A plan evolved by NITI Aayog found its way into the Union Budget on Saturday — to attach a medical college to an existing district hospital in public private partnership (PPP) mode to address the shortage of doctors.
Even as NITI Aayog’s proposal set off discussions on whether it would lead to privatisation of government district hospitals, Health Minister C. Vijayabaskar, responding to a question recently, ruled out privatisation of district hospitals in Tamil Nadu as the State’s rural health care was good.
But on Saturday, in the Budget speech, Union Finance Minister Nirmala Sitharaman said that States that fully allowed medical colleges to use the facilities of hospitals and wished to provide land at a concession would receive viability gap funding, details of which will be worked out.
Jan Swasthya Abhiyan, commenting on NITI Aayog’s scheme then, called the proposal violative of the spirit of universal health care and said it went against the government’s own National Health Policy of 2017. It said NITI Aayog lacked understanding that the district hospital is the apex of primary health care approach and not a surrogate of the medical college.
One of the problematic clauses in the model agreement is that the patients shall be categorised into “free patients” and others.
J. Amalorpavanathan, retired professor of vascular surgery, Madras Medical College, said that handing over a well-run district hospital to a private entity is a recipe for disaster.
“Medical education should be in the hands of the State government. Similarly, medical care too. Such a proposal is certainly not a good idea, especially in a State like Tamil Nadu, he said.
Tamil Nadu had been “over-producing” MBBS doctors, he said and added: “The need for doctors and specialists should be rationally and periodically evaluated, and production of doctors and specialists should be dynamic and in response to the assessed needs.”
P. Kuganantham, chairman, Indian Public Health Foundation, while welcoming the idea, said it should not end up with privatisation of the hospital. “A perfect Memorandum of Understanding should be entered between the private and public sector. The private college should be assigned to improve the infrastructure of the district hospital, maintenance of basic facilities, care of poor patients requiring advanced treatment and reduce the fee for the students,” he said.
