Regulating the private health sector

What is the issue?

In India there is an absence of strong regulatory system, to oversee exploitation or malpractice in private and public healthcare sectors.

What are the significance Indian healthcare sectors?

Indian health care has achieved success in delivering speciality services be it cardiology, oncology, complex surgery etc.
Sophisticated diagnostics have revolutionised medical treatment at a fraction of the cost of treatment overseas.
In India private health sector accounts for 80 per cent of outpatient care and 60 per cent of inpatient care.
The private health players were conferred the status of industry which opened access to cheap, long-term loans.
Private health sector followed 100 per cent automatic Foreign Direct Investment (FDI) from 2000 onwards.

What are the concerns in accessibility of proper healthcare?

In India speciality hospitals have a presence only in the metros and other major urban centres.
In India there are only about 30,000 Primary Health Centres, that to located some 5-15 kilometres away from hundreds of villages.
The cost of going to a qualified doctor involves foregoing the day’s wages for rural masses and facing unforeseen expenditure on transport.
Due to this a daily wage has perforce to go to an unqualified practitioner (UMP).
Provision for free medical treatment to economically weaker sections of patients is often ignored by private institutions.
There is general impression prevails that private establishments are often unethical, greedy, treating medical service as a business and hospitalisation as a source of profit.

What is the status of unprofessional medical services?

A WHO (2016) analysis reveals that India has more unqualified practitioners than qualified doctors.
The bulk of the Indian districts have no private hospitals while innumerable single practitioners run thriving businesses.
These establishments are run by persons whose highest qualification is at school level- possessing no recognised medical qualification whatsoever.
Rural inhabitants are expected to visit Government sub centres managed by an auxiliary midwife (ANM,) for health care.
An ANM is however not authorised to stock or prescribe drugs needed for acute illnesses.
In the absence of enforcement, UMPs and ANMs stock and treat with strong medicine often as demanded by the patient.
As a result multi-drug resistant TB, failed antibiotic treatment and the irrational use of fourth generation drugs have become a reality.

What are the shortfalls with government polices?

There is virtual absence of regulation of almost everything that happens standards, quality, costs and the absence of an ombudsman.
Due to unjustified exemptions many trusts and charitable hospitals across metros have avoided binding obligations towards the weaker sections.
Regulators like the Medical Council of India and the State Medical Councils rarely react to medical malpractice.
Consumer Protection Act 1986 deals with the failure of service contracts and compensation are not applicable for public sector doctors.
Clinical Establishment Act 2010 was made to register and regulate all health establishments.
Not a single state has actually adopted the Act by establishing a regulatory structure capable of enforcing either standards or quality.

What is the way forward?

Technological and regulatory oversight have controlled the private sector in telecommunications, electricity, civil aviation and corporate enterprise.
A host of Authorities, Boards, Commissions, Tribunals and Appellate bodies have exercised the power to supervise and enforce.
Likewise needs for a strong medical sector regulator for treating and saving human lives has a larger imperative.

Source: Business Standard