Pri­mary mo­tive

Pri­vate play­ers are eye­ing pa­tients, not health cen­tres

Down to Earth - - HEALTH - AMIT SEN­GUPTA


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

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