Primary motive

Private players are eyeing patients, not health centres

THE BELIEF

that private players can provide better healthcare services is the underlying logic for the government's unwillingness to appoint healthcare personnel at remunerative cost and provide them facilities if they serve in difficult areas. This is true for not only doctors, but all kinds of staff, including ASHA workers appointed under the National Rural Health Mission. Under the mission almost no permanent appointment was made; all were contractual. So you do not invest in human resource to run a public facility. Then, you argue that public services are not working and so, it is wiser to contract them out to private players. This flies in the face of the evidence in India as well as outside that privatising all public services never leads to better healthcare.

When you look at the ideological position that the private sector is more efficient through the politicaleconomic prism, you realise it is about selling public assets to the private sector. Classically, primary healthcare is not the area where you can make profit. Secondary and tertiary healthcare has been under the control of the private sector for a long time in India. Now the private sector has found a new avenue of profit-making which extends not just to health centres as earlier, but to primary healthcare services as well. It is not about how much profit they will make through the PHCs being contracted. They are going to use this opportunity to source patients, who can then be put into their private system in different ways, like through diagnostic tests. This thus becomes a source of drawing patients not into the contracted system, but into the private one.

(As told to Kundan Pandey) Amit Sengupta is Associate Global Coordinator, People's Health Movement