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Indian healthcare sector has undergone a transformative evolution. On the one hand, it is ambitiously working to emerge as a global leader in medical innovation and access. On the other, it grapples with acute shortages of infrastructure and skilled medical professionals, said Dr Raj Nagarkar, managing director, chief surgical oncologist & robotic surgeon, HCG Manavata Cancer Centre.
The Ayushman Bharat scheme, technological advancements, like AI-driven diagnostics and mobile health apps, have created efficiency in patient care. Also, India’s pharma industry, recognised as ‘pharmacy of the world’, continues to supply affordable generics globally. The rapid deployment of vaccines during the Covid-19 pandemic showcased India’s logistical prowess and scientific capability, with over 2.2 billion doses administered by 2023, he added.
Healthcare stands at a critical juncture. Persistent gaps in affordability, accessibility, and quality threaten to undermine the gains made. The number of medical colleges have increased from 387 in 2014 to over 700 by 2024. Initiatives like the National Digital Health Mission (NDHM) create a framework for unified health records, enable seamless data sharing and improve care coordination and yet there are unrelenting challenges, Dr Nagarkar noted.
Quoting the Lancet study, he said 55 million Indians are pushed into poverty annually due to healthcare costs. The doctor-to-patient ratio in India stands at 1:834, better than the WHO’s recommended 1:1,000, but this figure masks stark regional disparities as rural areas often have ratios as low as 1:10,000.
Further, the quality of care also varies widely. While private hospitals offer advanced treatments, public facilities often struggle with outdated equipment and overburdened staff. The Covid-19 pandemic exposed these vulnerabilities, with oxygen shortages and overcrowded hospitals highlighting systemic weaknesses. Additionally, non-communicable diseases (NCDs) like diabetes and cardiovascular conditions are rising, and straining an already stretched system.
Primary health centres (PHCs) and community health centres (CHCs) in rural areas function without a full-time doctor, forcing patients to travel long distances for care. The private sector, which accounts for 70% of healthcare delivery, caters primarily to urban and affluent populations. While it offers high-quality care, costs are prohibitive for most Indians. The lack of price regulation in private healthcare exacerbates this issue, leaving patients vulnerable to exorbitant bills, he said.
Rural healthcare is a neglected frontier. The migration of doctors and nurses to urban areas or abroad has left rural facilities understaffed. Telemedicine has helped bridge this gap, but inconsistent internet connectivity and low digital literacy limit its impact. For example, in states like Bihar and Uttar Pradesh, less than 20% of rural households have reliable internet access, he pointed out.
The next decade demands multi-pronged strategies to address these gaps. First, increasing public health spending to at least 3% of GDP is critical. Second, addressing the manpower shortage requires innovative approaches. Additionally, expanding nursing and paramedical training programs can create a robust allied health workforce. Third, technology must be maximised strategically. For instance, start-ups like Qure.ai have developed AI tools to detect tuberculosis from chest X-rays, a model that can be expanded nationwide. Finally, regulatory reforms are essential. Standardizing treatment costs in private hospitals and enforcing transparency can protect patients from financial exploitation, said Dr Nagarkar.
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