Strategies to Enroll Private Sector in Public Health Care: An Indian Experience

The Constitution of India under health care allocates various services to the Central or State Governments based on 3 lists viz. a) Central List includes research, establishment of tertiary level institutes etc. b) State List includes provision and regulation of basic preventive, promotion and curative services, establishment of public health and sanitation services, hospitals and dispensaries etc. c) Concurrent List includes programs like population control, family planning, medical education, registration of births and deaths etc. The Central Government provides guidelines and the respective State government implement them. On the whole, provision of majority of health services is States' responsibility. Due to the limited capabilities of the Public health Sector in providing health care service to all and the public expenditure on health being less than 1% of GDP, the need of Public Private Partnership in healthcare system was emphasized. The private sector today provides nearly 80% of outpatient care and about 60% of inpatient care. To reap the benefits of private sector in health care industry private healthcare sector is recognized as an integral part of the Indian Healthcare by the National Health Policy 1983 and thereafter Mtional Health Policy 2002, National Population Policy 2001 and National Rural Health. Private health care in its own way is complementing and supplementing efforts of public health care system. However the results are not encouraging as private sector is a profit making institution which is not ready to work with public sector unless they get profits. In this paper we will examine the reasons why the private sector is not ready to enroll itself in government programmes and what can be done to overcome this situation.