What is the issue?
- The Centre has proposed in the Union Budget 2020 to attach medical colleges to existing district hospitals in the PPP mode.
- This is being done to ostensibly address the shortage of doctors in the country.
What is the proposal?
- The proposal says that the States which fully allow the facilities of the hospital to the medical college and wish to provide land at a concession would be eligible for viability gap funding.
- Several details are already available in the public domain, as part of the plan, first proposed by NITI Aayog.
What did the NITI Aayog propose?
- The NITI Aayog argues that it is practically not possible for Central and State governments to bridge the gaps in medical education due to their limited resources and finances.
- This necessitated the formation of a public-private partnership (PPP) model which will combine the strengths of both sectors.
- (PPP model - Collaboration between a government agency and a private-sector company to finance, build and operate projects).
What would be the impacts?
- This would augment the number of medical seats available and moderate the costs of medical education.
- Experts have argued that the NITI Aayog hasn’t given sufficient role to the district hospital as the pivot of primary health care in every State.
- Allowing private parties to operate and maintain the district hospital could dent public health services.
- It is problematic that the NITI Aayog envisages the creation of free patients versus others, because this will create a new category of have-nots.
- The agreement indicates that the private firm can demand, collect and appropriate hospital charges from patients.
Why is there an opposition?
- There is understandable opposition to the scheme in States such as Tamil Nadu that have a robust public health-care system, and a medical college in nearly every district.
- These States are naturally loath to turning over a key unit in their health-care network to the private sector motivated by profit rather than public interest.
- This is because they are already running reasonably efficiently.
- The creation of quality medical professionals for a country should be on any government’s to-do list.
- But destabilising people’s access to affordable public health services will be disastrous.
What could be done?
- The government must consider raising health-care spending beyond the usual under 2% of GDP.
- It should ensure more resources are available to provide free, quality health care to all.
- If it does stay on its path of giving the private sector some control over district hospitals, it will be a small act that will lead to much larger, more serious, and less desirable consequence.
Source: The Hindu
