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Attaching Medical Colleges to Hospitals

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February 04, 2020

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

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