India Attracting Global Companies – A Pipedream
Most of the Indians are gloating over the fact that many Global Brands are planning to pull out of China and are going to come to India. This reminds of an old Indian adage – `Mungeri Lal Ke Haseen Sapne’. When the whole world is seeing the spectre of Indian migrant workers fleeing the urban centres in the most inhuman form, they are not going to take any fancy for India. These images will haunt the Indian Government for years to come despite all the flashy presentations that could be given about the attractiveness of the country. What has India got to offer to these global brands – hungry and desolute workforce. Different governments in the country are trying to force a labour code on the workforce in their attempt to emulate China. They are forgetting that India is a democracy which China is not. This will only create Labour Unrest in the country and no corporate honcho wants to invest in a country where there is slightest risk of their investment going down the drain. First of all, I do not agree with the fact that companies are looking to bolt out of China in any significant manner and even if some companies want to relocate, they would prefer countries like Taiwan, Vietnam and even Bangladesh. In the last few years we have seen the Indian society getting polarized on religious lines like never before and this does not bode well for any prospective investor. The present dispensation is highly indebted to the India Inc for their financial support during the elections and this is pay back time. So all the hullaboo about attracting foreign investment is nothing but to benefit the Indian corporates at the cost of Indian Labour. Only time will tell about the success of this attempt, as in a democracy it is extremely difficult to the muzzle the voice of the majority and these migrant labourers do form the majority.
The most important reason for India not attracting the Global Capital is the insensitivity towards quality. A very large section of the Indian Middle classes which is omnipresent on the social media is snobbish and uneducated. They are also the people who are mired in their religious identity and absorbed in the glorification of a mythological past. Such people can hardly provide leadership to the world in the 21st century. Scientific temper is sacrificed at the alter of superstitions and ancient achievements. Indian doctors and engineers are still considered best in the world but only when they are working outside of India.
Healthcare Institutes like Fortis and Medanta are vilified in the media and the society for their charges as nobody is bothered in finding out the reasons for these high charges. Quality comes at a cost and we Indians are not interested in quality. We are bargain hunters and always look for good looking products even if they lack inherent quality. Give us flashy hospitals with nice ambience dotted by low quality doctors and nurses and we would not complain. In any case very few of the Indians would know the difference between a DM and MD. For us a consultation fee of Rs. 1500 is exorbitant and the person charging it, is greedy. Our middle classes would be happy to consult a nicely dressed doctor in a nice consultation room charging Rs. 200 regardless of the experience and qualifications of the doctor. Most of them would not even know that it takes 12-14 years for a person to achieve superspecialization in healthcare.
This brings us to the Quality Accreditation system in the country. For ages we had ISI or ISO as quality marks. Very few would know as to what these standards are. Similarly healthcare has NABH as a quality accreditation certification for the last 10-12 years. This is a complete farce imposed upon the healthcare industry without any participation from the industry. For the last several decades, the healthcare in India was continuously improving its quality and the prices charged by each hospital were based on the quality of treatment given by them. The judge of the quality was the general public and their judgement was based on medical outcomes of the hospital and the doctor. The hospitals were happy to deploy the best quality of equipments because they could fix their own prices and there was no snobbish middle class to get shocked by these prices. In the beginning of this century the health insurance companies started burgeoning and started fixing prices for different hospitals. The guys who would come to negotiate on behalf of these health insurance companies or the TPA’s knew nothing about a Linear Accelerator or a 3 Tesla MRI. How would you expect these people to appreciate quality whose technical knowledge was zero. Then came CGHS where some babus decided that a doctor’s consultation fee should be Rs. 62 regardless of whether the doctor has graduated from AIIMS or from a private medical college through capitation fee. Now the Ayushman Bharat is imposing even lower tariffs on the private hospitals of India in the name of giving volumes. Who is going to bother for quality in such a scenario when the payment is not linked to any kind of quality measurement. I think our Prime Minister is right when he said that we should become self reliant. We should manufacture low quality cheap equipments for our own consumption because nobody values quality over here. There should be two categories of healthcare in the country – One which deploys the lowest possible quality and treats the panel and insurance patients while the other invests in quality and treats the cash patients. There is a big enough market in the country which appreciates quality and they are not from the snobbish middle class whose favourite pastime is to castigate the healthcare on the social media. Remember the labourers in this country are paying Rs. 7000 to be bundled in a container while the middle classes are travelling by Airconditioned trains for Rs. 4000. We should build our healthcare for these people who would pay for the quality of treatment and leave the `snobbish’ at the mercy of the `Babas’.
The second part will be about the farce of NABH.