Public-Private Partnership (PPP) in Diagnostics: Will It Be A Game-changer For India’s Healthcare Development?

The advancement in the healthcare sector is one of the major contributors to India’s economic growth which is growing by 8 per cent annually. Some of the key indicators like increase in life expectancy and a decrease in infant mortality, clearly talk about the country’s progress towards developing a good healthcare system. The healthcare market in India is further expected to increase to the US $372 Billion by 2022 owing to the rising health awareness, increase in incomes and health insurances etc.

Furthermore, the healthcare situation will be improved to a large extent with the launch of Ayushman Bharat, the largest government-funded healthcare scheme that provides financial protection to 10.74 crore families for secondary and tertiary hospitalisation. Providing health insurance of up to Rs 5 lakh to each family per year, the cost will be borne by the central and the state governments.

Although India’s expenditure has risen from 1.2 per cent of GDP in 2013-14 to 1.4 per cent in 2017-18, there is still a huge gap in equal healthcare access to all, as the percentage is far below the GDP among countries with significant universal health coverage (UHC) services, as per National Health Profile (NHP) data2.

Accounting for just 20 per cent of the total healthcare expenditure, India’s public healthcare sector is not just minute in size but also under-funded to meet the current health needs of the country. Despite public healthcare’s widespread infrastructural network with many primary health centres, sub-centres, community health centres, secondary level district hospitals and a few medical colleges, there is no uniformity in the quality of services provided and are completely subjected to regional vagaries.

PPP models in the overall healthcare sector have been talked about in detail many times, but PPP models in diagnostic services still remain at a dormant stage. An effective PPP diagnostic model can go a long way towards the overall vision of equitable health for all. This requires focus and investment of the government, especially in diagnostics and can be achieved only through better partnerships with the private industry experts.

There needs to be an efficient solution to this challenge that addresses it through a concerted effort of both the public and private sectors. The government must eye better partnerships and incentives with private healthcare and diagnostic players if it expects to successfully achieve its target of universal and equitable healthcare for all. It’s now time for the government to make a choice whether it wants to take up a role as a provider or a payer. As a provider, it can contribute towards building infrastructure and managing operations of hospitals and diagnostic centres. In this role, there will be a slowdown in social insurance growth. As a payer, it can pay for healthcare services provided by the private sector, but that would again slow down the growth of public beds. The latter issue can be resolved by adopting PPP models as the provision of having private players, as it is predicted to show strong growth.

Providing the best services in a healthcare deficit country like ours, SRL Diagnostics has reached rural, tribal-dominated areas, and remote areas of Jharkhand, Himachal and Uttar Pradesh and provided best diagnostic services to the inhabitants. Occupying the top slot in diagnostic PPP space in India, SRL has successfully partnered with various state governments and continued to provide quality diagnostic services to everyone.

SRL has provided trained manpower to carry out phlebotomy services by setting up many diagnostic centres in PHCs in Jharkhand. SRL has gone a long way in helping state government of Jharkhand to improve its health indicators by carrying out 7.5 lakh tests of infectious and non-communicable diseases and by providing diagnostic services to more than 2.6 lakh individuals in FY17-18.

Through a government project meant for improving health facilities in UP, UPHSSP (Uttar Pradesh Health System Strengthening Project), the UP state government extended the PPP contract of SRL for all 22 district hospitals for the entire FY 17-18 by recognising the yeoman services provided by the diagnostic centre. Under this project, 400 health camps were held by SRL in various district hospitals for screening patients for various nutritional deficiencies and their health management plants were charted by the clinicians. SRL successfully carried out more than 8.5 lakh tests and provided high-end pathology services to more than 3 lakh patients.

Likewise in Himachal Pradesh, SRL did laudable work by providing uninterrupted diagnostic services in 24 health institutions of the state government. It served as many as 2.3 lakh patients who are dependent on state health facilities.

In a PPP model, government contributions can vary from providing land lease, upfront capital infusion, to giving financial concessions on the capital infused by the private players. For ensuring an effective PPP model in diagnostic space, it is important to have a national body (Like Ayushmaan Bharat for diagnostics) that looks into the commercial model viability for a win-win outcome for both public and private players. Furthermore, to keep private players motivated, there needs to be a system in place that processes time-bound payment and simultaneously, a transparent KPI bound system is needed to monitor the performance of all the private players to improve patient care.

Public-private partnership models are generally long-term and involve immense cooperation from the private sides. By carrying out millions of routine and specialised tests, the diagnostic centres under PPP models are doing a commendable job in difficult topologies, and extreme weather conditions to help the state governments in providing quality healthcare services. Through this, the centres are utilising all its resources to alleviate the suffering, improving the health of people who otherwise have low access to quality healthcare services and ensuring ‘quality health to all’.

Arindam Haldar

Guest Author The author is CEO, SRL Diagnostics