The private sector in public health

It can provide services and capital

February 21, 2019 12:15 am | Updated 12:15 am IST

Ambulance flat icon, medicine and healthcare, transport sign vector graphics, a colorful solid pattern on a cyan background, eps 10.

Ambulance flat icon, medicine and healthcare, transport sign vector graphics, a colorful solid pattern on a cyan background, eps 10.

The healthcare panel at the recent India Conference hosted by students of the Harvard Kennedy School and the Harvard Business School discussed the role of the private sector in augmenting public healthcare services. Goal 3 of the UN Sustainable Development Goals (SDG) is to “ensure healthy lives and promote well-being for all at all ages”. India has a mammoth role in helping the world attain SDG-3 as global health indicators cannot improve without India making giant strides. In providing healthcare, the Indian government has led the way, as it should, given that India is a welfare state.

Over the past decade, courtesy changing demographics and lifestyles, India has been witnessing shifting disease prevalence in terms of the largest causes of morbidity and mortality. This requires that we give our health delivery system a re-look. The Harvard panel dove in to how the private sector can be leveraged for this purpose. The precondition is to create an ecosystem where partnerships between the private and the public sector can thrive. This must start with trust and stated common objectives. Once the ecosystem is more conducive, complementarities need to be identified.

While one may not foresee a great presence of the private sector in providing primary healthcare services, areas such as ambulance services and value-based care delivery can be promoted through this sector. Ayushman Bharat seeks to improve the network of the government’s first-point-of-contact health centres. For higher levels of services, the private sector can be incorporated by creating linkages between public health infrastructure and private providers through a hub-and-spokes model.

Besides services, the private sector is also a source of capital. A legally mandated way to provide this is through Corporate Social Responsibility. Companies above a certain annual turnover (₹1,000 crore), net worth (₹500 crores) or annual net profits (₹5 crore) have to earmark 2% of their net profits of the past three years to CSR projects, which may include healthcare projects. CSR has not yet reached its full potential. However, it is encouraging to see the merging of initiatives. This is seen in the government directing companies, albeit public sector ones, to the focus districts of the Aspirational Districts programme, which was started in 2018 to improve governance and service delivery across six sectors including health and nutrition.

At the end of the day the lesson was clear: as India strives to ensure availability, affordability and accessibility to quality healthcare for its people, both private and public stakeholders need to come together.

The writer is a doctor pursuing a Master’s degree in Public Policy at Harvard University

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