Public private partnership in health sector

The great nation of India is passing through a transformative phase with respect to the health sector, especially during the past one decade. The ongoing pandemic of COVID-19 has again reminded us of the need to reform and strengthen the health sector.

The public sector spending on health as a percentage of the GDP has always been called a grey area by experts, but as they say, less said the better in a democratic process. Health has been enlisted in the State list of the Seventh Schedule of the Constitution; hence it is a State subject except for the National Programs. It has to be categorized as preventive, promotive, and curative to provide comprehensive healthcare to all.

The futuristic approach has to be well conceived to move forward with vision to make effective delivery to beneficiaries with immediate and long term planning, sans stagnation for more than 10 years.

The health infrastructure players have to bridge the gap by giving comprehensive solutions for e-governance and computerization to be commissioned from primary to secondary level hospitals, inclusive of hardware and software customized according to the requirements. There is no doubt that the government should also not let this opportunity go waste as it happens at times, circling in a whirlpool of rules and regulations.

Each family will soon have a UID to register their visit to OPD and indoor treatment so as to capture the work load and material consumed to have valuable data for future planning. Here the health planners and government have to take a call to make more space for poor and middle level income group in public health facilities on the lines of Ayushman Bharat so that they can get quality health care. Also, the government must make necessary arrangements so that the upper middle group has access to affordable healthcare in corporate hospitals by making affordable insurance available to them. The maximum resources of public sector hospitals are consumed on the individuals who can afford the expenses and do not actually require the subsidies.

Technology is the vital sphere where the industry can make a big difference. The more we use technology, for example, laparoscope, endoscope etc., the quicker is the recovery rate and space utilized for the one waiting for the same procedure. Leasing of equipment or other such similar models can be explored so that industry can bring forward their equipment and train the medical and paramedical staff to deliver benefit to patients in public hospitals and can be paid the amount in fixed installments which will ensure the AMC/CMC of equipment in due course. The move of Central Government in introducing National Digital Health Mission (NDHM) is a step in the right direction, but in the absence of legislative mandate, the impetus seems to fizzle out for which Central Government needs to look into. The insurance sector needs to stress upon the private health service providers to formulate packages of each disease so as to make the insurance affordable according to level of healthcare delivery and rating of hospital.

The Government of India must proceed with universal health coverage in the first go with economical ceiling to cover all beneficiaries at first instance to avail the health coverage at par with Ayushman Bharat packages which are open to private hospitals to gain confidence with regard to amount payable being reimbursed. The government needs to amend its laws and financial rules, which are made applicable to all departments including health, as many of them remain a hindrance and repeatedly are misused by auditors/complainants to stop procurements. The health sector, especially government sector, needs to open their arms to the private sector, which will introduce diagnostics on public private partnership or leasing out machines with consumables, manpower, and chargeable per test with number of years fixed for machine to be in operation. The Central Government needs to bridge the gap in facilitating private sector, be it commissioning of hospitals or setting up venture on PPP model.

Solutions need to be sought for providing technological solutions for telemedicine from the private sector, which shall be provided to the public sector hospitals from primary level and upwards. Such technology must be installed and maintained by the private player too, so that unnecessary load on the government is decreased and efficiency of the system increases. Specifications for such technology must be uniform and must be valid for at least a decade. Further they can be uploaded on GEM (e-Purchase Module) so that other UTs/States too can procure such technology with ease. Adding on, the government should take a lead in sensitizing and facilitating the commissioning of telemedicine by States and UTs by private players. The present central government has already taken the lead, under the NHM and its fortification will bring the country’s healthcare to an affordable level and make it available to all.