The effects of the pandemic have exposed faults in the structure of healthcare systems. To date, more than 5.9 million people around the world have died due to COVID-19. Although lack of funding is a significant factor that needs to be addressed, the non-resilience of many countries’ health systems to this unforeseen calamity is a crucial point of concern. Notably, rapid changes in the spread and mutation of the virus superseded every step taken by governments and global organizations. Yet, there is opportunity in every crisis. COVID-19 has brought the world’s attention to the importance of securing well-structured health care infrastructure.
India, a developing country, has its challenges in delivering excellent public health infrastructure. Some of the challenges include lack of resources, high population density, accessibility of healthcare in remote areas, awareness of basic health hygiene among people in rural areas, and disparities in doctor-patient ratios (1:1445 nationwide). These factors make the path to resilience difficult, especially as India was already coping with a pre-COVID crisis with high levels of fatal non-communicable diseases (NCDs), which account for 71% of all deaths globally.
What does the Indian healthcare system need?
The Indian government has attempted to introduce various healthcare schemes and subsidies. However, despite spending around 1.1% of GDP on healthcare, the government’s efforts have not had a meaningful effect on India’s public healthcare infrastructure. About 75% of healthcare infrastructure is located in urban areas, which are home to just 27% of the population. Various social, political, and economic factors also inhibit the government’s ability to make improvements.
Creating meaningful healthcare solutions may require lateral thinking. For instance, public-private partnerships (PPP) offer a robust and under-utilized option. They are usually associated with infrastructure development, but governments can also apply such partnerships to invest in technological advancement, implement government policies more efficiently, increase awareness of and access to proven treatments, and partner with global entities to improve the healthcare ecosystem.
A public-private partnership is a consortium of public, private, and sometimes not-for-profit organizations that share risks, resources, and decision-making. There have been many PPP projects in different sectors. According to NITI Aayog, 125 PPP projects worth around US$22.8 billion (Rs 1,72,314 crore) were appraised in 2020-21. Private entities are well placed to bring in innovation, and the government can allocate the risks and opportunities of projects in order to facilitate successful collaboration.
Key performance indicators should measure progress toward intended results and be aligned with business objectives, which might include, for example, improving health personnel training, collaborating with leading global health entities, transforming digital health systems, improving health insurance systems, and enhancing emergency preparedness. Ultimately, the government must regulate PPP projects to secure the public interest and ensure that efficient and reasonable health services are provided to the public.
Three Pillars of Public-Private Partnership
The ideal image of the PPP model is that it involves a perfect collaboration that can ease every issue, but in reality PPP projects can come with many challenges. Embracing the core values of Integrity, Cooperation, and Courage can ensure a strong foundation for the PPP model.
1. Integrity
The power of government, the history of healthcare malpractice, and the frauds and scandals that have plagued some private organizations generally breeds distrust and makes it difficult for ordinary people to believe in the PPP model. As a result, there has to be integrity when it comes to managing operational, human, and financial assets. The PPP partners should make decisions promptly and transparently, and possess all necessary skills and experience in order to reduce the risk that the intended results are not achieved.
2. Cooperation
Although the partners can hail from varied backgrounds, their values should be aligned so that they might act with a unified purpose. While the goal of any private entity is to make a profit, the values of any organization collaborating with the government must be aligned with the goal of making the country’s healthcare system more resilient.
In pursuing financial goals, private organizations can sometimes work contrary to the objectives of public health. For example, the producers of tobacco have goals that are misaligned with the values of public healthcare. In order to ensure alignment, a private enterprise that joins a PPP project should not only benefit financially but also provide products that clearly improve public health outcomes.
3. Courage
A PPP project may involve revamping infrastructure, training staff, developing new technologies, or building resources.
In the case of misalignment between public and private entities, the former has to show courage and promptly resolve any conflict of interest. If there is scope for negotiation, the contractual agreements governing the PPP project should lead to a transparent process of dispute resolution that protects the public interest.
The bottom line
India should seize the day and adopt a PPP model that can be used to develop a more resilient healthcare infrastructure. Confidence in public-private partnerships is growing in many sectors, with success stories found in education, technology, sports, and entertainment. Ultimately, the public sector has to take the initiative, adopt the PPP model, and place their trust in private entities. The latter must demonstrate their willingness to contribute to a better, safer, and more secure India.
Prateek Natani is an Associate Consultant at KPMG, and completed a Computer Science Engineering degree in June 2020. He is passionate about consulting and entrepreneurship, and his research interests include institutional strategy, technology, human development, and consumer behaviour.
Image: Pexels
🔴 Interested in consulting?