Public-private tie-up in heart disease, cancer on anvil

Faced with a severe shortage of specialist doctors in smaller cities and towns, the central government is all set to invite private doctors and hospitals for diagnosis and treatment of heart disease, stroke and cancer patients in government health facilities.

Government think tank NITI Aayog on Wednesday released a set of documents, including guidelines and a model agreement, to facilitate public private partnerships on non-communicable diseases, focusing mainly on tier-2 and tier-3 cities.

The model concessionaire agreement and the guidelines would help co-locate private players at district hospitals for diagnosis and treatment of cardiac, oncology and pulmonary diseases.

The private partner will invest on building, upgrading and equipping a facility and run it, while the government will provide the space and other infrastructure in “as-is where-is” condition, besides support facilities.

To avail such services, there would be a “user fee” that would be decided in accordance with the existing government-funded medical insurance schemes.

Such “strategic purchasing” in public healthcare services was highlighted in the National Health Policy 2017.

“A beginning was made when the Health Ministry rolled out Pradhan Mantri National Dialysis Programme in private public partnership mode,” said Amitabh Kant, chief executive officer of NITI Aayog.

Explaining the rationale behind the model concessionaire agreement, Kant said in the past it had been seen that if well-crafted model agreements were in place, it was easier for states to use these templates and modify them appropriately to invite bidders.

The model pact was created in consultation with the health ministry, World Bank and a section of practising doctors from the government and private sector.

Huge shortage

India not only faces a huge shortage of doctors, particularly in smaller cities, there are barely any specialist doctors in the government programmes in many states even though the disease burden is on the rise.

Deposing before a Parliamentary committee last year, experts showed that the shortage of cardiologists, chest medicine specialists, neurologists, paediatrician, nephrologists and general surgeons is too huge to be filled up any time in the near future.

Currently, Indian patients, particularly those in mofussil towns and rural areas, have to travel long distance to seek care for non-communicable diseases like cancer, stroke and heart complications because secondary and tertiary healthcare is disproportionately skewed towards tier-1 cities.