Debating public health priorities

A recent release from the Department of Personnel and Training, Government of India stirred up a hornet’s nest

201603ehm01A recent release from the Department of Personnel and Training, Government of India stirred up a hornet’s nest. The DoPT release had a worrisome line: “In the times to come, the DoPT will also chalk out a possible plan for exit of government sectors from hospitals, air services, etc and a sunset clause will also be attached to every new scheme.” The release, which was a summary of points discussed at an internal meeting, was couched as an extension to the ruling BJP party’s poll manifesto promise of “minimum government, maximum governance.”

In line with the clamour to privatise public sector units (PSUs), this was seen as the government’s plan to do the same to the healthcare sector by selling off their interests in various public-run hospitals across the country.

Fortunately, a clarification followed, with Jitendra Singh, Minister of State in the Prime Minister’s Office drawing a distinction between ‘rationalisation of government participation’, which is being considered in certain sectors, and ‘full privatisation.’

In the final days before Healthcare Sabha, Express Healthcare’s public health focused summit, planned for March 4-6, it is indeed reassuring to know that the government does not plan to wash its hands of the responsibility towards assuring that the public health needs of India’s population are met.

A certain distance may be a good thing, so that the government gets in healthcare professionals to do what they do best, i.e. treat patients. But ensuring equity and access to affordable healthcare should be the remit of elected representatives of any country. Be it India or for that matter, Australia whose Health Minister recently had to issue a similar clarification when it was reported that her government was in the process of privatising Medicare, the publicly funded universal healthcare scheme. She had to clarify that while there was a proposal to outsource the payment of benefits, her government would still be the deciding authority when it came to laying down doctor payments and patient rebates.

Australia’s opposition party has vowed to “never accept the Americanisation of our health system,” underlining the deep distrust of the private sector, at least when it comes to healthcare.

So, what is the way forward? Governments have to cherry pick initiatives in order to ensure optimal distribution of limited funds. And bureaucrats may not be the best judge of healthcare outcomes. Will this year’s Union Budget again prove to be a damp squib for the healthcare sector? And what are the innovative ways in which the public health sector can partner with private healthcare players? Will the public sector be brave enough to pull the plug on
unsuccessful partnerships, like Karnataka’s Health Minister’s move to stop the Arogya Bandhu scheme? (See interview: pages 28-30)

We hope that we will be closer to at least a few of the solutions at Healthcare Sabha. To get a peek into the some of the topics up for discussion, read our March 2016 issue and do not miss all the post event coverage in the April issue.

This issue also has an in-depth analysis of the Startup India policy and its implications for healthcare startups. While analysts are still worried whether accessing the benefits of the policy hinge on the approval of a deserving startup by an inter-ministerial board, it will be a huge unnecessary road block. (See story: Startup India: Will it lead to Stand up India?, pages: 20-25)

Viveka Roychowdhury

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