From UPSC perspective, the following things are important :
Prelims level : Not much.
Mains level : Paper 2- The dominance of private health sector in India makes partnership with it a must to deal effectively with any pandemic.
The article delineates five areas in which partnership with the private sector is essential to deal effectively with the epidemic and ensure a whole-of-society response. Ensuring the participation of the private sector has been the recurring theme of many op-eds we have come across after the outbreak.
Significance of private healthcare in India
- According to the WHO, a critical lesson from the 2014-16 West African Ebola epidemic was that both the public and private sector need to work in tandem in responding to large-scale epidemics.
- In the COVID-19 response in India, the private sector has to play an even more important role, as it is the dominant provider of health services in the country.
- The private sector includes the for-profit and not-for-profit segments.
- The dominance of the private sector in India: The NSSO 71st round data on social consumption of health show that private hospitals, clinics and nursing homes provide over 70 per cent of healthcare.
- Data on the nearly 1 crore treatments received under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) corroborate this finding.
- AB PM-JAY data shows that over half of all treatments are being availed of from private providers, accounting for over 60 per cent of total disbursements.
UPSC asked about community-level healthcare intervention in 2018. So, pay attention to the significant role played by the private health sector in India.
Following five are the areas in which cooperation with the private sector will be essential-
- Creating a large and accessible testing infrastructure is the first weapon in the armoury.
- Countries like South Korea, Singapore, Germany and Japan have been successful at controlling the spread of COVDID-19 and reducing mortality through early detection and quick containment.
- This has been possible only through widespread testing.
- India has opened testing up to private labs.
- Testing has been included under the AB PM-JAY as well.
- We need to substantially expand testing capacity.
- This cannot happen without the active participation of the private sector.
2 Converting private hospitals into Covid-19-only hospitals
- As the government deepens its containment efforts, the country will need to rapidly surge the numbers of quarantine units, isolation wards and ICU beds in COVID-19-only
- It will also need to ensure increased and continued supply of essential medical products — from testing kits, masks and other PPEs to oxygen and ventilators.
- According to a recent ICMR study, around five per cent of those infected will need intensive care and half of those in intensive care units will need mechanical ventilation.
- These projections translate into large numbers that considerably exceed the capacity of the government health system.
- Private hospitals with adequate infrastructure will need to convert in COVID-19-only hospitals.
- There should be a clear policy framework of designated hospitals, reporting and referral systems and an appropriate payment system.
- With many government facilities being converted into COVID-19-only hospitals, a large number of non-COVID-19 patients will need facilities and providers to take care of their other urgent, critical or continuing healthcare needs.
- The AB PM-JAY has started a process to bring on board more hospitals to respond to such needs.
3 Protecting healthcare workers
- As more private providers join this fight, a major concern that will arise is keeping healthcare workers from becoming infected.
- In addition to being at a high risk of contracting the virus, healthcare workers are also potential carriers.
- Ensuring their protection is of paramount importance.
- Increasing the production: Companies manufacturing essential medical products such as ventilators, masks will need to crank up their production.
- Direct support from banks may be needed to keep production and supply chains going.
4 The private sector has to support the ecosystem driving health system
- The private sector will need to vigorously support the large ecosystem that drives the health system as the lockdown and ongoing epidemic restrict movement and normal economic activities.
- Activities such as the production of essential drugs and medical products, logistics to maintain smooth supply need to not only continue but also accelerate.
- Support for community activities such as night shelters and community kitchens will need to be strengthened.
5 Collaborate to share knowledge on the epidemic
- An adequate stage-wise response to the pandemic and its economic, social and political aftermath will require the rapid filling of the many knowledge gaps.
- Government, private and not-for-profit research institutions need to collaborate to understand the nature of transmission of the virus.
- They must understand the factors that slow its spread, the most at-risk communities, or the optimal quarantine period.
In 2015, UPSC asked whether the private health sector could help bridge the gap in providing universal health coverage. A question can be asked based on the same theme but in reference to dealing with the pandemic.
The fight against COVID-19 is not a race to a hilltop. It involves the continuous management of an evolving public health crisis that threatens to spawn economic and social crises. These multiple dimensions will require a whole-of-society approach that goes beyond the government alone.