KOCHI: Kerala has over the years seen several small hospitals close down due to rising costs and the increasing clout of corporate and multi-speciality hospitals.
According to data collated by the Kerala Private Hospitals Association (KPHA), as many as 99 hospitals have downed shutters in the state since 2011. However, the association reckons this is a very conservative estimate, and that the actual number is much higher.
“The strength of the Kerala model of healthcare was its street-corner doctors. There was a time when missionary hospitals co-existed with primary and community health centres. The combination of the two ensured that the state’s healthcare sector became a model for others.
However, the model was disrupted following the entry of private hospitals and the corporatisation of healthcare,” said Rajeev Mannali, CEO of BR Life SUT Super Speciality Hospital and a healthcare expert. According to him, the number of closed hospitals would be more than 200.
The nursing strikes of the 2010s and minimum-wage implementation also contributed to the closing down of several small- and medium-sized hospitals.
Financial liabilities proved the undoing of many small hospitals in the state. “Most of these hospitals were not able to balance income and expense. Minimum wages were increased. The cost of infrastructure and running the institutions also escalated. But all along, the cost of treatment remained the same,” said Hussain Koya Thangal, president of KPHA. He pointed out that the number of closed hospitals could be more than 100.
Hospitals have been closing down for the last 10 to 15 years, said economist D Narayana. “We have more large hospitals with specialist doctors and advanced technologies. These small hospitals, most of the time, are not able to afford specialists or invest in latest technologies. Moreover, the demand for small-scale hospitals in the state has declined,” said Narayana.
The situation has worsened over the last two years with the entry of corporate hospitals, say experts. “Over the past two years, we have been witnessing several mergers and acquisitions in the private sector. The problem with these private firms is that they are more interested in profit than patient care. The investments involved are also substantial. Smaller hospitals cannot withstand this onslaught,” added Rajeev.
Hussain added that the state government must take into consideration smaller hospitals, by introducing subsidies and projects.