INDIA'S HEALTHCARE IS FRAGMENTED - NEEDS TO BE FIXED

India's Healthcare System is Fragmented = Fuzzy Boundaries for eGovernance.

900K Doctors in India
50% in 4 large metros
40% in Tier 1 and Tier 2 cities
10% in semi-urban and rural India below that
There are Only 5000 Seats for Specialist Doctors every year.
Majority of Doctors go into Primary and Secondary Care.
Women and Child Health remains main focus because 
India adds 1 Australia to its Population every Year.

India has 1 Bed to 1000 Population
WHO recommends 1 Bed to 300 Population
5% are >150 bed facilities
5% are 50-150 beds facilities concentrated in Tier 1 and Tier 2 cities.
90% beds are in small Clinics and medium size Nursing Homes < 50 Beds.

Over 100,000 Labs
60% are Unorganised small and medium size Labs
<20% are Organised Labs
20% are Hospital based Labs
Only 1% of the Labs are Accredited by NABL
Total market size between INR 40-60K Cr.

65K Stockists and 750K to 1M Retail Pharmacies
6% of the total Sales come from Organised Pharmacies
6% of the total Sales come from Hospital Pharmacies

#IndiaHealthcare Ranks 154 Among 195 Countries in Healthcare Index: According to the Global Burden of Disease Study (GBD) published in the medical journal The Lancet, India ranks 154th among 195 countries on the healthcare index.

Healthcare is a state subject. Centre govt funds 85% of most public health programs. However all the regulation and execution authority is with States. The states are free to accept or totally reject any healthcare ruling from the center. India is too diverse to expect a single Healthcare solution across all States. Unity in diversity is elusive.

MoHFW regulates the public health only. That too most of it is done by respective Directorates under the various Disease Control Programs. Rest of Healthcare eludes MoHFW.

Pharma sector is governed by DCGI which is an independent body. It has dotted line reporting to the Min. of Chemicals. It has no direct connection to MoHFW.

Health Insurance is governed by IRDA which is an independent body. It has no direct connection to MoHFW.

Hospitals standards are defined by NABH. Lab standards are defined by NABL. NABH and NABL are part of QCI which is an independent body but it has no teeth to enforce.

Building new Govt Hospitals e.g. AIIMS and Govt Medical Colleges is given to independent bodies like HLL/HITES or HSCC, again with no direct connection to MoHFW.

Doctors practices, medical education and Primary care comes under MCI. This is an independent body. It has no direct connection to MoHFW.

Out of 40K Doctors coming out of Medical Colleges every year only about 5K get into MD/MS/PG Specialty courses. The rest remain in the rat race to get into that limited Specialty seats. Some of the gap is filled up by DNB Specialty seats, but MCI keeps DNB at arms length and doesnt want to give it the deserved recognition. Rest of the new Doctors don't want to serve in Private practice but would rather serve as RMO in secondary /tertiary Hospitals. Primary Healthcare is breaking down in this country. These Doctors are concentrated in Tier 1 cities and some Tier 2 cities. Cant find much qualified Doctors below the District and rare to find any at Tehsil/Taluka level towns. Obviously the gap is filled by quacks or quasi medical professionals.

Clinical establishment bill has been pending for discussion in parliament for ever. National Identification Number [NIN HFI] for Healthcare Facilities of India hasn't been implemented across public and private as yet.

Radiology centers are controlled by BARC, which is an independent body which comes under Dept. of Atomic Energy. It has no connection to MoHFW.

There is no regulatory control over - Emergency support, Technicians, GDAs etc. The National Paramedical and Auxiliary medical staff Councils are still elusive.

Almost all Pvt. Medical Collages openly flout MCI standards as they enjoy political patronage.

I didn't even go into other areas e.g. medical research.