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ROLE OF THE PRIVATE SECTOR IN DELIVERY OF HEALTH CARE

ROLE OF THE PRIVATE SECTOR IN DELIVERY OF HEALTH CARE. Dr. Aruna Rabel Medical Administration Manager Durdans Hospital Annual Health Forum – 2007, BMICH. This is a joint presentation of. Appollo Hospital Ceylon College of General Practitioners

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ROLE OF THE PRIVATE SECTOR IN DELIVERY OF HEALTH CARE

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  1. ROLE OF THE PRIVATE SECTOR IN DELIVERY OF HEALTH CARE Dr. Aruna Rabel Medical Administration Manager Durdans Hospital Annual Health Forum – 2007, BMICH

  2. This is a joint presentation of • Appollo Hospital • Ceylon College of General Practitioners • Durdans Hospital • Glaxo Smith Kline • Mackwoods • Nawaloka Hospital • Oasis Hospital

  3. What is the Private Sector ? Any thing other than Government (State or Public) Sector - Mr.C.P.de Silva – Former Chairman Chamber of Commerce At OPA Annual Sessions 2004

  4. Private Sector in Health Care The whole gamut from small scale pharmacies and General Practitioners to large scale hospitals and pharmaceutical companies

  5. Contribution to GDP • State Sector - 20% • Informal Private Sector – 45% • Formal Private Sector – 35%

  6. Private Sector in Health Care • Hospitals • General Practitioners • Diagnostics Services • Physiotherapy and Rehabilitation Units • Ambulance Services • Home Nursing Services • Centres for Disabled • Pharmacies • Pharmaceutical Companies • And many more

  7. Health Expenditure – Sri Lankaas a percentage share of GDP [Source – National Health Accounts 2000 – 2002 ]

  8. Number of Private HospitalsCourtesy – Institute of Health Policies

  9. Beds in Private HospitalsCourtesy – Institute of Health Policies

  10. Bed Capacity • State : Private – Sri Lanka -- 16 : 1 Western Province – 8 : 1 • 65 % of the Private Sector beds are in Western Province

  11. Performance

  12. Performance ( 1990 – 2005 ) • Number of Private Hospital beds - + 100 % • Number of Inpatients - + 100 % • Number of Out patients - + 140 %

  13. Performance - CABG

  14. Performance - PTCA

  15. General Practice • Full Time GPs – 600 ( CCGP ) 800 ( Independent Survey) • 2.8 / 100,000 population ( 1:35,000 people ) • 35 % of Ambulatory Care handled by GPs

  16. Exact details of the private sector performance is not readily available as there is no mechanism to collect data.

  17. Challenges • Investment barriers • Infrastructure • Human Resources • Maintenance of High Quality Care • Introduction of Cutting - edge Technology • Expectations of Consumers

  18. History of Public – Private Partnership • Involvement of Traditional Health Care Providers • Referrals to State Hospitals by General Practitioners • ‘Channel Practice’ by Government Sector Consultants • Supply of equipment and pharmaceuticals by private sector

  19. Partnership - unofficial • State sector doctors working in private sector after working hours • Referrals to govt. hospitals from General Practice • Investigations and admissions through channel consultations • Certain investigations sent to private sector and patient bears the cost.

  20. Partnership - official • Laboratory and other diagnostic services are obtained during trade union actions and break downs. • Purchases – drugs state sector monopoly was done away with open economy in 1978. • Purchases – equipment mainly supplied by the private sector

  21. Partnership - official • President’s Fund – assistance in major surgical procedures, treatment abroad • Employees’ Trust Fund • Social Services Ministry • Govt. employees’ insurance

  22. Advantages of Partnership • Multi - sectoral collaboration • Cost reduction • Participatory planning • Increased efficiency in delivery of health care • Fill the service gap

  23. Advantages …….. • Sharing of resources • Quality assurance • Improved community participation • Reduced cost for health • Confidence of donor agencies

  24. Outcome of Poor Partnership • Poor utilization of available resources • Unnecessary investments by both parties • Increasing cost of health care • Drawbacks in quality assurance • Unplanned health care delivery

  25. Areas for partnership • Primary Health care • Secondary Health care • Tertiary Care • Training of Health Care Personnel • Health Care Planning • Management

  26. State Policy The government will facilitate the development and regulation of the private health care sector and promote better coordination with this sector. -National Health Policy 1996

  27. Private Sector must be enhanced and strengthened to provide a buffer for free health care Hon. Nimal Siripala de Silva Minister of Health & Nutrition Annual Health Forum - 2007

  28. Need of the Hour Public – Private Dialogue initiated by the state With equity and fairness

  29. Can’t we do it now?

  30. Acknowledgements • AHF – Secretariat • Dr. Amal Harsha de Silva – Director PHSD • Dr. Ravi Rannaneliya

  31. Thank you

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