The NITI Aayog has come up with a public-private partnership model to link new or existing private medical colleges with a functional district hospital to augment medical seats. The move aims to address the shortage of qualified doctors and bridge the gap in medical education.
In its draft guideline named ‘Model Concession Agreement for Setting Up Medical Colleges Under the Public-Private Partnership’, NITI Aayog has concession agreement that has been developed based on international best practices and similar PPP arrangements that are operative in Gujarat and Karnataka.
According to the guidelines, those district hospitals should have at least 750 beds, of which at least 300 beds plus 20 per cent of the remaining beds would be “regulated beds” where patients receive free treatment. A 900-bed hospital, for instance, would have 420 beds for such “free patients, while the remaining 480 beds would be “market beds.”
“In consideration of making available the healthcare services, to the category of patients other than free patients, the concessionaire shall have the right to collect, appropriate and demand hospital charges…the concessionaire shall display the rates for the healthcare services, including the daily rate, for the bed occupancy in the district hospital at a place where it is visible to all,” according to the guideline document.
Though the draft makers think that this model can bridge the gaps of the healthcare in India, several groups of health experts are worried that such a model could transform district hospitals from public service-oriented healthcare centres into profit-oriented healthcare centres.
“The district hospitals are the final port of call for the poor across India,” said Abhay Shukla, national co-convenor of the Jan Swasthya Abhiyan, or People’s Health Campaign, a network of non-government health organisations.
“Many of us are concerned that private entities that take over district hospitals might prioritise healthcare for the patients charged fees and de-prioritise healthcare for the free patients,” Shukla said. “We have weak accountability systems that might facilitate such practices,” he added.
He also said that the model will also add more private medical colleges in the country amid concerns about burgeoning numbers of private medical colleges that charge exorbitant fees from medical students. Over half of India’s 539 medical colleges are private colleges.
The nationwide alliance of doctors campaigning for ethical healthcare would examine the Niti Aayog document detailing the guidelines and submit their responses to the think tank. A gynaecologist and founder-member of the Alliance of Doctors for Ethical Healthcare Dr Arun Gadre said that this is a disturbing proposal.
George Thomas, an orthopaedic surgeon in Chennai, ADEH member, and former editor of the Indian Journal of Medical Ethics opined that Such a model for private operations of district hospitals is likely to drive up healthcare costs.
“The concessionaire shall provide all healthcare services to the free patient, free of cost,” the guideline document said.
Stakeholders can provide their written comments by or before January 10.

Source: News 18, Livemint, Telegraph India

   Send article as PDF