Wednesday, November 30, 2016

Public Private Partnerships to heal Healthcare.

We all know that the healthcare system in India is creaking.  The situation is going to become progressively worse , because we cannot keep up with the demand for medical attention. Epidemics of infectious diseases such as dengue and malaria have become increasingly common, because of poor infrastructure. The rise in non-communicable diseases because of poor life style has created a double whammy, and we are reaching a breaking point.

The government is supposed to provide healthcare services to citizens, but the problem is that the public sector doesn't trust the private sector. We know that there's a shortage of hospital beds, but still the government is hell-bent on passing rules and regulations which are forcing nursing home owners to shut down. That means the shortage of hospital beds is going to become much worse in the future.

We've tried the PPP ( Public Private Partnerships) models, but these have been plagued by political problems.  They've not delivered the results which were promised , because of vested interests.

This is a shame. We should use a blend of both private healthcare facilities along with public hospitals, by combining the strengths of both.  The public hospitals are great at providing cost effective care to seriously ill people. The private small nursing homes have the major advantage of being able to provide care locally , so that it's much more convenient for patients. We need to marry the best of both worlds, but we often end up extracting the worst of both. Poor patients are forced to run to public hospitals for minor problems, which could be much better tackled locally.

We need to set up partnerships as well as linkages , so that there is no unnecessary duplication of services. Both private and public hospitals need to trust and respect each other, so that they can do what's right for the patient. There are many opportunities to create unique models for success , but these are being frittered away. We need to create a robust referral system, to make sure patients get the right care in the facility which is correct for them.  It's high time we learned to develop medical processes and protocols so both the private and public sector can work together and complement each other.

Thus, simple elective surgical procedures such as hernia repair could be done in the nursing homes, so that there's no need for these patients to block up an expensive tertiary hospital bed, which could then be used only for the critically ill patient. If a poor patient goes to a public hospital , and the diagnosis of hernia is made, he could then be referred to the private nursing home nearest to him, which could provide him care at a subsidised rate.

Similarly, public hospitals could outsource lab services to reputed private players  who provide high quality diagnostic reports because they are so well-equipped. This way patients would benefit, because they would get reliable reports, rather than have to depend upon the poorly equipped public hospital lab. Everyone benefits. The public hospital doctors now have results they can trust;  the private lab processes more samples, which helps them to improve their revenue; and the public hospital does not need to invest in extremely expensive lab equipment, saving them a lot of capital expenditure, which could be used to upgrade their ambience.

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