Calling out the Centre’s purported attempts to privatise public health care, the Congress governments in Madhya Pradesh and Chhattisgarh have junked a plan to link private medical colleges with government-run district hospitals through a public-private partnership (PPP) model across the country.
Pointing at the shortage of qualified doctors, the NITI Aayog admitted it was “practically not possible” for the Central and the State governments to bridge the gaps in medical education with their limited finances. Hence, the scheme, by combining the strengths of public and private sectors, would augment medical seats and rationalise the cost of education.
“We reject this scheme and will not implement it,” Madhya Pradesh Health Minister Tulsiram Silawat told The Hindu . “The intent of the State government is to provide complete health care services and continue doing that.”
If district hospitals were handed over to private players, where would the poor go, he asked. “Dalits, Adivasis, labourers, the last person in society, all depend on these hospitals. How can we give it in private hands?” he said.
Terming the “selling” of public health care to private players by the BJP government at the Centre “unacceptable” and “condemnable”, Chhattisgarh Health Minister T.S. Singh Deo had earlier said, “This assault on the common man by the BJP to help its few rich friends will not be tolerated. We have to understand that allowing private players in health care would mean higher expenses and an attack on common man’s pocket.”
Furthermore, he claimed on Twitter, it was another attack on cooperative federalism. “By snatching the subject of health care from the States the BJP wants to further its authoritarian agenda. We must oppose this tooth and nail... the BJP shouldn’t try to impose its anti-poor crony capitalist agenda on us.”
Additional expenditure on defence and burden of economic slowdown had compelled the Centre to see public health services as a source of revenue rather than fulfilling its commitments as a welfare state, according to the Jan Swasthya Abhiyan, a network of nonprofits working in the sector.
Under the scheme, the concessionaire, a private party, shall design, build, finance, operate and maintain the medical college and also upgrade, operate and maintain the associated district hospital with a minimum annual student intake of 150 MBBS seats.
The model agreement will allow the party’s control over the land and assets for 60 years, with a provision for extension. Moreover, the lease agreement for the site of the medical college would be for 99 years, at a subsidised lease rent of “8% of the circle rate of the land”.
“It is incomprehensible how the proposal to hand over public facilities to private entities for 60 years, that is for a whole generation, is being made,” said Amulya Nidhi, JSA member.”This means a whole generation will be at the mercy of this revenue generation model.”
The model distinguishes between ‘free patients’ and others based on their ability to pay, with the former requiring an authority’s sanction to procure a document proving it. The ‘free patients’ would be provided free consultation, drugs and diagnostics, but incur a Rs.10 registration fee too. The rest would be charged at “market competitive rates”.
Moreover, all the beds will be categorised as ‘regulated beds’ and ‘market beds’. With at least 750 minimum beds at a hospital, a minimum of 300 plus 20% of the remaining beds would be for ‘free patients’. Yet, the concessionaire will have the discretion to charge all patients alike on ancillary facilities like vehicle parking or cafeteria.
“The ‘regulated beds’ are implicitly for patients who are covered by Ayushman Bharat Yojana or other insurance. So though it is stated as ‘free’ care, the payment for these patients would mostly come from government itself,” said an analysis document prepared by the JSA.
As for medicines, while ‘free patients’ would get them free, others would be provided with them at subsidised rates.
Published - January 22, 2020 01:05 am IST
