Name of Presenter: Ajay Bhattacharyya Position : Deputy Secretary-Medical Services Branch

1. PUBLIC PRIVATE PARTNERSHIP (PPP) MANAGEMENT UNIT INWEST BENGAL Name of Presenter:Ajay Bhattacharyya Position : Deputy Secretary-Medical Services Branch Health & Family Welfare Department Government of West Bengal, India

2. Overview of PPP initiatives under Government of West Bengal • Onset of PPPs was in the mid nineties at the Secondary and Tertiary health care. However, structured PPP initiatives started only from 2003 under KfW funded Basic Health Project in West Bengal • PPP Policy officially launched in Jan 2006 for improved health care services for the community at large • PPP Cell was also formed subsequently at the State and District level to develop, implement, monitor and coordinate all PPPs. • More recently, a high powered Committee has been formed at the Apex level to explore the possibilities of new areas of PPP initiatives. • For implementation, West Bengal Medical Service Corporation would be the entrusted agency.

3. Type of PPPs Primary Health care level Initiated under KfW funded Basic Health Project Ambulance Services in Rural Hospitals (RHs) and Block Primary Health Centers (BPHCs) through operational management by NGOs/CBOs under PPP Diagnostic Services in RHs and BPHCs by Private Sector Partners/NGOs under PPP Planned Preventive Maintenance (PPM) Other Initiatives by the Department Running of Training Schools for Auxiliary Nurse & Midwives (ANMs)-[need based]. Mobile Healthcare Services in Sunderban riverine area. Secondary Health care level CT Scan services through Private Sector Partners in District Hospitals Disposal of Bio-medical waste Tertiary Health care level CT Scan and MRI Services in Medical Colleges through Private Sector Partners Mechanized Laundry Services (in selected facilities)

4. Partnership/Actors Involved PUBLIC PARTNER Health & Family Welfare Department and its various wings Government of West Bengal PRIVATE PARTNERS NGOs, CBOs, Trusts, Social Welfare Organizations Private Sector Organizations Corporate Bodies Support from Consulting Organization in effective implementation

5. Project Objective Improved and increased access of the community at large for quality health care services Supplement the ongoing efforts of the Government of West Bengal Affordable cost/rate for services under PPP Proper safety net for the Below Poverty Line (BPL) population Optimum utilization of scarce public resources targeting the poor. Consolidating the strengths of both the partners on mutually beneficial terms to achieve the desired health outcomes Involving NGOs/CBOs and Civil Society for ensuring better access to services by reaching the community at large

6. Project Set-Up and Arrangements Consultations with stakeholders on structured check-list to find out issues and addressing of these issues before designing of scheme Designing of schemes, agreement and Standard Operating Procedures Selection of Partners based on eligibility criteria and Expression of interest (EoIs) and subsequent bidding Necessary measures and support to selected partners for setting up and launch of services Post operationalisation administrative support and troubleshooting Monitoring for strategic intervention for compliance of SOPs and greater utilization of services

7. Key Milestones Ambulance Services Round the clock emergency transportation facilities through NGOs in remote places at user charges fixed by District level Authorities Transportation of delivery cases facilitating institutional deliveries Adequate and proper Safety net for the poor Facilitating development of ambulance network in rural areas Diagnostic Services Providing essential Pathology and Radiology services at low cost with quality assurance at Primary Health Care level Safety net for BPL category of patients with free services

8. Challenges and Mitigation Plans Challenges Changing mind set of the stakeholders on PPP Resistance from the stakeholders of prevalent practice. Capacities of both the partners on management of PPPs Compliance of SOPs by the operating partners and quality assurance Initiating proper safety net and monitoring its utilization Mitigation plan Consultation with stakeholders on issues before designing of scheme Advocacy initiatives and Capacity Building programme were planned after launch of services Administrative support and trouble shooting by the department PPP cell at the state and district level for better monitoring

9. Progress to Date Ambulance Services in BPHCs: Round the clock services through out the State by133 ambulances provided under KfW funded project initially and subsequently 201 ambulances by DFID funded project Subsequent introduction of safety net through cashless delivery transportation under NISCHAY JAN Scheme Ensuring availability of Ambulance through Dial-up tool free networking system. Diagnostic Services in RHs and BPHCs: 64 such centers could be established till date. Others are in progress. Other PPP schemes Inspired by the success, other PPP Schemes e.g., Dialysis services, CT Scan and MRI facilities have been introduced in secondary and tertiary sectors.

10. Lessons Learnt Formulation of schemes under PPP requires involvement of all stakeholders in general and people in particular. Need for greater understanding of the PPPs at the People’s representative level (e.g. Panchayeti Raj Institution) Need for Advocacy for PPP initiatives at the initial stage Initiatives for capacity building and change of mind set for both the partners at the operational level immediately after signing of agreement Protocol for quality assurance needs to be put in place Periodical financial analysis required for sustainability

11. THANK YOU