IN 2006, THE WEEK flagged off its Best Hospitals survey to help readers make an informed choice. This year, THE WEEK initiated an awards ceremony, which was, like everything else these days, held online on November 23.
It was a Monday morning, yet the event attracted some of the best medical minds in the country. The keynote speaker was Dr Randeep Guleria, director, AIIMS, New Delhi. As the man who set up India’s first centre for pulmonary medicine and sleep disorders, he was ideally placed to look at how Covid-19 has changed health care’s future. Adaptability was key for AIIMS, he said.
From strengthening the basics, to reassuring and strengthening team members, and receiving wisdom from unlikely corners, the past nine months have been filled with learnings, said Dr Guleria. “We used to hold meetings in the morning and evening with all staff, and sanitation workers or hospital attendants would (flag issues) we would not have thought of as members of the faculty,” he said. As with most heads of hospitals, the problems that crossed Dr Guleria’s desk were not just medical.
Looking forward, he said that the spotlight would be on infection control in all hospitals. Investing in the upskilling of ancillary staff was another area that needed attention, Dr Guleria said. He signed off emphasising that preventive health care would decrease the load on hospitals and lead to a healthy nation.
The keynote address was followed by a panel discussion led by Special Correspondent Namita Kohli. The panellists were Dr H. Sudarshan Ballal, chairman, Manipal Hospitals; Dr Santosh Shetty, executive director and CEO, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute; Dr Bobby John, global health advocate and editor, Journal of Development Policy and Practice; and Dr Naresh Trehan, CMD and chief cardiac surgeon of Medanta-The Medicity.
Dr John started off from where Dr Guleria had stopped and said, “It seems we are discovering infection control with every new challenge. With HIV we discovered universal precautions, but nothing was done on the Hep B/C side which had the same modes of transmission. Tuberculosis and SARS taught the value of cough etiquette and use of masks.” He quipped that the benefits of hand-washing were discovered 150 years ago, but it had to be taught all over again in 2020.
While emphasising that he was not indicting anybody, Dr John pointed out that India was rather slow in picking up the Covid-19 signal. “In future,” he said, “we will need a better understanding of the signal and the scale to devise an appropriate response.”
Elaborating on the scale of the infection, Dr Ballal said, “We have all learnt in the past nine months that a country is only as strong as it health care system. No matter how mighty your military is or how big your economy… it comes down to health care.”
A blessing that Covid-19 brought with it, he said, was the boost that telemedicine received. “For years… we were mired in regulatory issues,” he said. “And, in a week’s time in March, all the regulatory issues were taken care of.” This move has far-reaching consequences, he said, especially in solving “rural health famine”, the paucity of doctors, and in a future where hospitals will push day care or out-patient care in a big way.
Coming from one of the heavily hit metros, Dr Shetty said the challenges were many in Mumbai, starting from the lack of public transport for health care workers. “It was scarcity all around,” he said, “scarcity of information about the virus. Scarcity of PPEs and N95 masks….”
Dr Shetty said hospital design was bound to change. “Flexibility in design will be seen, especially in hybrid hospitals like ours that treat both Covid-19 cases and regular patients,” he said. “Health care will move to a system where large parts of a hospital can be turned into negative or positive pressure areas, (with suction and central oxygen).”
Dr Trehan emphasised the need for the common man to take responsibility in a pandemic. “Considering our country’s diversity in income, education, language, habitat, demographics… we have done well in dealing with Covid-19,” he said. “But, if people are irresponsible, the health care industry or the government cannot do anything despite being proactive.” While discussing the costing of medical care, Dr Trehan said the issue was “transparency and not affordability”. He exhorted all stakeholders to come together and find out price points at each level of health care.
After the panel discussion, Bikash Padhi, research director of Hansa Research, outlined the parameters of the hospital survey. Hansa has been partnering THE WEEK in the survey for six years now.