The art of Health Care in India can be traced back nearly 3500 years. From the early days of Indian history the Ayurvedic tradition of medicine has been practiced. During the rule of Emperor Ashoka Maurya (third century BCE), schools of learning in the healing arts were created. Many valuable herbs and medicinal combinations were created. Even today many of these continue to be used. During his rein there is evidence that Emperor Ashoka was the first leader in world history to attempt to give health care to all of his citizens, thus it was the India of antiquity which was the first state to give it's citizens national health care
Health care facilities and personnel increased substantially between the early 1950s and early 1980s, but because of fast population growth, the number of licensed medical practitioners per 10,000 individuals had fallen by the late 1980s to three per 10,000 from the 1981 level of four per 10,000. In 1991 there were approximately ten hospital beds per 10,000 individuals. The National Health Policy was endorsed by the Parliament of India in 1983 . However, the government sector is understaffed and underfinanced; poor services at state-run hospitals
Primary health centers are the cornerstone of the rural health care system. By 1991, India had about 22,400 primary health centers, 11,200 hospitals, and 27,400 dispensaries. These facilities are part of a tiered health care system that funnels more difficult cases into urban hospitals while attempting to provide routine medical care to the vast majority in the countryside. Primary health centers and subcenters rely on trained paramedics to meet most of their needs.
The main problems affecting the success of health care centers are the predominance of clinical and curative concerns over the intended emphasis on preventive work and the reluctance of staff to work in rural areas.
According to data provided in 1989 by the Ministry of Health and Family Welfare, the total number of civilian hospitals for all states and union territories combined was 10,157. In 1991 there was a total of 811,000 hospital and health care facilities beds. The geographical distribution of hospitals varied according to local socioeconomic conditions. In light of the central government's goal of health care for all by 2000, the uneven distribution of hospitals needs to be reexamined. Private studies of India's total number of hospitals in the early 1990s were more conservative than official Indian data, estimating that in 1992 there were 7,300 hospitals. Of this total, nearly 4,000 were owned and managed by central, state, or local governments.
Another 2,000, owned and managed by charitable trusts, received partial support from the government, and the remaining 1,300 hospitals, many of which were relatively small facilities, were owned and managed by the private sector. The use of state-of-the-art medical equipment, often imported from Western countries, was primarily limited to urban centers in the early 1990s. A network of regional cancer diagnostic and treatment facilities was being established in the early 1990s in major hospitals that were part of government medical colleges. By 1992 twenty-two such centers were in operation. Most of the 1,300 private hospitals lacked sophisticated medical facilities, although in 1992 approximately 12 percent possessed state-of-the-art equipment for diagnosis and treatment of all major diseases, including cancer. The fast pace of development of the private medical sector and the burgeoning middle class in the 1990s have led to the emergence of the new concept in India of establishing hospitals and health care facilities on a for-profit basis.
Present :
Since Independence, improvement in health care services in the country has been one of the most important objectives of public policy. India being a vast country with high population the task was not easy, as the health care base at the time of independence was extremely poor. A lot of money has been spent in the health care sector but the results have not been upto mark. Reach of health care systems is still poor and skewed and various health indicators are much below the globally fixed standards. After grossly missing the targets set under the UNsponsored and supported programme called “Health for All by the Year 2000”, the government of India has recently come out with another ambitious programme called the National Rural Health Mission(NRHM) to take care of the problem in a holistic manner.
With ever growing population, health care and family welfare, along with education, have been quite high on the agenda of social development in the country. It was in the decade of 1990s that the mortality rate in the country reached a plateau and the country faced the dual disease burden. While communicable and waterborne diseases continued to be a problem area, the changing lifestyles of the people in urban areas posed a new challenge of non-communicable diseases including the diabetes, cardiac-related problems and hypertension.
The existing health care system suffers from various problems and deficiencies. There is inequitable distribution of health care institutions and the technical and para-medic manpower. Despite the fact that about 25,000 doctors in modern medicine are produced every year in the country, along with similar number of other practitioners and paramedics, there still exists huge shortage of trained and skilled manpower in the institutions providing primary health care, particularly in the rural areas. The problem is even more pronounced in remote and tribal areas
Future :
The healthcare industry in the country, which comprises hospital and allied sectors, is projected to grow 23 per cent per annum to touch US$ 77 billion by 2012 from the current estimated size of US$ 35 billion, according to a Yes Bank and an industry body report published in November 2009. The sector has registered a growth of 9.3 per cent between 2000-2009, comparable to the sectoral growth rate of other emerging economies such as China, Brazil and Mexico. According to the report, the growth in the sector would be driven by healthcare facilities, both private and public sectors, medical diagnostic and pathlabs and the medical insurance sector. According to the report, diagnostics would contribute US$ 2.5 billion to the healthcare industry by 2012.
An increasing number of public and private healthcare facilities are expected to propel demand for the industry, accounting for another US$ 6.7 billion in this period.
As per a study by an industry body and Ernst & Young, India would require another 1.75 million beds by the end of 2025. The public sector however is likely to contribute only around 15-20 per cent of the required US$ 86 billion investment. The corporate India is therefore, leveraging on this business potential and various health care brands have started aggressive expansion in the country. Some of the companies that plan to increase their footprints include Anil Ambani’s Reliance Health, the Hindujas, Sahara Group, Emami, Apollo Tyres and the Panacea Group.
Sahara Group is planning several healthcare projects such as a 200-bed multi-specialty tertiary care hospital at Gorakhpur in Uttar Pradesh, a 1,500-bed multi super-specialty, tertiary care hospital at Aamby Valley City and 30-bed multi-speciality secondary care hospitals across all the 217 Sahara City Homes Townships.
Meanwhile, Artemis Health Sciences (AHS), a health care venture of the Apollo Tyres Group, is also planning to establish four to eight multi-specialty hospitals in Punjab, Uttar Pradesh, Madhya Pradesh, Rajasthan and Haryana over the next three years.
The rural healthcare sector is also on an upsurge. The Rural Health Survey Report 2009, released by the Ministry of Health, stated that during the last five years rural health sector has been added with around 15,000 health sub-centres and 28,000 nurses and midwives. The report further stated that the number of primary health centres have increased by 84 per cent, taking the number to 20,107.
The Foreign Direct Investments (FDI) in the hospitals and diagnostic center segment has reached a new high this year with total FDI inflow of rs. 35,544,.34 million. This maybe a small but significant step for the health care sector
