India’s population has been growing at a significant rate. Over the past decades, the rate of growth of the Indian population has been one of the highest and the total number is soon to overtake that of China, the most populated country in the world. This, according to the UN, may happen close to 2022. Keeping the other socio-economic, environmental and ecological factors aside, there is one important factor that would be necessary for India of the future to sustain such a population; their access to adequate and timely healthcare options.
By many estimates, the healthcare sector is poised to grow at a significant rate in the coming years. Defined by the IBEF, healthcare sector in India includes hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. Therefore developing the healthcare sector from a jobs perspective, will lead the growth in employment across such areas.
Why delivering in the healthcare sector is crucial
The increasing population pressure would in parts be a major driving force behind the need to have available and accessible healthcare services. Both in terms of geography and the level of healthcare intervention necessary, there seems to be a large gap that the growing reach of the sector can fill. And in the process create a valuable impetus to job growth.
The service sector in India for many years now has been the engine of India’s economic growth. A look at the total GDP contribution shows how vital the service sector in the modern context. This trend is also reflected in the total jobs created within the organized sector.
With the growth rate of manufacturing sector still struggling to reach its former heights and policies like 'Make in India' still to have a significant impact, the services sector becomes a crucial component of the jobs creation equation.
But all is not quite that well within the services sector. Over the last year, two of the biggest employers within the sector has had a turbulent time. The IT sector has had to let go a significant proportion of their workforce during this period. Due to the changing nature of the business and the advent of tech-driven business solutions, the IT sector has also been falling in its job-creating potential. The telecom industry, the other large employer within the services sector has been facing unusually high rates of attrition of its own.
In a period which has been defined as “hypercompetitive”, with companies either closing down or merging to remain in operation, the telecom industry has witnessed mass layoffs. In such times the growing demands of robust healthcare system present a favorable option in front of policymakers.
Healthcare as an employment generator
Within the healthcare sector in India, the government is responsible to provide primary healthcare services while the secondary and tertiary levels of care are usually taken care by the private players in the sector, most of whom are localized in Tier I and II cities. In its effort to bridge this gap in the need for quality healthcare professionals (doctors, nurses and other medical and nonmedical staff employed within the sector) policymakers would also be generating newer avenues of employment.
In its 2016 report on the healthcare system, KPMG mentions:
“The sector offers direct employment to nearly five million citizens in India. Strengthened coverage and increased investments by both public and private players have empowered the Indian healthcare sector, which is expected to generate close to 7.5 million direct opportunities by 2022.” The report then goes on to add, “one physician, on an average, requires support from 5.6 full-time employees to deliver quality healthcare service in different settings. The healthcare system generates more employment per unit established as compared to other sectors that are given priority and supported by the government.”
But in order to tap into this potential within the healthcare sector, a proper coordination between the public and private sector is required.
The same KPMG study points towards the intricacies of the Indian healthcare sector. The report explains that “while the public healthcare network is widespread, a majority of the service share lies with the private sector, which today caters to 70 percent of out-patient and 60 percent of inpatient services.” The sector is projected to continue on its growth path, with an estimated market size of USD 280 billion by 2020.
Although it’s been projected that the private sector is likely to contribute in a major way to this growth, unless the market is favorable for investment, this growth might just remain localized to urban centers, limiting the overall impact on creating decentralized job growth.
The public healthcare system, on the other hand, is also due for an overhaul. Many of the Primary Health Centres who provide basic health care services still remain inaccessible or are still understaffed. According to an estimate put forward by the Minister of State for Health and Family Welfare, of the total 25,650 Primary Health Centres (PHC) in the country, 15,700 have only one doctor in each hospital and 1,974 centers don’t have a single doctor.
Furthermore, in 9,183 centers, there are no lab technicians while 4,744 centers do not have a pharmacist. These are vital areas to fill when it comes to strengthening the public healthcare system. The employment generated by virtue of improving these services come as an added bonus.
How can things actually improve?
As it is with many problems on policymaking, there isn’t a clear-cut solution. Although the rise in demand for quality healthcare services provides great opportunities, the Indian healthcare sector is not without its own set of problems. Problems can often become roadblocks to improvement. Today around 700 million people reside in rural areas, where the current state of medical facilities is significantly weak. In parallel, with the rise of “lifestyle” diseases like diabetes and cardiovascular issues, the need for better secondary and tertiary services is also on the rise. With a shift in focus towards the quality of service, particularly with the rising demand for tertiary and quaternary care, the sector requires specialized and highly skilled resources.
One of the key reasons that many experts blame for the mismatch has been due to the comparatively low budgetary allocation for the health sector (China spends 5.6 times more, the US 125 times more than India). During the last budget session, the Finance Minister unveiled a national healthcare program which, on paper at least, sought to provide basic health cover to many households. But increasing budgetary allocation is perhaps just the first step towards improving the healthcare sector.
Training professionals that can fill in the roles that growing sector demands would be key towards making the healthcare sector an employment generator. Increasing the scope of medical education might also have an impact on shifting people from the unorganized to organized sector of employment.
Today, the lack of job opportunities present in the labor market has made finding quality jobs difficult for millions of odd people that enter the market every year. But by improving the healthcare system, policymakers open avenues that were traditionally unavailable. For example, filling up the vacancies within existing PHCs and improving public-private linkages to bring better services (through telemedicine) into rural areas would create new medical and non-medical jobs.
This sector doesn’t just involve primary caregivers like physicians, surgeons or the nurses, but also a host of other professionals working at physicians’ offices, nursing and residential healthcare facilities etc. Improving the quality of services and training professionals that slip into the various roles within the larger framework can help increase both direct and indirect employment in the sector. Focusing on improving service delivery and establishing clear guidelines that help spur private investment can greatly improve the access to good healthcare services. But all this finally has to also be supported by people having a better access to medical education.
But like any other change, no isolated policy or intervention can bring about the intended effects. A comprehensive approach of policymaking, bringing private players in to provide better services, increasing budgetary allocation and improving the access to quality education and skill building schemes pertaining to the sector become vital for not just pushing the overall state of the healthcare sector but also creating an adequate number of jobs in the process.