Q. Private medical practitioners are believed to provide better care than government practitioners. What reasons do you attribute to it?
A. Yes, it is true that the private health care practitioners have more up to date health care options at their disposal. They do make better doctors as they can afford the extra learning classes and conferences. Moreover, private health care practitioners earn more than the public health care practitioners. They always have the motivation to do better and provide better services. Another important thing is the fact that they have fewer regulations to contend with. The government health co-ops put lot of restrictions on the doctors they hire, and they are not even paid well. So they probably attract the doctors who are just freshers and willing to work in such environment.
Q. In India, it is the private sector which spends more than 80 per cent on the health care even when we have 65 per cent of the population living below poverty line. Why is the public health care sector lagging behind?
A. Despite the substantial progress made in various fields, India still has the lowest expenditure on health care in the world. Though the public health service infrastructure is widespread, with many sub centres, primary health centres, community health centres, secondary level district hospitals and medical colleges; the quality of health care delivery is not uniform and subject to various regional vagaries. According to various reports and surveys, the public sector accounts for only around 20 per cent of the total health care expenditure, representing around one per cent of the GDP. India’s public health care is not sufficiently funded and smaller in size to meet the current health care needs of the country, which is the biggest reason for the sector to lag behind.
Q. Is the inadequate government funding or official apathy and indifference the prime reason for the poor quality of services offered by the public health care sector in India?
A. I think the prime reason is lack of government funding. As I mentioned it before, the public sector accounts for only one per cent of the GDP, which is quite abysmal. Items like public health, hospitals, sanitation fall under the state government, while items having wider ramification at the national level like food and drugs, family planning, medical education and vital statistics come under the jurisdiction of central government. We can say that the basic health infrastructure in the country is slipshod and far from what is desired.
Q. Do you think poor people seek out expensive private facilities due to the absence of robust state-funded health infrastructure in India?
A. Yes, I agree. The latest technology and sophisticated expertise available at most of the state-funded health care facilities is not up to the mark to handle the critical cases. Also, the sheer imbalance in demand and supply often leads poor people to seek out the private facilities, despite their insufficient financial resources.
Q. Private sector has become synonymous with flexibility of access, shorter waiting time, greater confidentiality, and sensitivity to user needs. Do you think it is possible to replicate the model in public sector as well?
A. Yes, this model can be replicated in the public sector through public-private partnerships. That will ensure proper utilisation of funds and right talent and infrastructure to provide better facilities to the end consumer. The model is increasingly becoming popular in India, with the active participation from government and many corporates.
Q. What are the measures public sector should take to strengthen its health care delivery?
A. Innovative strategies can be adopted as a measure to bridge the yawning resource gap in infrastructure for health care. Proper planning, designing and development of the health care facilities will add value to that effort. It is important for public hospitals to be appropriately managed and operated. They can be provided with finances at a reduced rate of interest by the government. In fact the government should give priority sector status to health care industry to facilitate lending by commercial institutions.
For a healthy India, it is important to strengthen primary health care, bring expertise in new technology and service innovations and produce effective drugs and vaccines at affordable rates to make sure that everyone can avail them without any hassles.
Q. What is the present scenario of Public Private Partnerships (PPP) in health sector in India? How can the PPP model be executed effectively?
A. The PPP model can be executed efficiently and effectively if proper infrastructural development accompanied with proper planning and management is put in place. The government should make available mobile clinics for people from the remote areas of the cities to avail the health care facilities, since they are otherwise unable to reach the main facilities. In India, despite all the accomplishments in medical technology, there are still more than 90 per cent people who cannot afford the modern health care facilities. Hence, there is an immediate need to bring down the cost of health care facilities.
