Profit motive vs duty of state to save more lives

Can PPP model be used in healthcare, is a question that boggles authorities

Can’t the government do away with outsourcing in the health sector? Despite it being a straight question with no mention of the Sushruta Trauma Centre incident, health minister A K Walia is cautious enough to know what the next question could be.

He is in no hurry to reply. After a minute-long reverie, the doctor-turned-politician neither commits to a yes nor a no.

“Whether it is outsourcing of some private individuals or work being done by our own government staff, unless there is proper monitoring, there will be a problem,” he says, then questions how come private hospitals like Apollo, Fortis and Max are run smoothly by individuals.

“It is because there is proper monitoring by superiors. Sushruta Trauma Centre failed here. The contractor was supposed to hire four helpers and four supervisors, along with a senior over these eight,” he says.

“But he was managing with just one unqualified supervisor. This should have been brought to our notice by the hospital staff, and the tragedy could have been averted,” adds Walia. He says the same contractor could be supplying oxygen to some private hospitals as well, but there they won’t have him behave negligently.

Former city health minister Harshvardhan says public-private partnership (PPP) in the healthcare sector should be avoided as much as possible. “Providing quality medical facilities to all is not charity, but a duty of the state. However, private individuals — businessmen or contractors — will only come with profits as the motive,” says Harshvardhan.

“They will cut corners to make profit. The contractor at Sushruta was doing exactly the same.”

He adds that if at all the government has to outsource some work, it should be in non-critical areas.

“Outsource sweepers, reception, canteen, laundry, etc. But in such critical areas like supply of oxygen, it should have been kept in the hands of its own staff,” he says.

Walia also agrees to the suggestion, but says the contractor responsible for negligence at Sushruta was hired by the BJP government in 1998 when Harshavardhan was the health minister.

“We cannot do away with the PPP model. Work is done faster with a private party on board, and decisions are also taken faster and monitoring is closer,” says Walia.

“Also, there is lots of flexibility. So, it has lots of advantages,” he says, adding the city government is opening its dialysis centres in collaboration with private individuals.

But there is another difference between private and government hospitals. No one ever loses a job in a government hospital. Walia only smiles.