Public-Private Partnership in healthcare not good idea: Experts
The Union government’s think tank Niti Ayog hails Karnataka as an example for a successful public-private partnership (PPP). But, public health experts are not convinced.
“When there is evidence of failed PPP models in primary and tertiary healthcare in Karnataka, why continue with the same mistakes? Why not invest in good public healthcare institutions instead of feeding the corporates?” asks Dr Sylvia Karpagam, a public health expert who extensively studied the PPP healthcare model in the state.
Stakeholders of Niti Aayog are meeting on January 21 to discuss a PPP model to reportedly bridge the gap between medical education and the availability of qualified doctors.
“Several models have been studied and tried since early 2000, but there is no dearth of stories of disasters in healthcare PPP,” she explained.
Dr M Madan Gopal, former principal secretary to health and family welfare department said, “there have been examples of failures in Karnataka. For instance, the PPP for primary healthcare, the Arogya Bandhu scheme, was scrapped by the state government in January 2016 following a series of complaints of non-compliance with rules, misuse of funds, lack of accountability, poor availability of qualified human resources and failure to provide quality service to patients by the NGOs running the primary health centres,”
The PPP for tertiary care, the Rajiv Gandhi Super Speciality Hospital, was rolled out by the government in Raichur in tie-up with Apollo Hospitals. The government provided 73 acres land for the hospital building and staff quarters, power and water and a financial aid of Rs 60 crore.
Following an evaluation by the state government in April 2011, it was found that there was poor governance, accountability and grievance redressal mechanism in the hospital. The contract was terminated in May 2012 and hospital equipment worth Rs 37 lakh was seized by the Principal District and Sessions Court for unpaid dues. “These two have been highlighted as successful models of PPP?” Dr Karpagam said.
Dr Sulakshana Nandi, national joint convenor of Jan Swasthya Abhiyan said, “It will not only compromise on the quality and access to healthcare for poor patients but also lead to flourishing of private medical colleges. To encourage setting up of a medical college hospital, why should government hand district hospitals to a private entity?”
She felt the trend will only produce doctors who have paid huge money as capitation fee. Meanwhile, Dr Alex Thomas, president of Association of Health Care Providers India said it is a good idea but it doesn’t sound realistic.
“If the government actually does a 50-50 of management of these hospitals, then the tie-up will work. Financial sustainability of private partner is also something which one has to look at,” he explained.
Experts say the policy of encouraging private medical colleges, both through diminishing investment in public-funded medical education and through regulations designed to facilitate private colleges needs to be reversed.