK; Primary care of Israel; Community services of Brazil; Mental health and well being of Australia; health promotion of the Nordic countries; patient and community empowerment in parts of Africa; Research and development of US; Innovation, flair and speed of India; Information, communications and technology of Singapore; Choice of France; Funding of Switzerland and Aged care of Japan.

Whether it is malaria, HIV or TB, there have to be collaborations for an early outcome on prevention and treatment. There is something to teach and something to learn from.

Why is that Indian healthcare never received the attention even after 60 years of independence? Do we have misplaced priorities or compulsion to focus on other things first?

In India, it has never been a political priority earlier as there was polarization between health and other issues. Few times, I am told that it becomes important to think of food and immediate survival than the health. Besides that, the twenty nine states of India also add up to the difficulties in laying out universal health insurance. I can think of many countries like Singapore which too gained independence from British but were fast in increasing the health spending in the overall percent of GDP. South Korea is an example to have grown industrially but they also made sure that their health system gains public funding support.

However, despite its own complicated system yet India has been a unique example of being patient in resolving its healthcare issues through indigenous efforts. But now is the time that India has to take a cue from others and realize that it is important to share the wealth across verticals. Slowly the health issues are catching up on attention in political space too. That is a good sign.

What do you make out of the Jugaad innovation in India? Isn't this indigenous low cost tech development a way out to bring some change?

I love this word as it is based on the spirit that Indians believe in living and creating solutions in unfavorable circumstances. It is a wonderful example of tackling issues and has to be scaled up with the right funding support on case to case basis.
In the west, we call it frugal innovation and there is hardly any doubt that 'Jugaad innovation' can surely play its role in empowering medical practitioners or healthcare workers at basic levels.

Which are the major challenges faced by Indian healthcare system? How can we improve?

It is easy to talk about difficulties than solutions which is generally not in Indian spirit. But since you asked, I may highlight five major challenges. The primary healthcare is missing in rural areas, not having enough hospital administration, and corruption in the drugs procurement system as well as management of resources.

Now if you want me to turn these negatives into the positives, I will say India needs more public private partnerships for both primary and secondary healthcare. In terms of producing more doctors and nurses, India can set an example. The utilization of information communication tools can help in updating knowledge and faster delivery.

Can the healthcare start ups their role in healthcare delivery? Have the lack of enough public funding measures curtailed the success of healthcare system?

Pressing priority in India is to develop the primary healthcare. The Tele-health and innovative health technologies can play a significant role here.

There is an ambitious plan to roll out universal health insurance by 2019. But government has to be realistic before announcing it and if once done, should be followed up rigorously. The public funding has to be doubled and conditions made conducive for private funders. Asian country like Indonesia which is just second to India in population, has declared that by consolidating their insurance schemes, it will provide universal health insurance. India can do that too but that requires enormous political will to do so.

You have made strong comments on corruption and mismanagement in India. How and will ever this system be corrected?

The corruption in public healthcare system has reached cancerous levels within the health system here. The mismanagement at the procurement and distribution as well as delivery has been a part of this problem. I think Mr Narendra Modi has made it clear that he won't tolerate the corruption in any form. I am sure; he will follow up on it to see that health is made accessible to all.

How do you look at 'Make in India Campaign'? What are the ways in which Modi government can put the healthcare on fast-track?

Mr Modi has done a brilliant job of adding the value to this country in terms of branding. It is inspiring but I hope he realizes that healthcare requires lot of follow up. Healthcare is the second largest industry in the world and worth approximately $ 7-9 trillion globally. It is a good move to attract investors but now follow through has to happen too.

How do you envision the state of health in various nations in future?

My belief is that if 20th century was the age of healthcare, the 21st century will be the age of health and well being. If you ask me specifically about India, it requires decent, affordable healthcare in the next 15 years. Without a dignified health system, you cannot reach the goal of being a global powerhouse. The country has to continue investments in innovating. We have seen examples in South Korea, Singapore, and Brazil. Even South Africa has shown that the healthcare can be a value creator. India has to follow into their footsteps and stop looking at healthcare as a burden or from cost perspectives only.

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