A big announcement, with perhaps far reaching implications in the Indian healthcare sector, was made on Thursday. The Union Cabinet chaired by Prime Minister Narendra Modi approved the Allied and Healthcare Professions Bill, 2018 for regulation and standardisation of education and services by allied and healthcare professionals.
The bill provides for setting up of an Allied and Healthcare Council of India and corresponding State Allied and Healthcare Councils, which will play the role of a standard-setter and facilitator for professions of Allied and Healthcare. A much needed measure many would say.
The allied health professionals in India are not covered by medical or nursing councils. Think: lab technicians, X-ray technicians, ICU technicians or people who are not covered by any other council and are currently unregulated.
There are over 100 such categories across every branch of healthcare - in eye care for instance: optometrists, in ear problem: audiologists, for diabetes care: diabetologists - covering large number of people across the country.
You would want such critically important professionals to be regulated and adhere to high quality. Since, much of this is still wanting, the plan for new councils for them is arguably much needed. But then this bill has been in the works for over five years now, what is clearly apparent is that this is at best a good starting point.
The bigger challenge lies in effectively implementing it. As every institution teaching these professionals will need to be accredited and those coming under regulation, will fight tooth and nail and given the history of healthcare regulation in India, there could be scope for manipulation.
Also, while the act may lay down strict regulations, what happens when the supply of professionals is less than the demand? How will stipulation on higher qualifications help if supply of talent is not matched? Regulation, after all, works best when the regulators as well as those to be regulated understand the need to be disciplined. Are the regulators always well intentioned?
Ask some private healthcare providers and those within the government in turn point to the various training shops that tend to duck the strict standards and regulations.
After all, this act should not be good only on paper and well drafted piece of regulation but be one that is effectively implemented. And the reason people are sceptical is because there is so much money involved that there is always the danger of abuse. How can that be minimised?
State government and medical community must all be on board and young people joining training courses to be such professionals must see the need for standards - laying down the curriculum, syllabus and laying down the period of training.
How many hospitals today publicly declare their rates and are transparent about their pricing? Also, what if the training provided is not matching and is shoddy?
Every provider, be it a pathology lab that is keen on quality or a diabetics chair that wants to retain its reputation, will need to continue what they do today, which is to largely train their own people.
It all boils down again to history of healthcare regulation in India. It certainly has room for improvement and therefore what is being done to ensure that the new councils will not go down the same path and instead chart out a new course? Also, what will be done to ensure that this will not be used by the big and powerful healthcare providers for eliminating smaller players under the garb of enforcing quality?
What be the view on ensuring high quality delivery in tier II and tier III cities and towns, where even doctors are in short supply, not to talk of high quality allied healthcare professionals? How all these questions get addressed, still needs to be seen.