Shahid Akhter, editor, ETHealthworld spoke to Manoj Jhalani, Add Sec, MOHFW & MD (NHM), Mission Director, Ayushman Bharat (NHPS), Ministry of Health & Family Welfare, Govt. of India, to understand more about the government’s flagship National Health Protection Scheme. Edited excerpts :
Ayushman Bharat- Mission & Vision
Ayushman Bharat is a historic opportunity, this is the next level of healthcare which is organised on a platform of health and wellness centres and then covers the primary, secondary healthcare and the tertiary healthcare. So this is the principle vehicle for achieving universal health coverage which will ensure that citizens of this country are able to access quality healthcare in an affordable manner.
How will the new scheme add value to the existing primary health centres?
What is difference between an existing sub-health centre or PHC and a health and wellness centre will provide comprehensive level of primary care. So far we were providing selective level of primary care largely limited to our CHC and care limited to communicable diseases like TB malaria etc, but the care in relation to non communicable diseases mental health etc was generally not available. So the health and wellness centres will provide much wider band of services including non communicable diseases. The second difference is a big focus on prevention and health promotion.
Today if you look at healthcare it is fractured care, you go to a facility they provide you a care and they request you to come back again after a fortnight or so. What we are not looking forward to an entire organisation of healthcare where the primary healthcare system works in a manner that they identify cases which need to be referred to secondary or tertiary care and then under NHPS. Such cases get addressed and receive free care under the national health protection scheme at the secondary and tertiary level. Subsequent follow up of these cases happens again at the primary healthcare level.
Overall it is going to be a game-changer for the Indian healthcare and it will require very large partnership among various stakeholders.
To what extent IT has been incorporated?
A big important element of this Ayushman bharat is a very robust IT backbone and what we are looking forward to is a next generation state of the art and the best IT systems in the world and we are involving the best minds in the country to advisors in terms of how to create that health system.
We are having some track 1 which is 4-6 months duration where we will operationalise certain modules. Then track 2 which is a much bigger and much far sighted state of the art IT backbone which will facilitate this organisation of healthcare in a continuum.
Measures that you have taken to ensure quality and safety?
Quality both interms of safety as well as in term of satisfaction for the patients, so one of the things that we are going to do within the National Health Protection Scheme is that when the hospitals will be empanelled there will be differentiated rates for those hospitals which are NABH empanelled and those which are not so that help for even better hospitals or high quality hospitals also to come and join NHPS. So there is likely to be differentiated rates and that is the broad understanding…
We have launched a “Mera Aaspataal” application where we try to capture the feedback of the patients who visit various healthcare facilities and seek feedback about their experience in those healthcare facilities and rate them on the basis of feedback of the patient. We have more than 1000 such hospitals under this application that the government of India launched where the patient is satisfied or not satisfied and then the ranking of the hospitals are created. So these are small measures which have been initiated, within the public health system, we have created a National Quality Assurance Programme and there is a mechanism for certification of public health hospitals which can also happen in a graded way, that they could pick up not all the 18 departments but some of the departments get certified first and other departments get certified later.
Are the fundings in sync with the scheme?
I think funding is adequate. Different states may role out NHPS at different times as they have an existing scheme so there is a possibility that not all state may be able to start on the same date and some other states. A very critical thing that the finance minister announced was a provision of health and education cess, which is now four percent of the income tax and the corporate tax. This will generate an additional 11 crores so that is more than adequate to meet our requirements.