PPP Hospital Model Faces A Health Check

Bhopal: The Madhya Pradesh govt plans to offload management of a district hospital on PPP model, asserting that this will enhance healthcare and medical education in remote districts.Critics in the public health sector ask for evidence, pointing out that pilot projects in the past failed to meet expectations.In response to TOI report on Monday, Madhya Pradesh deputy chief minister and health minister Rajendra Shukla said that the initiative aims to make MP a leader in health parameters by ensuring accessible and timely healthcare for all citizens. To achieve this, the state is adopting the PPP model to strengthen and expand healthcare services, he explained.Shukla said that NITI Aayog and the union govt support this approach, which includes establishing new medical colleges in 12 districts — Katni, Morena, Panna, Bhind, Ashoknagar, Guna, Dhar, Sidhi, Betul, Khargone, Tikamgarh, and Balaghat. This initiative seeks to uplift health standards and transform Madhya Pradesh into a medical hub through optimal resource utilization.The govt has set specific contractual terms to ensure that the benefits reach public effectively. This strategy is part of a broader vision to enhance quality and accessibility of healthcare services across the state, he said. By focusing on expanding and improving healthcare infrastructure, MP aims to deliver better health outcomes for its residents.Countering this, nine organizations representing various wings of the govt health sector and non-profit organisations expressed their opposition at a press conference on Sunday.They argued that the draft document heavily favours the private hospital operator. For instance, it does not mention "free medical care" explicitly, they claimed.However, it does specify that charges for medical services and treatment at the hospital will be as per Ayushman rates. Concessionaires would be entitled to receive payments under the Ayushman or any substitute thereof for services rendered to free patients.However, once the upper limit of Ayushman card is exhausted, will the patient be eligible for free care? Govt-run hospitals provide free care and heavily discounted care, irrespective of Ayushman card status."The draft document refers to medical treatment. Under Article 21 of Constitution, the govt has a duty towards safeguarding the Right to Life, and Article 47 lists improvement of public health among its primary duties," said Jan Swasthya Abhiyan representative, Amulya Nidhi."There is no evidence that PPP model for hospital operation has been successful anywhere in the country. The proposal has been undertaken without evidence or pilot projects that lead to improvements in public healthcare. A hub-and-spoke model, introduced in 2014, is a notable failure," he added.Dr Madhav Hasani, president of MP Medical Officers Association, highlighted a persistent issue in MP health department. "In undivided MP there were 620 MBBS seats, today there are 1,700. In the last decades there has not been a single instance when health department had 100% filled posts. The reason is it was unattractive to lure doctors," Dr Hasani said.Govt says the PPP-model will solve this by facilitating recruitment of specialist doctors and skilled healthcare personnel in the new medical colleges and hospitals.