In India the public health services are under severe strain. The lower income group and poor people cannot afford to go to a private doctor.They depend mainly on government health care systems. But most Primary Health Centers and hospitals don’t provide tangible health care to its people. The reasons for this are– irregular and limited supply of medicines, shortage of doctors, inadequate funds, apathetic and callous medical staff and the excessively bureaucratic operation of the system.
Primarily due to these reasons and due to its inadequacy and inefficiency, people see the government health system as falling. But health care staff feel that they need more and better resources and a degree of autonomy, if they are to function at their best.
Because of the inability of the government department to provide satisfactory health care to its people, new and revolutionary alternatives in health system management are constantly being searched for. In this context, the concept of Public Private Partnership(PPP) can be considered, but how effective it is, needs to be analysed.
It has been thought to be a good alternative because it has the capacity to reduce the financial burden of the state, strengthen the capacity of the private sector to cater to the health need of the people and improve the quality of health care through new management structures, by providing subsidized land to set up private hospitals, handing over the management of PHCs to NGOs and by involving industries to manage the health centers and so on.
It seeks to involve all actors to raise funds for the upkeep of the public hospital, thereby ensuring their participation in the management of health services. In other words, it seeks direct involvement of the users(people) and service providers(doctors) in the management of the hospitals by levying user fees on the patients, opening up the land for commercial purpose and giving the cheque signing authority to the secretary and taking care of the patient welfare department(by opening canteen etc).
There is no doubt that the promotion of the private sector in the health care has the potential to generate extra resources and make way for the redistribution of existing government resources to the poor.
But first there is a need to clearly identify the proper roles of the government sector and the private sector. The eternal question is, will these private partners be really helpful in promoting the health of the society or will be there just to make profit, and if that is so, what is the possible solution.There is also a need to draw the distinction between financing and providing health care services and between two kinds of non-government entities—private for profit and non-profit organizations .It is somewhat evident that the private (profit organizations) might not be interested in achieving the health goals, so some services like laundry, catering etc can be given to them.
In the above context, societies like Rogi Kalyan Samiti in Madhya Pradesh, Rogi Kalyan Samiti in Rajasthan and Chikitsa Prabandhan Samiti in Uttaranchal were formed, their main aim being the involvement of the community in hospital administration .
Chikitsa Prabandhan Samiti is working in 27 district hospitals of Uttaranchal. A preliminary survey was carried out in these hospitals about the functioning of CPS , by seeing the condition of these hospitals and by studying the satisfaction levels of the patients and based on these findings, certain conclusions were derived.
