Camel in the tent

• The proposal is to attach medical colleges to existing district hospitals in the public-private partnership (PPP) model.
• Viability gap funding is provided for projects that the government does not find commercially viable because of long gestation periods, and relatively minor revenue flows and involves PPP.
• States that fully allow the facilities of the hospital to the medical college and wish to provide land at a concession would be eligible for viability gap funding.

Arguments of the government:

• The proposal is envisaged primarily to address the shortage of doctors in the country.
• Given the fact that it is practically not possible for Central and State governments to bridge the gaps in medical education with their limited resources and finances, it necessitates the formation of a PPP model to address the challenge.
• The proposal will help increase the number of medical seats available and moderate the costs of medical education.

Arguments against the proposal:

Significance of district hospitals:

• The proposal originally made by NITI Aayog does not attach significance to the role of the district hospital as the pivot of primary health care in every State.
• There is opposition to the scheme in States such as Tamil Nadu that have a robust public health-care system, and a medical college in nearly every district. There are concerns regarding handing over the hospitals to the private sector motivated by profit rather than the public interest.

Effect on public health services:

• The move to allow private parties to operate and maintain the district hospital and provide healthcare services could seriously dent public health services.
• The provision which allows the private firm to demand, collect and appropriate hospital charges from patients may destabilize people’s access to affordable public health services.

State’s welfare role:

• Providing quality, accessible and affordable healthcare is the duty of the government and it should guard against privatizing this vital sector.

Way forward:

• The government must consider raising health-care spending beyond the usual under 2% of GDP, and ensure more resources are available to provide free, quality health care to all.

Thank you!