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HR CHALLENGES IN HEALTHCARE DR NAGENDRA SWAMY

HR CHALLENGES IN HEALTHCARE DR NAGENDRA SWAMY PRESIDENT MANPAL HEALTH ENTERPRISES. CHALLENGES & OPPORTUNITIES- HEALTHCARE IN INDIA. CHALLENGES

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HR CHALLENGES IN HEALTHCARE DR NAGENDRA SWAMY

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  1. HR CHALLENGES IN HEALTHCARE DR NAGENDRA SWAMY PRESIDENT MANPAL HEALTH ENTERPRISES

  2. CHALLENGES & OPPORTUNITIES-HEALTHCARE IN INDIA • CHALLENGES • Affordability of Quality Healthcare. Currently ~3% of population are covered by Insurance/Third Party Funding • Accessibility to Quality Healthcare, especially in rural areas • Brain Drain: Availability of trained Doctors / Nurses / Paramedics • Intense Competition: Entry of private players, and MNCs • Govt. Spending(<1% of GDP): Low healthcare spending by the government and increased load towards the payment of Salaries (80%) • Ailing Government Infrastructure: healthcare with high maintenance costs OPPORTUNITIES • Recognition as an Industry: Transition from “healthcare” as a Social Responsibility to “healthcare” as a business. • Tap Domestic Potential: Increased Health Insurance Cover, improving Domestic affordability • Integrated Urban-Rural Presence: Tele-Medicine and integrated networks of care to help tap the large rural population • Medical Process Out-Sourcing: Clinical Research, Tele-Radiology, Medical Transcription etc. • Medical Tourism: International community recognizing India as a quality care provider

  3. Healthcare Snapshot • Traditionally, a social sector with high Govt. role • Dominated by Small time players in the Private Sector • Growing @ 14-16 % per annum

  4. SUMMARY: INDIAN HEALTHCARE MARKET • Indian healthcare a US $ 35 billion industry, expected to reach US $ 75 billion by 2012 and US $ 150 billion by 2017. • Will grow at the rate of 10-12% over the next few years. • WHORecommends India to add 80,000 hospital beds a year for the next 5-8 years to meet the demands of healthcare sector • 4 MN PEOPLE ARE EMPLOYED, MAKING IT ONE OF THE LARGEST SERVICE SECTORS IN THE ECONOMY GOING UP TO 9 MN IN 2015 • Clinical trials have the potential to become a US$ 1 billion industry by 2010 and the health services outsourcing sector has the potential to grow to US$ 7.4 billion by 2012, from US$ 3.7 billion in 2006. • Private Equity funds are expected to invest at least US$ 1 billion in the healthcare in the next five years.

  5. SUMMARY: INDIAN HEALTHCARE MARKET • With only 10% of the Indian urban population covered by health insurance, the sector has growth potential of US$ 5.75 billion by 2010 • In fact, 84% of hospital beds are in urban areas, whereas 75% of the population still resides in rural villages. • Medical tourism will be a US$ 2 billion industry by 2012, growing at 25-30% annually. In 2007, India treated 450,000 foreign patients and ranked 2nd in medical tourism globally.  • The total healthcare market with Pharma will be US$ 53 – 73 billion (6.2 – 8.5 per cent of the GDP) in the next 5 yrs • The Indian middle class estimated at 300 million has strong Purchase power. • According to Ernst & Young, the Indian medical equipment industry was US$ 2.6 billion in 2006 and is growing at 15 per cent and expected to reach US$ 4.5 billion by 2012. Only 35 per cent is accounted for by the domestic sector, while the rest is imported

  6. Figures in Rs crore * Projected Source: Healthcare services in India:2012, the path ahead. ASSOCHAM-YES Bank, 2009; McKinsey 2007

  7. CHANGING – DISEASE PROFILE Expected to Decrease • Lower Respiratory Tract Infection • Diarrhea diseases • Perinatal Conditions • Measles • Malaria • PEM • Anemia • Expected to Increase • I.H.D • COPD • CVA • Diabetes • Cancer • Road Traffic Accident • HIV • Psychiatric Conditions Transition from Infectious & Nutritional Diseases to Chronic & Lifestyle related diseases Source: www.cia.gov - Fact Book UK /USA 2007

  8. CHANGING – DISEASE PROFILE • USD 237 Billion in National Income for India Loss due to CNCD in 2015 • Globally over 36 million will die of this epidemic- 80% death is lower and middle income groups- amounting to 44% of premature death world wide. • This is double the number of deaths dues to infectious diseases. • WHO report • FOCUS ON PREVENTIVE TO CURATIVE: • Life style modification • Early Diagnosis • Ancillary & Auxiliary Therapies • Prophylaxis • Utilization of Genetic & Biotechnology

  9. MARKET REALITY • India has only 0.7 beds per 1000people in contrast to the average of 3.3 beds per 1000 in other countries. • The demand completely eclipses capacity. India needs 80,000 beds each year for the next8- 10years at Rs 50,000 cr per year. • Double the number of doctors from 0.7million to 1.5 million • Triple the number of nurses from 0.8 to 2.5 million. • Four times the number of paramedics from 2.5 to 10 million. • 60% of the 15,393 hospitals and 80% of all qualified doctors are in private sector

  10. MANPOWER GAP

  11. HEALTHCARE TODAY Industrial Age Medicine to Information Age Medicine

  12. UNIQUE CHALLENGES OF HEALTHCARE ( HOSPITALS)

  13. Healthcare Today Cures Reach Ego Compassion Emotions & Feelings Family & Friends Patient Friendliness Labor intensive Cost Super Specialty Technological Advancements Hope Continuum of Care Complex Quality Health Tourism Anxiety Expense Commercialization Healing Managed Care Telemedicine

  14. Attendants Security Staff Housekeeping Lift Operators Canteen Room Boys Counselors Receptionist Technicians OT Staff OPD Secretaries Dietician Pt. Care Coordinators Admissions Admin Manager Nursing Pharmacist PRO Cashier Super Specialist Primary Physician Anesthetist Radiologist Physiotherapist Jr. Doctors Sr. Management • LOW • Socio-Economic Status • Education Levels • Intellectual Capability • MEDIUM • Socio-Economic Status • Education Levels • Intellectual Capability • HIGH • Socio-Economic Status • Education Levels • Intellectual Capability Healthcare Organization PATIENT / RELATIVES • LOW • Socio-Economic Status • Education Levels • Intellectual Capability • MEDIUM • Socio-Economic Status • Education Levels • Intellectual Capability • HIGH • Socio-Economic Status • Education Levels • Intellectual Capability HEALTH CARE TODAY(Spectrum of Skill Sets Involved in Service Delivery) Complex interaction

  15. CHANGING TRENDS Transformation of Patients’ Status, Hospitals’ Attitude and Doctors’ Profession PatientsCustomersGuestsBlood Relatives HospitalsHospitality Homely Care Profession Generalist Specialist Super specialists Sub Specialist

  16. Ego Levels vs. Criticality of Organs Ego Levels of Health Professionals Anatomy handled CHANGING EGO LEVELS

  17. CHANGING TRENDS-BEHAVIORAL • Doctors • More Communicative, Humility • Doctor–Patient Relationship • Hospital-Doctor Relationships • Encouraging Second Opinion • Integrated approach- Respect all systems • Patient Safety / Medical Errors • Patients • Patient Education and Charter of Right • More Demanding • Nursing, Paramedical & Administrative Staff • Equipped with Tech Tools • Care Beyond Nursing

  18. PREPARING THE 21ST CENTURY GLOBAL HEALTHCARE WORKFORCE To meet the growing global demands of caring for the increasingnumbers of patients with chronic conditions, we need to developa new approach to training. A different set of competencies The five basic competencies Patient centred care Partnering Qualityimprovement Information and communication technology Publichealth perspective

  19. QUALITY AND QUANTITY OF HUMAN RESOURCE TO ENHANCE • The Govt Policy must encourage PG Courses so that Hospitals meeting certain minimum criteria can offer these courses with relaxation in terms of restrictions. ( Fellowship / DNB) • Qualitative Educational Institutions to be commenced. • Continued medical education (CMEs) for medical, nursing and para-medical professionals, • Mandatory credentialing of Medical Professionals while recruiting. • The current compulsory rural stint for medical professionals. • Huge Health cities/ medi-cities will induce employment and even provide human resources through education facilities. • To have 2nd line – Health Assistants to assist Nursing in non clinical work and Physician assistant programmes • To give importance to Healthcare management programmes and make them popular career option. • Staff for accreditation programmes- NABH / NABL/ JCI / ISO etc

  20. FEW DAUNTING CHALLENGES • ACUTE SHORTAGE OF QUALIFIED AND TRAINED STAFF • GETTING REPLACEMENT IN TIME – SERVICE GETS EFFECTED • UP COMING NEW FACILITIES TAKING AWAY TRAINED STAFF WHICH RESULTS IN REPLACEMENT BY UNTRAINED STAFF- GAPS IN SERVICE. • MOST OF THE CONSULTANTS ARE ON CONTRACT, NON-EMPLOYEE STATUS WHICH MAKES IT DIFFICULT TO MANAGE THEM. • ABSENCE OF BENCH MARKING FOR STAFF : BED RATIO • QUALITY / PATEINET SAFETY / MEDICAL ERRORS – PROACTIVE REPORTING. • INCREASED MEDICO-LEGAL RISK, COMPLIANCE TO STATUTORY OBLIGATIONS. • IR ISSUES AND LABOR UNION ACTIVITIES. • VICARIOUS RESPONSIBILITY OF CONTRACT EMPLOYEES.

  21. THE REAL CHALLENGE IS …….. Managing Diversity

  22. MHB – Awards and Accolades NABH

  23. 2006 2005 2004 Recognition & Awards 2010 2009 2008 2007 Ranked 1st in Bangalore for the 7th consecutive year by ‘The Week’ among ‘India’s Best Hospitals’

  24. Sources: McKinsey report – Technopark- E&Y – KPMG- WHO-Cygnus -ASSOCHAM-YES Bank-MOH- CRIS-INFAC-IRDA-HOSMAC-NIPER- Netscribe-FIICI THANK YOU VERY MUCH FOR YOUR PATIENCE - Dr Nagendra Swamy

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