Chhattisgarh diagnostic project on hold
SUVOJIT BAGCHI, The HINDU
State government says the policy requires a “fresh look”
While Chhattisgarh’s Principal Health Secretary M.K. Raut said privatisation of diagnostic services was rolled back “for the time being,” the National Rural Health Mission (NRHM) refused to partially fund the outsourcing of diagnostic services. Last February, the State government invited private players to “set up shops” in the health facilities sector. Defending the programme on the government’s behalf, the Health Department’s technical assistance body, the State Health Resource Centre (SHRC), said that “outsourcing of health services” to private laboratories would enhance efficiency and facilitate delivery of services.
Mr. Raut, however, denounced the flagship privatisation project, which required a “fresh look.”
“In [the] near future we will take a fresh look at the project and decide a course of action,” he told The Hindu . A “revised PPP model” would be in place “in the coming months.”
Chhattisgarh has 154 community health centres (CHC) and 756 primary health centres (PHC). The government, Mr. Raut said, may consider implementing the PPP model in “a few” remote CHC and PHCs. “It would depend on whether it is possible for us to reach those areas or not. The PPP in diagnostic services will not be implemented in the district hospitals or 5,211 sub health centres.”
The government had issued request for proposals (RFP) from private health service providers to set up diagnostic services at public hospitals and health facilities, paid for by the taxpayer. The proposal was severely criticised by health activists and Mr. Raut said the “RFP and the floated tenders are closed chapters now.”
Explaining what compelled the government to retract a project floated only few months back, he said the “gaps need more scrutiny.” “We have to figure out a mechanism to monitor private players in remote areas.”
The Health Department is also not sure how the private players can be regulated. “A diagnostic chain may use government premises to market its services to the outpatients. We need to ask, why the government should provide incentive to a private player to do business using public facility,” said Mr Raut. He clarified that the government would not dismantle its “existing infrastructure and retrench staffs” to create space for the private players.
Owing to inadequate and chaotic public health care services in India, patients turn to private facilities, which are mostly unregulated and where quality is a concern. With the Union Health Ministry’s growing focus on more privatisation in health care, it was clear decades back that the health budget would not get the necessary boost. Rather, in view of the growing flow of private finance in health sector a National Health Policy was formulated in 2002 and the PPP model was suggested.
Chhattisgarh, known for abysmal health care in remote regions, has followed that model as it could not fill the post of 965 radiographers and laboratory technicians over the last several years. To fill those vacancies and provide necessary equipment to the health centres, the State health budget needed an additional funding of at least Rs. 30 crores, which was not available. Besides, trained technicians are generally reluctant to work in remote areas. In this context, the government opted for the PPP model.
However, in a span of four months the policy changed and Mr. Raut said the government had a “new PPP policy” in place and the “diagnostic sector policy has to fall in line with the new one.”
The NRHM has also refused to partially fund the present model and asked the State to “revise the proposal based on the Government of India recommendation” and submit a supplementary programme implementation plan.
- Private players were invited to “set up shops” in the health facilities sector last February.
- The Chhattisgarh Government has put the scheme on hold pending a “fresh look”.
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