Need to re-introduce Indian Medical Services to boost public healthcare sector, say experts

New Delhi: Medical experts representing public and private sector have underscored the need to re-introduce Indian Medical Services, akin to Indian Administrative Service, to boost the public healthcare sector and address the wide gap between demand and delivery.

They have submitted a five-point agenda to the government to roll-out of IMS.

Think Change Forum (TCF), an independent think tank dedicated to generating new ideas and finding solutions for navigating through a new changing world recently held a panel discussion titled 'Is it time for India to resurrect Indian Medical Services?’.

The discussion highlighted the imperative of strengthening the public healthcare system and emphasised the pivotal role that IMS can play in achieving this objective.

The IMS will help bring the sheen and trust back to public health sector which has been lost to private sector; help stop brain drain from public medical services by attracting and retaining the best medical talent; allow for superior healthcare outcomes with better managed facilities and processes, as no longer generalists will be managing the specialists, the experts at the panel discussion said.

It will reduce health crises and reduction in tertiary cases by improved preventive healthcare at primary levels and enable seamless coordination between states and the centre for healthcare policy making.

The IMS was present during the British era but was discontinued after Independence. Current government has made commendable efforts in healthcare and has implemented impactful schemes like Ayushman Bharat.

However, still the gap is huge, requiring systemic changes, the experts noted.

In the five-point agenda, the experts have emphasised an excessive reliance on the private sector for meeting healthcare demands of Indian citizens.

Overall, the healthcare infrastructure is fractured and falls short of providing quality and effective healthcare at scale. These shortcomings primarily stem from inefficient bureaucratic management rather than lack of skills among healthcare professionals. An IMS will help bring the sheen and trust back to the public health sector which has been lost to the private sector, they said.

Dr Rajesh Gupta, Additional Director, Pulmonology and Critical Care, Fortis Healthcare, Noida, said, "The majority of the Indian public relies on the private sector for healthcare services, with 60 per cent of inpatient admissions (IPDs) and 80 per cent of outpatient visits (OPDs) occurring in private facilities." The second point highlighted challenges in staffing the public healthcare system with skilled doctors. Lack of incentives for these highly educated professionals to work under generalist administrators has resulted in brain drain.

To retain quality doctors and ensure health security for the population, there is an urgent need to establish IMS, which will help stop brain drain from public medical services by attracting and retaining the best medical talent, the expert said.

Dr Sharad Kr Agarwal, the immediate past national president of IMA, said, "The implementation of IMS holds the promise of enhancing service quality through induction of skilled doctors and addressing the persistent doctor shortage, especially in rural areas. Crucial to its success is equipping the cadre with ample facilities and resources comparable to those provided to IAS or IPS officers.” “This will ensure that doctors are incentivized to join IMS, drawn by a clear career trajectory and motivated to serve communities, even in remote areas,” he said.

The third point in the agenda underscores the necessity of superior health outcomes for the citizens with better managed facilities and processes, which will happen when no longer generalists will be managing the specialists.

Meanwhile the fourth point focusses on an urgent need to avert growing incidences of health crises and reduction in tertiary cases, which can happen by improving preventive healthcare and delivery at primary healthcare levels. An effective IMS will enable this, which in turn reduces the cost of health for all stakeholders.

The last point highlights that an IMS will be able to enable seamless coordination and cooperation between the central and state health departments, for improved national healthcare policies for the country.