Healthcare industry has welcomed NITI Aayog's draft proposal to improve access to quality screening, diagnostic and treatment services related to three non communicable diseases (NCDs) viz. cardiology, oncology and pulmonology in district hospitals through public private partnerships.
Anjan Bose, secretary general of NATHEALTH, complementing the NITI Aayog's initiative, said “The government is keen to have collaborative approach to improve the healthcare delivery. We have had discussions with the NITI Aayog and Health ministry to promote PPP model in healthcare to ensure accessible, affordable and quality healthcare for all.”
NCDs will cost India US$ 6.2 trillion by 2010. Considering the severity of NCDs and overcrowded and resource-starved district hospitals, NITI Aayog's proposal to reduce the burden of public health facilities and ensure standard of care for NCD patients through PPP model is an interesting step. This will help manage and prevent NCDs in parts of the country, he said.
The aim of the proposal is to help state governments enhance access to NCD services in the district hospitals and also decongest tertiary facilities at the state level, reduce out-of-pocket expenditures for the patient on diagnosis, treatment and care and create infrastructure and develop capacity in the assigned district hospital to provide at least basic tertiary care and advanced secondary care related to the three NCD specialties in the medium and long term, he opined.
The PPP models in healthcare have not been very successful and scalable in the past. Therefore, it is important to ensure that robust agreements are drawn up and adequate regulation, governance mechanism is setup, added Anjan Bose.
As per the proposal drafted in consultation with World Bank, the state governments will lease space in district hospitals in tier 2 and 3 cities to a private player or a consortium of private players for 30 years to run 50-100 bedded hospitals offering NCD services. The space in district hospitals will be leased to private hospitals through bidding process. The government will provide private players viability gap funding (VGF) or one-time seed money, share blood banks, ambulance service, mortuary service, physiotherapy services, bio medical waste disposal and other infrastructure in the district hospitals.
There will be no reserved beds or no quota of beds for free services. Those having insurance will get cashless treatment at the health facilities. The state government will reimburse the private hospitals for the patients referred/approved by designated authority of the assigned district hospital.
User fee may be fixed as the package rates discovered periodically through states/centre health insurance scheme(s). States which do not have any such health insurance packages, could use Central Government Health Services (CGHS) package rates for period when such insurance rates are not available.