Very often a nation's growth is measured just by its economic performance, leading its government to focus on and celebrate corporate successes. But this approach leaves the more fundamental aspects of society unaddressed, a major one being the collective health of the people. Despite the rapid growth of the private sector, the government has been unable to employ its services in providing quality healthcare across all segments of society. And we need to ask why!
Despite the rapid growth of the private sector, the government has been unable to employ its services in providing quality healthcare across all segments of society.
Universal healthcare in India remains a distant reality, as demand and supply in healthcare services still show a significant gap in urban and rural areas. The two primary needs of healthcare in the country—affordability and accessibility—remain unmet. For India's economically and geographically diverse population, universal health care is mandatory to offer protection from healthcare catastrophes and to improve accessibility.
Even though universal healthcare is primarily a responsibility of the government, its exacting nature makes it difficult for any one sector to undertake it effectively. Therefore, it is imperative for the government to foster an environment that enables the growth of Public-Private Partnerships (PPP), with the corporate sector and NGOs in order to ensure that healthcare services reach all sections of society.
Public-private partnership has proven to be one of the most feasible financial mechanisms to facilitate growth in the Indian healthcare system. India has tailored its fair share of successful PPPs in the healthcare sector. There are numerous examples. Rajiv Gandhi Super-Specialty Hospital, Karnataka, saw the Government of Karnataka and Apollo Hospital jointly venturing to provide super-specialty clinical care services and management of the hospital, along with free outpatient services for BPL patients. Another example is of rural healthcare delivery and management of PHCs in Arunachal Pradesh, in which the Government of Arunachal Pradesh contracted in Karuna Trust for management of 11 PHCs and provision of healthcare facilities to the local population.
Others examples of PPP include Merry Gold Health Network (MGHN) and SAMBHAV voucher scheme in UP, Community Health Insurance Scheme in Karnataka, Mobile Health Service in West Bengal and Arogya Raksha Scheme in Andhra Pradesh, among many other.
It needs a push
Although it's been successful many times, PPP remains widely untapped, as it still lacks immersion in the mainstream aspects of healthcare. Encouraging PPP for training, medical education, diagnostic equipment and preventive care delivery requirements will promote efficient use of corporate resources for public health.
To deal with the challenges of budget constraints, the government could adopt a balanced mix of PPP in health insurance coverage.
On the government's part, it is imperative to provide adequate financial room to give legitimacy to the efforts of the private sector in delivering health services at affordable rates. The upcoming general budget can be leveraged in this context by prioritising health and giving it due importance in terms of budget allocation. Analysis of global evidence on health spending reveals that unless a country spends at least 5–6% of its GDP on health, basic healthcare needs are hard to meet. Furthermore, to deal with the challenges of budget constraints, the government could adopt a balanced mix of PPP in health insurance coverage.
In addition to this, strong adherence to standard treatment guidelines needs to be ensured in both public and private hospitals to maintain an acceptable level of quality and accountability in provision of care—this will help strengthen policy and surveillance in the Indian healthcare system. PPP can further be employed in delivering primary healthcare across all tiers and assist in leveraging existing infrastructure and schemes. Collaborative public-private partnerships will bridge the gap in healthcare demand and supply, by extending PHCs to tier-2 and tier-3 cities. While the government can provide the infrastructure, private players can appoint staff, put equipment in place and maintain them.
Building capacity by allowing collaboration of public and private healthcare facilitates broader access to quality healthcare. With the 2017 Union budget around the corner, the government needs to take into account such mechanisms to coherently analyse the health funds and make the most of the budget confines.
Orchestrating practicable public-private partnerships will not only help in enhancing delivery for better accessibility but will also offer affordability to a wider population by providing innovative coverage options. The government must encourage an environment that allows PPP to grow for the overall development of the health sector in India. It is a win-win situation for all, most of all for the patients.