‘Liberalisation can upgrade public healthcare facilities’

Ever since WTO negotiations on liberalisation of trade in services began in 2000, there has been a global debate on its benefits to countries in improving their economies. In case of medical services, it will facilitate movement of people, encourage foreign investments, promote services like telemedicine, medical tourism etc. In spite of the apparent goodies, WTO and WHO acknowledge that, in some cases, problems of access and equality in the areas of medical services and financing have been exaggerated, especially for poor populations in developing countries. Dr Yogi Mehrotra, managing director - Indraprastha Apollo Hospitals, New Delhi and member of the Expert Group on Services Negotiation formed by the Ministry of Commerce, GoI, tells Soumya Viswanathan how GATS will impact healthcare in India.

How will GATS benefit the medical services in India?

The Indian medical professionals are of high calibre and with the opening up of medical services, they will be able to access foreign markets, also there might be an increased influx of foreign patients into the country.

Wouldn’t Mode 4 of GATS Agreement relating to cross-border movement of people prove to be a deterrent to medical services?

Today, movement of personnel is restricted because of non-recognition of qualification. This is specially so for postgraduate qualifications. An Indian doctor/nurse has to undergo further training and is allowed to appear for their postgraduate exams, which really means a delay of three years. There can be two solutions here. One is to have mutual recognition of post graduate degrees or to replace the training requirement with an examination. But, first, unfortunately, we have to set our house in order so that disparities in training provided at various universities are eliminated. This should apply to nursing and paramedical courses also. One of the suggestions is that there should be a common post-graduate exam like the National Board in India. We should also restrict entry of other nationals and make them appear for an exam before allowing them to practise in India.

What according to you will be the impact of liberalisation on public health?

There are more advantages than disadvantages. The advantages would be free movement of medical personnel and access to new markets for Indian healthcare sector. It will also help in the propagation of telemedicine so as to provide consultation at competitive rates and will also help make India an affordable destination for medical care. As regards brain drain, it is already happening. On the contrary, liberalisation can stem the brain drain and help us to upgrade public healthcare facilities through partnerships with private enterprises.

What kind of regulations does India need to have in place before it opens up its healthcare service sector?

One of the most important thing is to improve quality and this can be done through accreditation by an independent authority. It requires standardizations of medical/nursing/ paramedical education and bringing about uniformity in training and qualifications.

What are the risks for India from liberalization of health sector? Would the focus be shifted to the rich?

The concept that liberalization only help the rich is not borne out by facts as has been observed in other sectors that are already liberalized. On the contrary, the benefits of liberalisation would trickle down to the rural areas also.