The ailments — failure to develop institutional healthcare system, failure to establish credible local patient base, tariff structure inappropriate to customer base, inability to create centres of excellence, failure to invest in training and manpower, lack of transparency in packages, poor understanding of patient’s needs and pocket.
If Bengal’s public healthcare delivery system is pathetic, its private counterpart ranks no better than poor. And this is the diagnosis of a large section of senior doctors in active practice. This, in spite of the built-in opportunities — a woefully inadequate government infrastructure, a huge hinterland, no worthwhile competition in the region or in neighbouring Bangladesh…
The constant exodus of patients down south, up north and away west tells the tale. “Almost all major corporate hospital ventures here have struggled with poor capacity utilisation, and it’s time the profession recognised it is terribly under-achieving and wakes up from its slumber of complacency,” observes Kunal Sarkar, consultant cardiac surgeon, Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), who will be presenting a paper along these lines at The Health & Wellbeing Show 2003.
A glance at Calcutta’s cardiac case count alone would point to the grim prognosis. The total number of heart surgeries conducted in the city in a month has crawled from 210 in 1999 to 280 in 2002, spread across 13 centres. Narayana Hrudayalaya in Bangalore alone does at least 300 cases a month and Escorts in Delhi more than 350 procedures. Going by sheer need, Calcutta should target a minimum of 500 heart operations every month, doctors concur.
“Most of the corporate hospitals in Calcutta have got their pricing wrong,” feels Amit Ghose, consultant urologist, CMRI, Woodlands and Anandalok, co-chairman of the health committee of the Bengal Chamber of Commerce and Industry. Hospitals should be doctor-driven, rather than management-driven, asserts Ghose. “And rates must be tailored to suit the middle-class, which forms the core body of patients in private centres,” he adds.
Sarkar ascribes the poor growth rate in healthcare to “a nihilistic indifference to fundamentals”, including failure to establish a credible local patient base, inadequate manpower and infrastructure and, of course, inappropriate tariff structures. “The so-called patient packages are like a poisoned chalice, lacking transparency in most cases,” he argues.
Satadal Saha, general surgeon and MD of Westbank Hospital, agrees that there is an appalling lack of transparency and an endemic pricing problem.
“That is largely because Bengal has failed to develop a holistic institutional healthcare system over time. Medicine has remained oriented towards individuals, seriously impacting the final quality we are imparting,” observes Saha.
Doctors might differ on the deficiency parameters. But most agree on the absence of the “human face” in dispensing treatment at most corporate centres. The system is also plagued by patchy attempts at quality benchmarking, little investment in training and manpower development, unholy nexuses to peddle needless technology, poor understanding of patients’ needs and paying power, and myopic marketing.