Public Private Partnership In Healthcare

1. Healthcare East 2008 Hotel Oberoi Grand; Kolkata 3 September, 2008 Public Private Partnership In Healthcare Dr. Ajit K. Nagpal MBBS (AIIMS), MHA (AIIMS), MPH (Harvard) Chairman CII Healthcare Sub-Committee on PPP Batra Hospital & Medical Research Center Wellogic Group of Companies Former Advisor Ministry of Health United Arab Emirates

2. Public Private Partnership in Healthcare Preamble “Healthy People make a Healthy Nation” Therefore, Healthcare must form an integral part of Socio-Economic development of the Society

3. Public Private Partnership in Healthcare Preamble • The extent of healthcare spending in a country depends largely on its national economy • However, the manner in which these funds are collected, allocated and utilized depends largely on Public Policy • Consequently, the extent to which healthcare services are developed, distributed and accessed is also influenced by Public Policy • Therefore, many progressive nations have used Public Policy initiatives to incentivize financing and provision of Healthcare

4. Public Private Partnership in Healthcare CII Initiative • CII National Committee on Healthcare has constituted a Sub-Committee from amongst the Lead Stakeholders in Healthcare Industry: • To study the avenues of collaboration between the Public and Private Sectors of Healthcare Industry, and • To recommend Public Policy initiatives that would foster Public Private Partnerships and stimulate investment in Health Sector to shape the future of Healthcare Industry in the country

5. Public Private Partnership in Healthcare Deliberations • The Healthcare Sub-Committee has had extensive and exhaustive deliberations over the past four months since its constitution and has observed that the avenues of Public Private Partnerships in Healthcare have very wide dimensions which extend: • From: • Development and Strengthening of Healthcare Infrastructure evenly distributed geographically and at all levels of care

6. Public Private Partnership in Healthcare Deliberations • Through: • Management and Operation of healthcare facilities for technical efficiency, operational economy and quality; and • Capacity Building for formal, informal and continuing education of professional, para-professional and ancillary staff engaged in the delivery of healthcare

7. Public Private Partnership in Healthcare Deliberations • To: • Creation of voluntary as well as mandated third-party financing mechanisms • Establishment of national and regional IT backbones and health data repositories for ready access to clinical information; and • Development of a maintenance and supply chain for ready availability of serviceable equipment and appliances, and medical supplies and sundries at the point of care

8. Public Private Partnership in Healthcare Observations • The Sub-Committee has further observed: • That the Government is the largest provider of healthcare in the country especially at the Primary and Secondary care levels; and • That the Government is also the largest buyer of healthcare services at the Tertiary and Quaternary care levels

9. Public Private Partnership in Healthcare Observations • Further: • The Private Sector investments in healthcare have been driven by free market economy, and the pricing of healthcare services has been largely influenced by investment cost • Consequently, these services have remained out-of-reach of a large majority of our population due to cost consideration

10. Public Private Partnership in Healthcare Recommendations • The Sub-Committee therefore suggested the following measures as Public Policy initiatives to incentivize investment in healthcare and enhance the pace of development of healthcare infrastructure in the country: • equity participation by the Public Sector • low rates of interest on investment • tax holiday for an extended period • buy back arrangements, and • non-compete agreements

11. Public Private Partnership in Healthcare Recommendations • The Sub-Committee also suggested: • That healthcare services, must of necessity, be reachable by the beneficiaries within a reasonable time/distance, and therefore prime land at subsidized rates could reduce the investment cost and consequently the price of healthcare services

12. Public Private Partnership in Healthcare Recommendations • Further: • That management and operation of public hospitals was a serious concern and could be considered a major thrust area of Public Private Partnerships where the Private Sector could take responsibility of strengthening and management of public hospitals against a consideration or against sharing of services between various economic segments of the society and funded partly through a budget grant and partly through fee for service

13. Public Private Partnership in Healthcare Recommendations • And: • That education facilities for development of human resource in medical and allied disciplines are highly inadequate and would need a major policy initiative in building capacity in which Private sector could play a significant role in complementing the efforts of the Government

14. Public Private Partnership in Healthcare Recommendations • And Since: • This issue of development of human resource is a major success factor in the development and management of healthcare infrastructure; there was an imminent need for major Public Policy initiatives to foster and facilitate capacity building, credentialing and accreditation of human recourse for the healthcare industry

15. Public Private Partnership in Healthcare Recommendations • The Sub-Committee further suggested: • That the financing options to provide equitable and universal access to basic healthcare services through mandated and voluntary insurance and other third party payment programs is yet another area of interest in Public Private Partnerships, where Public Policy initiatives could mobilize substantial resources for the Health Sector and facilitate cross subsidy for BPL and APL segments of the society

16. Public Private Partnership in Healthcare Recommendations • The Sub-Committee further observed: • That availability of demographic and clinical information at the point of care can significantly influence the choice of clinical intervention and consequently the clinical outcome, and therefore suggested development of regional and National data repositories accessible through web based smartcards applications and/or an IT Backbone, where feasible

17. Public Private Partnership in Healthcare Recommendations • The Sub-Committee also observed: • That ready availability of serviceable medical equipment and appliances and medical and allied supplies and sundries at the point of care significantly influence clinical effectiveness and quality in the delivery of care, and therefore suggested establishment of nation wide equipment maintenance and distribution networks through Public Private Partnerships

18. Public Private Partnership in Healthcare Summary & Conclusion • In summary: • It has been my endeavor to project the big picture of the healthcare scenario in the country as perceived by the CII Healthcare Sub-Committee and the envisioned role of Public Private Partnerships to foster rapid development and optimizations of healthcare delivery mechanisms that would provide universal access and continuum of care in the country for the collective good of our people 18

19. Public Private Partnership in Healthcare Summary & Conclusion • The Report of the Sub-Committee is under final scrutiny and is likely to become available for distribution before the end of the month • With heartfelt appreciation of my Team members for their significant contributions, my gratitude to the organizers of Healthcare East 2008 for the opportunity to share the observations and recommendations of Sub-Committee with you, I wish to conclude my presentation with my sincere appreciation for patient listening 19

20. Healthcare East 2008 Hotel Oberoi Grand; Kolkata 3 September, 2008  Thank You 20