Private Sector in Indian Healthcare Delivery: Consumer Perspective and Government Policies to promote private Sector

Abstract

This research paper attempts to collate literature from various sources, in an attempt to answer three pertinent questions related to healthcare in India. Firstly, what is it meant by ‘private sector’ in healthcare delivery system of India, secondly how has the private sector evolved over the decades and what has been the role of the government in propelling the growth. Finally, the paper tries to highlight some of the factors that have promoted the growth of private sector in India with specific reference to quality of medical care. The paper explicitly indicates that the deficiencies in the public health delivery system of India, was the key to growth of private infrastructure in healthcare. The shift of hospital industry for ‘welfare orientation’ to ‘business orientation’ was marked by the advent of corporate hospitals, supported by various policy level initiatives made by the government. Today, there are over 20 international healthcare brands in India with several corporate hospitals. However, a large section of the ‘private healthcare delivery segment’ is scattered and quality of medical care continues to remain a matter of concern. This paper tracks the various government initiatives to promote private investment in healthcare and attempts to explore the reasons for preference of the private sector. Surprisingly, in contrast to contemporary belief, quality of medical care doesn’t seem to be the leading cause for preference of the private sector. Except for a few select corporate and trust hospitals, quality of medical care in private sector seems to be poor and at times compromised.

An Exploratory Study of the Impact of Top Leadership on Effectiveness of Privatization of Hospitals Through Mergers and Acquisitions in Kenya

“…For example, there was an agreement among seventy percent (70%) of respondents that privatization of public hospitals improves governance, leadership and performance. These findings confirm studies conducted by Shah and Mohanty (2010), Ramamurti (2000), Jarrell and Poulsen (1998) and concluded that privatization of hospitals can remove inefficient management due to improvement of governance.…”

“…The philosophy and objectives of an organization can be determined by privatization and incorporation. However, this doesn"t take into account certain considerations regarding professional management orientation towards efficiency and the generation of surplus (Shah & Mohanty, 2010). One of the main changes introduced in privatization at the firm level is governance arrangement because it has an impact on the top leadership of the firm.…”

“…Nellis (2005) states there is a need for sub-Saharan African countries to expand their private sector. Privatization of healthcare has been ongoing in the U.S. since the 1980s and studies by Shah and Mohanty (2010), Doherty (2011), Sinha (2012), Villa and Kane (2013), DeNoble (2013), Action Platform Health and Solidarity (2014) and Hail (2016) show that this trend is continuing in the U.S., Germany, India, China, Saudi Arabia and Africa/Kenya.…”

The Migration–Development Nexus and Organizational Time

“…Until the early 1990s, the public sector still dominated Indian healthcare provision, while the private sector played only a limited role (Shah and Mohanty, :79). But deficiencies in “accessibility and availability in the public sector” drove growth in the private sector (Mavlankar 2000:5, ctd.…”

Moving toward reform? Mobility, health, and development in the context of neoliberalism

“…3 Privatization also transformed the health care industry, building upon trends already long under way. Until the 1990s, the state, in combination with a host of informal private providers, such as pharmacists and unregulated street vendors, provided most of the health care received by the urban poor, creating what Nishtar refers to as a 'mixed-health systems syndrome' (Nishtar 2010, Shah and Mohanty 2011, Kamut and Nichter 1998, Das and Das 2007. But deficiencies in 'accessibility and availability in the public sector' drove growth in the private sector (Mavlankar 2000: 5, cited in NRHM 2012).…”