Activists say these centres will end up serving outside patients at the cost of hospital patients
The Chhattisgarh government has decided to outsource diagnostic services at its public health facilities. It has issued a request for proposal (RFP) in this regard. According to the RFP, the government would outsource radiology and lab services in 379 facilities, including district hospitals, community health and primary health centres. The state is planning to enter into an agreement with private parties for 10 years with provision for annual renewal.
In the PPP project, the government will provide space and electric meter to the partner firm or individual who will be free to cater to “external customers”. The rates will be those approved for National Accreditation Board for Testing and Calibration Laboratories (NABL), the accredited centre in Delhi under the Central Government of Health Scheme (CGHS). Monitoring will be done by third party. After setting performance level mutually, the government will reward high performers with five per cent bonus; low performers will be penalised.
Activists are critical of the move. Sulakshana Nandi of Jan Swasthya Abhiyan in Chhattisgarh says the government has not done its homework properly before taking such a big decision. “Tamil Nadu offers an example in contrast where, without any outsourcing, even the public health centres have been able to provide well functioning diagnostic services. In states where outsourcing of diagnostic services has been tried out, it has been a failure. The recent Common Review Mission, which analyses working of the National Rural Health Mission, clearly states that Bihar model was a complete failure,” she says.
Referring to the RFP, she says that concession of serving external patients could disturb the entire mechanism and the patients for whom the system is meant will become secondary. Pointing to the monitoring aspect, she says there would always remain a doubt whether the private (third) party is doing fair monitoring.