Even as the Indian healthcare sector has grown rapidly over the past few years to become one of the largest contributors to the country’s GDP, it is still at a nascent stage. Reason? Making quality healthcare accessible to a billion-plus population is a major challenge that the Central and state governments are trying to grapple with. The doctor patient ratio in India, stands at 1:1700, as per a report jointly published by KPMG and FICCI. That is abysmally low. So, what steps can the government take in such a situation? “The government of Uttar Pradesh is all set to roll out a state health policy,” UP health minister Sidharth Nath Singh disclosed during a chat with BW Businessworld’s Paramita Chatterjee. The fine prints have been worked out and the policy document will be presented to the Cabinet, he said.

Once approved, UP will become the second state after Karnataka to have its own health policy, which to an extent will address the problems pertaining to the imbalances in the healthcare sector at primary and secondary levels. “For instance, we don’t need qualified MBBS doctors to give primary clinical care. This also can be given by para-medical or nursing staff. What we need here is skilling. Once that is done, a small part of the problem will be taken care of,” said the minister at the Ayushman Bharat Healthcare Summit jointly organised by BW Businessworld and India Virtual Hospital.

Edited excerpts:

The much-talked about NHPS can prove to be a game changer going forward. But the biggest challenge lies in financing and implementation. What is your take on these issues?
Well, to begin with, we have already had the Rashtriya Swasthya Bima Yojana (RSBY). But it was never rolled out the way the NHPS is being rolled out. To put it simply, the NHPS is like a universal health coverage where you are covering almost 10 crore families that roughly make up about 40-45 per cent of the country’s population. So, in that sense, this is a big initiative and Uttar Pradesh has a big role to play in its implementation. We are a big state and we do aspire to become the true backbone of any health services — or for that matter, any other services — in the country. We have that extra responsibility on our shoulders. Fortunately for us, we have been in a position where we have learnt a lot about RSBY. The previous government had discontinued RSBY almost two and a half year ago and we decided to roll it out again. Last year, we did a lot of preparation and our deliberations were quite intense. We met insurance companies, private and public hospitals and that, in turn, helped us do some groundwork on how NHPS will operate.  
 
Apart from the coverage, both in terms of the insured amount and the population to be tapped, what would you say are the key differences between RSBY and NHPS?
I think the key difference lies in the number of ailments NHPC is slated to cover. Going forward, there will be a lot of focus on secondary healthcare. So far, that was missing as there was more focus on tertiary care. In fact, now with the due focus on secondary healthcare, we will be in a position to facilitate the PPP model in tier-2 and tier-3 cities. Besides, as I mentioned earlier, NHPS is a pan-India scheme — one that will have the same IT platform across India, the same platform for selection, the same platform for claims to be settled. Once everything is in place, delivery should not be a problem.
 
So, have you tied up with hospitals?
We already have a list of hospitals that we have tied up with. During RSBY, we had done a lot of groundwork. In that regard, I would say that we are well prepared. So much so that we are targeting August as the deadline.
 
Apart from RSBY, many states already have their own healthcare financing schemes. Now, given that healthcare is more of a state subject in India, do you think there will be any overlap while implementing NHPS?
 You see there has to be a convergence of schemes. The states that have already launched these health insurance schemes need to bring some conversions to NHPS. After all, there is no other scheme which covers such a vast population to such an extent. In that regard, I would say, it is advisable that everyone stops playing politics  with it and adopts the scheme to cover the poor. After all, sometimes you need to leave politics behind for the larger interest of the nation; you unite to deliver something together and what better when it is for the poor.
 
In terms of delivery, all eyes are currently on the smooth implementation of systems for on-boarding, quality management and payment from the government. Your comments.
You have to use the technology in the right way. Therefore I said just a while ago that an IT platform has to be backbone of the scheme. The Central government is currently in consultation with Niti Aayog and they, in turn, are preparing the IT platform. Once that’s done, a state can always tweak it according to its own requirements. In my view it will be done soon as enough homework has been done on the subject.
 
In India, the main problem is that there is a huge paucity of doctors. Besides, making healthcare affordable to the masses is also another challenge. Your thoughts…
Well, we in Uttar Pradesh are all set to roll out a state health policy. The fine prints have been worked out and it will soon be tabled before the Cabinet. In fact, once approved, the state will become the second after Karnataka to have its own health policy. It will address problems pertaining to the imbalances that exist in the healthcare sector at the primary and secondary levels. For instance, we don’t need qualified MBBS doctors to give primary clinical care. This also can be given by paramedical or nursing staff. So what we need here is skilling. Once that is done, a small part of the problem will be taken care of. We plan to take this up in our state health policy. Of course, we do understand that currently there is a huge paucity of doctors. We want to address that. We want to increase the number of doctors, nurses, paramedical staff. Telemedicine is the other area that has huge scope. Through that, we will be able to reach the remote corners of the state.

Having said that, in our state health policy we are also looking to bring in a ‘referral policy’ wherein a doctor will have to offer an explanation for referring a patient to another medical practitioner.  Besides, we are also looking to set up trauma centres.

You see, the dream of any state government or health minister is to make healthcare affordable to the masses. This can be done through Ayushman Bharat once all stakeholders come together.