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Public-Private Partnership in Health Services in India: Models & Challenges

Explore the dynamics of public and private sectors in the Indian health system, discussing PPP models, challenges, and potential benefits for access, efficiency, and quality improvement. Discover the complexities and opportunities of collaborating for sustainable health service delivery.

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Public-Private Partnership in Health Services in India: Models & Challenges

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  1. The 6th Global Health Supply Chain Summit November 18 -20, 2013Addis Ababa, Ethiopia1 CLICK TO ADD TITLE PUBLIC-PRIVATE PARTNERSHIP IN HEALTH SERVICES IN INDIA: MODELS & CHALLENGES A.Venkat Raman Faculty of Management Studies University of Delhi, India avr@fms.edu [SPEAKERS NAMES] [DATE]

  2. HEALTH SYSTEM IN INDIA: PUBLIC & PRIVATE SECTORS Health service delivery is provincial responsibility Vast, but poorly funded, staffed, and ill-equipped public sector health system Rapid, Rampant, Unregulated growth of private sector Click to add text A.VENKATRAMAN-FMS,DU-INDIA

  3. Private Sector in Service Provision Pvt. Sector-Outpatients (NSSO:2005) Pvt. Sector- Hospitalization (NSSO-2005) Pvt. Diagnostics-Rural areas (NCMH,2005) A.VENKATRAMAN-FMS,DU-INDIA

  4. Who Pays for the Services?(NHA-2004-05) • Unregulated private sector and its behavior - effect on the poor • But Private sector is indispensable A.VENKATRAMAN-FMS,DU-INDIA

  5. WHY PPP IN HEALTH SECTOR? • PPP COULD POTENTIALLY • Improve Access • Reduce OOPE • Better Efficiency • Opportunity to Regulate • Improve Quality (rational practices) • Imbibe Best practices • Augment Resources Given respective strengths and weaknesses, neither the public sector nor private sector alone is in the best interest of the health system A.VENKATRAMAN-FMS,DU-INDIA

  6. BUT WHAT IS PPP? Financing vs Delivery:Public vs Private modes(Bloom, 2001) • o • Rhetorical and Ideological Polarized views A.VENKATRAMAN-FMS,DU-INDIA

  7. PPP MODELS IN HEALTH SECTOR(Venkat Raman, 2012) A.VENKATRAMAN-FMS,DU-INDIA

  8. HEALTH SERVICE PPP MODELS IN INDIA A.VENKATRAMAN-FMS,DU-INDIA

  9. HEALTH SERVICE PPP MODELS IN INDIA A.VENKATRAMAN-FMS,DU-INDIA

  10. CHALLENGES: 1. MINISTRY OF HEALTH • Most PPPs are “Initiatives in Good Faith”: Lack of Policy Driven Strategy thus lack of continuity • No Institutional structures to manage or lack of Institutional Capacity for PPPs • Primarily Input-Based contracting A.VENKATRAMAN-FMS,DU-INDIA

  11. CHALLENGES: 2. PRIVATE SECTOR • Diversity of Private Sector: Predominantly Individual run units- not easy to contract. • Variable Quality - Lack of Accreditation or Regulation • Risk of working with Govt.: Payment Delays, Auditing, Incompatible work culture…… A.VENKATRAMAN-FMS,DU-INDIA

  12. CHALLENGES: 3. BUREAUCRACY & HEALTH STAFF • Senior Bureaucracy: Often Enthusiastic- Pro reform image; but success takes them away • View PPP from Infrastructure framework • Health Staff/ Lower Bureaucracy: Do not comprehend or suspect PPP as privatisation- Fear job loss; Distrust private sector A.VENKATRAMAN-FMS,DU-INDIA

  13. CHALLENGES: 4. PERSPECTIVES OFPOLITICAL & CIVIL SOCIETY GROUPS • Cultural stereotype/ antipathy/ squeamishness towards private sector or term “profit” • Govt.’s inability to regulate compounds scepticism on ability to manage PPP • Long Term Sustainability – what happens to Public sector capacity? A.VENKATRAMAN-FMS,DU-INDIA

  14. IN CONCLUSION • Working with Private Sector is inevitable • PPP does improve access and reduce OOP (Venkat Raman & La Forgia, 2013) • PPP portend huge potential….. But Policy, Institutional capacity, Regulatory systems and Accreditation systems are must for sustainable PPP A.VENKATRAMAN-FMS,DU-INDIA

  15. THANK YOU References: Book: A.Venkat Raman & J.W.Bjorkman. 2009. Public Private Partnership in Health Care in India: Lessons for Developing Countries. Routledge. London. Web-link: http://south.du.ac.in/fms/idpad/idpad.html A.VENKATRAMAN-FMS,DU-INDIA

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