Home Healthcare Gaining Ground, But What About Regulations?

By Gokul Bhagabati 

Private home healthcare appears to be gaining ground in India, but this critical segment is surprisingly outside the purview of a proper regulatory framework.

Even the recently-announced National Health Policy, 2017, seems to have completely missed this segment, industry leaders have said.

“Till date there is no regulatory framework for the private home healthcare segment. The regulatory framework is for physical HCP (health care providers) centres only (for example, hospitals, clinics, nursing homes, laboratories, etc.),” Gaurav Thukral, Senior Vice President and Business Unit Director, Health Care At Home, told IANS.

Health Care At Home, a leading provider of technology-driven home-based medical services, is a joint venture between the Burman family, the promoters of fast moving consumer goods (FMCG) company Dabur, and founders of Health Care At Home of Britain. The company provides a multitude of services ranging from routine procedures like injection administration to home chemotherapy, home ICU services, and even maternity services.

“The widely popular NABH (National Accreditation Board for Hospitals & Healthcare Providers) has also not framed any healthcare regulatory framework for the private home healthcare segment,” Thukral added.

Nidhi Saxena, CEO, Zoctr Health Private Limited, concurred. “Currently, there is no regulatory framework for the private home health segment. There are specific regulations for nursing bureaus and clinical establishments but no specific law addresses patient care at home,” she said.

Zoctr Health is a pan-India home and tele-health company that provides a wide range of home-based medical services, including long-term intensive care, chronic care and health check-up programmes.

With acute shortage of doctors and hospital beds across India, coupled with the dramatic increase in lifestyle diseases in urban areas and a rising ageing population, healthcare at home is emerging as a major healthcare option.

“The entire market of Home Healthcare is worth above Rs 12,000 crore and so far not even one per cent of the market has been captured by all the players combined,” Kshitij Garg, Founder and CEO, Healers at Home, a New Delhi NCR-based home healthcare provider, pointed out.

“According to a PwC report, the demand for Home Healthcare services is expected to increase by 20 per cent on an annual basis,” Garg said.

Home health care appears promising, especially in view of the large-scale deficits in institutional care in India.

“As per World Health Organisation (WHO), India has just 0.9 beds per 1,000 population. This is far below the WHO’s recommendation of 1.9 beds per 1,000 population. With economic and financial stability on the rise, thanks to a buoyant economy, patients are increasingly veering towards personalised care through home-based healthcare services,” Thukral said.

He added that over 70 per cent of patient’s healthcare requirements can be met at home — excluding radiation therapy, surgery and emergency medical procedures for which hospitalisation is a must.

But in the absence of a proper regulatory framework, how the industry would evolve in the future and what would be the standards of services that the unsuspecting patients receive is left to the mercy of individual players in the industry which appears to be fast getting crowded.

“To leapfrog the home healthcare scenario we would want a regulatory framework to be launched and the guidelines to be followed by all private home healthcare service providers to deliver the best clinical quality to patients at home,” Thukral said.

“Having a proper regulation and stipulating some minimum standards would help the industry evolve,” Saxena added.

The National Health Policy, 2017, which was approved by the Union Cabinet on March 15, envisages the setting up of a National Digital Health Authority (NDHA) to regulate, develop and deploy digital health across the continuum of care.

“Home healthcare is beyond digital… hence regulatory mechanisms beyond what NDHA envisages would need to be looked at,” said Anjan Bose, Secretary General, NATHEALTH — Healthcare Federation of India, a forum for advocating better healthcare.

(Gokul Bhagabati can be contacted at gokul.b@ians.in)