Affordability of Health Care is a Serious Problem for Vast Majority of Population, Especially in Tertiary Care – Vice President

Vice President Address at 5^th foundation Day and 2^nd Convocation of the Institute of liver and Biliary Sciences

New Delhi, Jan 22, 2015 – The Vice President of India Shri M. Hamid Ansari has said that affordability of health care is a serious problem for the vast majority of the population, especially in tertiary care. The lack of extensive and adequately funded public health services pushes large numbers of people to incur heavy out of pocket expenditures on services purchased from the private sector. Addressing at “ 5^th Foundation Day and 2^nd Convocation of the Institute of Liver and Biliary Sciences” here today he said that Healthcare infrastructure gaps remain substantial and are exacerbated by underutilisation of existing resources. The situation is further aggravated by the inequity in healthcare delivery across states and demographic segments. Rural areas are especially poorly served. Around seventy percent of our population lives in rural areas but only two percent qualified doctors are available in these areas.

He expressed his concern that Healthcare workforce remains inadequate and underutilised. Regulatory standards for public and private hospitals are not adequately defined and, in any case, are ineffectively enforced. A well functioning and effective regulatory system is required to manage the large and diverse set of healthcare service providers. The problems outlined above and some more are likely to worsen in future. Healthcare costs are expected to rise because, with rising life expectancy, a larger proportion of our population will become vulnerable to chronic Non-Communicable Diseases which typically require expensive treatment.

The Vice President opined that the bulk of the population today relies upon private sector health providers, paying amounts which they cannot afford, because of the inadequate reach of the public sector. There must be substantial expansion and strengthening of the public sector health care system if we are to meet the health needs of rural and even urban areas. As supply in the public sector increases, it will free the vulnerable sections of society from dependence on high cost and often unreachable private sector health care.

He said that the Institute of Liver and Biliary Sciences is a fine example of what the public sector can do and must do in the actualization of our desired goal to have a universal health coverage and thereby ensure healthy and economically productive population. He complemented all members of the Governing Council of the ILBS, Dr Sarin and his entire team for making the coveted vision of establishing new super-speciality medical institute a reality. He hoped that the Institute would continue to deliver quality public and community health care for all in the future and set a worthy example for other institutions to follow.

Following is the text of Vice President’s address :

“I am happy to have been invited for this ceremony to mark the 5^th Foundation Day and 2^nd Convocation of the Institute for Liver and Biliary Sciences (ILBS). I congratulate the management, staff, students, faculty, alumni and all others connected with the Institute on this joyous occasion. I extend my warm felicitations to the students who are graduating today. It is their hard work and dedication which has brought them to this stage in their academic life. Their journey in life, beyond the portals of the Institute, begins now. My advice to them today is to continue the relentless pursuit of excellence which, as Aristotle said, is never an accident and always the result of sincere effort: “choice, not chance, determines your destiny”.

As you move ahead in your professional life, use your knowledge and skills for the well being of the largest numbers of your compatriots, and even others, who may require your help. Create facilities and train fellow doctors in other institutions, so that the specialisation which you have acquired at the ILBS becomes available to more and more people, especially the poor and the needy, in every part of our country.

Since its inception, the Institute of Liver and Biliary Sciences has emerged as a high-quality super-specialty, medical and research institute, providing a high-class facility for diagnosis and treatment in the field of Liver and Biliary Diseases. The Institute following a unique model of university-based hospital and patient care has amalgamated teaching and research as its core values.

I understand the Institute has treated thousands of patients suffering from liver disorders and has performed the highest number of liver transplants amongst all government institutions in the country. It has been declared by the World Health Organization as a Collaborative Centre on Liver Diseases, the first such global centre. The Institute is also emerging as an acknowledged centre for excellence for study and research in liver and biliary sciences.

The credit for these achievements goes collectively to the doctors, nurses, faculty, staff and the leadership of the Institute whose professionalism, hard work and commitment have borne these fruits. They are all worthy of our commendation and applause.

As we celebrate the achievements of the ILBS, we must remain cognisant of the fact that the health outcomes and the quality of the underlying healthcare system in our country lags behind peer nations. In 2000, the World Health Organization’s global healthcare profile ranked India’s healthcare system 112 ^th out of 190 countries. Since then, concerted efforts have been made by the Government and private sector but the outcomes have been mixed. India still lags behind other comparable countries in most healthcare parameters.

While total healthcare spending as a percentage of GDP in India is comparable to other developing countries, at similar levels of per capita income, public spending on health is very low by any standard. Even the total healthcare spending is not commensurate to the increasing demand for healthcare.

Affordability of health care is a serious problem for the vast majority of the population, especially in tertiary care. The lack of extensive and adequately funded public health services pushes large numbers of people to incur heavy out of pocket expenditures on services purchased from the private sector.

Healthcare infrastructure gaps remain substantial and are exacerbated by underutilisation of existing resources. The situation is further aggravated by the inequity in healthcare delivery across states and demographic segments. Rural areas are especially poorly served. Around seventy percent of our population lives in rural areas but only two percent qualified doctors are available in these areas.

Healthcare workforce remains inadequate and underutilised.

Regulatory standards for public and private hospitals are not adequately defined and, in any case, are ineffectively enforced. A well functioning and effective regulatory system is required to manage the large and diverse set of healthcare service providers.

The problems outlined above and some more are likely to worsen in future. Healthcare costs are expected to rise because, with rising life expectancy, a larger proportion of our population will become vulnerable to chronic Non-Communicable Diseases which typically require expensive treatment.

My intention in spelling out the myriad challenges before us in the healthcare sector was not to devalue the work done or underestimate the progress made since independence. My purpose is to underscore the unfinished agenda that is before us, especially for you all who work in this field. In view of the large population size and the stark social and economic realities of our country, the healthcare system, especially the doctors, have performed to the best of their ability. We are thankful for the services rendered and proud of the work done by them.

However, much more needs to be done before we can attain our long-term objective of universal health coverage, which has been defined as ensuring equitable access for all Indian citizens in any part of the country, regardless of income level, social status, gender, caste or religion, to affordable, accountable and appropriate, assured quality health services (promotive, preventive, curative and rehabilitative), with the Government being the guarantor and enabler, although not necessarily the only provider of health and related services.

The realisation of this objective will require filling the existing gaps in healthcare spending, infrastructure and workforce by increasing significantly the resources deployed and better utilisation of existing ones. Issues of availability, affordability and quality need to be addressed. Our healthcare system will have to be prepared to cater to a much higher demand for healthcare services as inclusive growth will raise incomes and living standards for all sections of society.

The bulk of the population today relies upon private sector health providers, paying amounts which they cannot afford, because of the inadequate reach of the public sector. There must be substantial expansion and strengthening of the public sector health care system if we are to meet the health needs of rural and even urban areas. As supply in the public sector increases, it will free the vulnerable sections of society from dependence on high cost and often unreachable private sector health care.

The Institute of Liver and Biliary Sciences is a fine example of what the public sector can do and must do in the actualization of our desired goal to have a universal health coverage and thereby ensure healthy and economically productive population.

I once again complement all members of the Governing Council of the ILBS, Dr Sarin and his entire team for making the coveted vision of establishing new super-speciality medical institute a reality. I hope that the Institute would continue to deliver quality public and community health care for all in the future and set a worthy example for other institutions to follow.

Let me conclude by leaving a thought for the graduating students. Gandhi ji said that ‘ the best way to find yourself is to lose yourself in the service of others’. So, in the years ahead, remain true to your Hippocratic Oath and take the opportunity your noble profession offers by rendering selfless services to your fellow beings, especially those who are the neediest, irrespective of their origin, economic status, caste or creed. By doing so, you will become better human beings and even better professionals. You will also make the world a much better place for everyone to live in.

I thank Dr. Sarin for having invited me. I wish you every success in the years ahead.

Jai Hind.” CCI Newswire