The most important learning from the outbreak of the Covid-19 pandemic is to build “future hospitals” where patients suffering from both communicable and noncommunicable diseases can be treated simultaneously, said Dr H Sudarshan Ballal, chairman of Manipal Health Enterprises, the group that owns Manipal Hospitals,
One of the saddest things in Ballal’s four-decade-long career was watching patients suffering from non-Covid illnesses unable to receive enough attention from hospitals during the pandemic when he was running a healthcare chain that has 27 hospitals in 15 cities.
During the peak of Covid, non-Covid care was halted. “Postponing emergency surgeries and watching patients progress from stage 2 to stage 4 cancer was very sad and it really happened,” he said, adding that “a lot of people didn’t receive the care they needed.” Covid took a back seat.
As the majority of beds were allocated for Covid care, those suffering from chronic illnesses such as cancer, kidney failure, and heart disease were not given priority.
People were also restricted from moving freely due to lockdowns or fears of infection (in hospitals). “The future hospitals, as I would imagine, would be those who can treat both – communicable diseases and noncommunicable diseases – at the same time. Everyone should have equal access to healthcare services.”
‘Focus on preventive and not tertiary care’
According to Dr. Ballal, a nephrologist and chairman of the Manipal Institute of Nephrology and Urology, the pandemic has shown us the need to change the rules of the game.
He said until now, the understanding was to strengthen the tertiary care hospitals.
But Covid demonstrated the importance of off-loading the unnecessary load from tertiary hospitals so that those who are acutely ill and in need of treatment do not have to wait, he said.
But Covid demonstrated the importance of off-loading the unnecessary load from tertiary hospitals so that those who are acutely ill and in need of treatment do not have to wait, he said.
“Too much emphasis has been placed on tertiary care,” Dr Ballal, himself a tertiary care provider, said. “As much as we concentrate on in-patient care, we should also focus on public health, primary health, and preventive health.”
According to him, most communicable and non-communicable diseases can be treated outside of hospitals, and hospitals should only be used for people who are seriously ill.
“This is the first lesson to be learned from the pandemic,” he said, adding that instead of overburdening hospitals, the focus should be placed on prevention and strengthening primary health centers (PHCs).
Dr. Ballal believes that India needs to strengthen its primary and secondary health care systems in rural areas, remote areas, and smaller towns.
Dr. Ballal, who began his career as a professor of medicine at Saint Louis University School of Medicine in the US, has said that the policy of promoting wellness is better than treating illness. “We definitely need tertiary care, but the focus should be on keeping people healthy.”
