Making the future of healthcare strong: Stressing on Hub and Spoke Model
Covid-19 has brought upon us a very unsettling time where not only the backbone of our personal health has been challenged, but also that of our national and state-level healthcare infrastructure. With a population of 132+ crores, people of 12 large countries can fit inside India. With such a big and socially diverse audience to serve, no doubt it is got to take the best efforts from our healthcare system and other social institutions to tackle the Covid-19 pandemic. For now, the only way out of this disaster is through one, following Covid-19 guidelines meticulously and two, boosting up vaccination and treatment for the disease.
Presently, hospitals and vaccination centres are overwhelmed with huge and unmet demands of the patients which has also shown a mirror to the crippling public healthcare system in the country. Burgeoning demand of vaccines and increasing infection has deemed the government run hospitals and clinics unfit to face the devil. Therefore we need a robust hub and spoke model to serve the needs of the Indian population.
But before coming to this model, let us discuss some reasons for the collapse of public healthcare in India. Firstly, being a developing nation we need an effective primary health care system which is essential to protect the population from infectious diseases that is one of the predominant cause of pandemics like Covid-19. Usually public systems cover such kind of healthcare demand in contrast to private systems which normally focus on specialisations, limited socio-economic demography and individual-specific treatment options. And to our misfortune, we have a lower number of public hospitals as compared to the private settings in the country. Second in line comes the lack of sophistication and upgradation of medical services due to which people customarily shy away from seeking treatment at government run hospitals, clinics and dispensaries. Such failure stems out from the lack of financial spending by the government on state run health system resulting in morbidities in public well-being. Lastly, gaps in the organisational structure and governance of these public hospitals lead to ineffective functioning and usual scapegoating by the administration and service providers.
Therefore, to empower the state driven healthcare system, we need to emphatically build upon a hub and spoke model for our hospitals. In such a scheme, multiple primary healthcare units or spokes are developed at the local level across the district including cities and villages, all connected to zonal secondary establishments or hub across the larger urban centres in the states. The secondary healthcare units are relatively more specialised in providing advanced treatment to the patient and are equipped with a larger patient handling capacity. The local or primary level establishments are issued to deal with everyday illnesses usually focussing on consultation and drug-based treatment. This kind of setup reduces load on a single healthcare unit and therefore, distributes the pressure of provisioning healthcare services across different and many spokes of the scheme. The primary health units help to reduce cost and travel required to approach larger health centres with respect to illnesses that can be effectively treated in the vicinity of villages or smaller towns. Further it helps the government to systematically allocate financial and human resources to the overall infrastructure based on regional need. Funds can be proportionally given to secondary (which requires more resources) and primary units owing to the demand side economics of the healthcare system.
All of the above can help us achieve health sufficiency even with limited resources, through selectively galvanising health professionals and other inputs according to demographic and spatial need in the area. In conclusion, such a model would prevent skewing of resources totally into the larger cities and help maintain a balance in the overall healthcare ecosystem of the country. Although such an infrastructure already exists in our country in the form of primary and secondary health centres, strict and non-redundant guidelines through federal governance with adequate spending for development by state institutions is inevitable. Just building plans on policy papers lead to existence of a skeleton but without flesh and bones to serve the public.
