'People who are seriously ill prefer govt sector over private'

In an interview with Deccan Herald, Anshu Prakash, principal secretary, Health and Family Welfare, Government of Delhi, spoke on the situation of primary health care in the Capital.

Can public-private partnership model work in primary health care in Delhi?

PPP is a wide canvas. There can’t be one model. What can be done in Delhi
is different from what can be done in other parts of the country. Delhi has a fairly extensive network of the government primary health care. We also have a large network of secondary and tertiary care hospitals. Interventions by the private sector in providing primary health care can largely be for charity purposes.

Therefore, there are so many charitable hospitals giving primary health care. Additional proposal can be considered but land being a scarce and an expensive resource has to be optimally utilised by the government. Also the different conditions that can make a PPP project a success must exist in which the benefits of that model will be or can be reaped.

Is the ratio of one Primary Urban Health Centre per 50,000 persons good enough as stated under Delhi State Health Mission?
These are just numbers. They essentially should be justifiable to put a standard and service delivery in place. It has to be seen holistically otherwise. In places, where alternatives exist, less patients come for the government health care delivery and thus the government doesn’t need to spend in infrastructure there. At other places, the ratio would differ.

This has to decided on the basis of footfalls received. You cannot generalise the target population of a particular PUHC. However, one PUHC per 50,000 persons gives a benchmark. They are yardsticks depending on the area and similar medical facilities in such places. We have arrived on the figure based on our experience. It has to be a more dynamic process.

What measures are you adopting to improve infrastructure and service delivery?
Normally, all our dispensaries provide basic tests, and people have confidence in us. My experience shows that people who are seriously ill prefer the government sector over private. But whenever there is a situation where a dispensary is not functioning well, we need to rectify. We take proper measures to resolve it.

A patient going to a government dispensary doesn’t get any priority even after being referred to a government hospital. Your comment on this.

Our health care system is different than other countries. In the UK, a person goes only to one’s own general physician. Hospitals do not take care of the patients directly.
In India, it is not the same. In Delhi, we receive even outstation patients. So, there cannot be any prioritisation. Ideally for basic routine problems, primary health centres and dispensaries should be contacted. People should go to secondary and tertiary level only when needed. But that unfortunately does not happen.