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 Table of Contents  
EDITORIAL
Year : 2022  |  Volume : 12  |  Issue : 5  |  Page : 195-196

Busting the myth: Has there been desensitising corporatisation of the Indian private health-care sector?


1 Department of Dental, Indraprastha Apollo Hospital, New Delhi, India
2 Manav Rachna Dental College, New Delhi, India
3 Department of Medicine, Sir Ganga Ram Hospital, New Delhi, India

Date of Submission29-Sep-2022
Date of Decision10-Oct-2022
Date of Acceptance15-Oct-2022
Date of Web Publication31-Oct-2022

Correspondence Address:
Shikhar Tripathi
Sir Ganga Ram Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmrp.cmrp_93_22

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How to cite this article:
Kakar A, Kakar S, Tripathi S. Busting the myth: Has there been desensitising corporatisation of the Indian private health-care sector?. Curr Med Res Pract 2022;12:195-6

How to cite this URL:
Kakar A, Kakar S, Tripathi S. Busting the myth: Has there been desensitising corporatisation of the Indian private health-care sector?. Curr Med Res Pract [serial online] 2022 [cited 2022 Nov 27];12:195-6. Available from: http://www.cmrpjournal.org/text.asp?2022/12/5/195/359945



Recently, the former Chief Justice of India (CJI) Mr. N. V. Ramanna commented on the 'Corporatisation of India's Health-care System' calling it “growing and unchecked”. He further went on to say “We are seeing hospitals being run like companies, where profit making is more important than service to society. Due to this, hospitals and doctors alike are desensitised to the plight of patients. They are just numbers for them”. While we are talking about numbers, we would like to remind the ex-CJI as well as the readers about the most recent example of the importance of the 'exponentially growing' private health-care sector – the COVID-19 pandemic.

It has been seen that the public sector health-care facilities have frequently been at the mercy of politicisation, with the biggest example of the same being that out of the entire gross domestic product of our country, only a meagre 2.1% is spent on the health-care sector. In such a scenario, private health-care establishments offer a haven for patients, through an unabridged and thorough medical approach. This is not just an abstract statement but has been proven to be an absolute certainty during the COVID-19 pandemic, where the private sector proved to be an integral and majority stakeholder of patient care in India.[1]

The WHO defines the private health sector as 'the individuals and organisations that are neither owned nor directly controlled by governments and are involved in the provision of health services.'[2] This umbrella definition covers over two-thirds of the health-care sector in India and gives us an important insight, i.e., the need for public–private partnerships for universal health-care coverage for the Indian population. During the first wave of COVID-19 in India, around May 2020, the last reported data claimed that there were 0.53 hospital beds for every 1000 citizens.[3] Out of these, the majority come from the private health-care sector, which are accompanied by vast numbers of doctors as well as nursing care providers. This brings us to a simple conclusion that the majority of health-care services could potentially be provided by the private health-care sector, given the massive numbers. However, there has been a great sense of underutilisation among the stakeholders of this sector,[4] majorly pertaining to the stigmatisation of the 'prejudiced' corporatisation.

During the pandemic, there was a time when the private health-care sector could not get optimally involved in patient care due to a lack of information and protocols regarding the novel disease; however, even at such a junction, these health-care workers contributed in many ways. We saw a surge in telehealth services, majorly driven by the private health-care sector to aid patients suffering from all kinds of ailments, during the many lockdowns our country faced.[5] There were crucial researches and trials that were conducted and published, by the private health-care sector in tandem with the public governing bodies. Once the integration of the private health-care sector into patient care for COVID-19 was possible, there was a smooth surge in the improvement of patient outcomes; this was not the story of merely the first wave, but the awakening reality of the second wave, where the public–private integration became integral to curb negative patient outcomes irrespective of the increasing number of cases.

Considering that the distinction of the health sectors is solely based on economic and administrative control and not that of distinction of efficiency among the doctors, if we were to qualitatively compare the two sectors to assess the efficiency of the statement by the Honourable ex-CJI, we will have to do it based on the most important variable quality of care. For the same, let us refer to the most widely used standard for this assessment, the structure, process and output Framework by Donabedian, along with the WHO Framework for health system performance assessment.[6],[7] Based on these standards and figures from the latest reports as already cited within the text, the quality of care in the private sector was found to be better than the public sector. If both sectors were to be considered equivalent for efficiency, accountability and medical effectiveness, the private sector was still considered better with respect to timeliness and hospitality towards patients.[8]

Furthermore, if we are to talk about the highlighted remark, calling the advancement of the private health-care sector in India 'growing and unchecked', we should refer to the recent publication from the NITI Aayog.[9] The body has clearly stressed about the incentivised investment opportunities in the said sector and aims at further growth within it. What can be explicitly seen is the wide array of possibilities that the private sector is presenting as 'services' and potential employment, along with the guarantee of improved patient care, as discussed above. As a humble reply to the claim of 'profit-driven approach' by the private health-care sector, it is integral to remember that these institutions often function without economic support and require capital to continue providing quality care that is optimum as per the required standard of care.

The aforementioned paragraph was only intended to do a factual assessment and to bring to light the distinction between the two arms of Indian health-care services. If we were to believe that the statements stood no ground, it will be arrogant of us, not merely as individuals, but as the fraternity as a whole. There are definitely gaps that can be targeted. We definitely require a more steady public–private partnership, where patient care can transition from one sector to another, without any disturbance to the patient. While talking about this, we must refer to the recent innovative policies initiated by the government, where patients receive aid within their health-care services. As it has long been seen with the private players of the insurance market, delays in the release of claims often hurt both private institutions and patients alike. With the onset of beneficial policies by the government, there needs to be an establishment of mechanisms that could ease the transition of health-care services between the two sectors by allowing easier financial access to these services, majorly by increasing the liquidity within these policies. This potentially relieves the issue of 'excessive barriers' for the poor to access decent healthcare.

It is true that there is a disparity in the distribution and access to healthcare among both the economically stable and weak sections of society and the rural and urban sections of society. However, it is a gap that can only be bridged by a joint public–private partnership. Given that the government's policies provide means for the same, it is only correct to harness this relationship rather than raise claims of immoral practices towards one or the other.

To conclude, we are students at the inception of our professional careers, and there should not be negative publicity about either health-care sector, which might affect the promising minds of our country. India is en route to a successful journey towards achieving Agenda 2030, and the public–private partnership in the health-care sector will be the key to achieving universal health-care coverage in our country.



 
  References Top

1.
Economic Survey 2021-22. Ministry of Finance, India. 2022. Available from: https://www.indiabudget.gov.in/economicsurvey/ebook_es2022/index.html. [Last accessed on 2022 Sep 1].  Back to cited text no. 1
    
2.
Klinton J. The Private Health Sector: An Operational Definition. Geneva: 2020.  Back to cited text no. 2
    
3.
Hospital Beds (per 1,000 people) | Data. Available from: https://data.worldbank.org/indicator/SH.MED.BEDS.ZS?End=2019&start=1960&view=map. [Last accessed on 2022 Sep 01].  Back to cited text no. 3
    
4.
Davalbhakta S, Sharma S, Gupta S, Agarwal V, Pandey G, Misra DP, et al. Private health sector in India-ready and willing, yet underutilized in the COVID-19 pandemic: A cross-sectional study. Front Public Health 2020;8:571419.  Back to cited text no. 4
    
5.
Kakar U, Tripathi S, Gogia A, Kakar A. Telemedicine: An evolving practice in India. Curr Med Res Pract 2021;11:62-4.  Back to cited text no. 5
  [Full text]  
6.
Donabedian A. Evaluating the quality of medical care. 1966. Milbank Q 2005;83:691-729.  Back to cited text no. 6
    
7.
Murray CJ, Julio F, World Health Organization, editors. WHO framework for health system performance assessment. In: Global Programme on Evidence for Health Policy: World Health Organization; 1999. Available from: https://apps.who.int/iris/handle/10665/66267. [Last accessed on 2022 Sep 24].  Back to cited text no. 7
    
8.
Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D. Comparative performance of private and public healthcare systems in low- and middle-income countries: A systematic review. PLoS Med 2012;9:e1001244.  Back to cited text no. 8
    
9.
Sarwal R, Prasad U, Madangopal K, Kalal S, Kaur D, Kumar A, et al. Investment Opportunities in India's Healthcare Sector.: NITI Aayog; 2021.  Back to cited text no. 9
    




 

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